COVID-19 & Diabetes| What Health Care Professionals Need to Know – FREE Webinar

As health care professionals and Diabetes Specialists, how do we prepare people with diabetes for the possibility of a COVID-19 infection and hospitalization?

What are best practices to care for people with diabetes and COVID-19 in the outpatient and hospital setting?

Updates:

The Telehealth guidelines for providing DSMT have been updated since the streaming of this webinar.  Please see this blog, Telehealth and DSMT | Latest Updates from CMS, for updated information.

Webinar Viewing Options:


Coach Beverly Thomassian, RN, MPH, CDCES, BC-ADM, has summarized key information including critical teaching points and management strategies for people with diabetes who develop a COVID-19 infection.

In addition to the webinar, we will provide attendees with useful resources to provide care and education to colleagues and community members alike.

Topics:

  1. Discuss the relationship between social determinants of health, diabetes, and COVID-19.
  2. List how people with type 1 and type 2 diabetes can prevent and prepare for a COVID-19 infection.
  3. Describe how the COVID-19 virus can cause serious illness in people with diabetes and underlying health conditions
  4. State management strategies for people with diabetes and COVID in the inpatient and outpatient settings.
  5. Discuss the latest regulations regarding DSMT and Telehealth

Updates:

The Telehealth guidelines for providing DSMT have been updated since the streaming of this webinar.  Please see this blog, Telehealth and DSMT | Latest Updates from CMS, for updated information.

Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator and a nationally recognized diabetes expert.

Can’t make it live? Your webinar registration means you receive a link to the recorded version within hours of airing.


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COVID-19 and Inpatient Care for People with Diabetes

At a local hospital, a person in their mid-40s, with type 2 diabetes was admitted for treatment of COVID-19 and Diabetes Ketoacidosis (DKA). An insulin drip was started and their SGLT-2 Inhibitor was stopped.

How do we help prepare people with diabetes for the possibility of hospitalization and what are best practices to care for people with diabetes and COVID-19 in the hospital setting?

The American Diabetes Association (ADA) is providing a flurry of webinars and Town Hall Meetings to help diabetes care professionals keep pace with the latest developments on the impact of COVID and people living with diabetes.

COVID-19 & Inpatient Care for People with Diabetes

On April 9, a panel of experts (see below) shared their clinical opinions on the best inpatient practices for treating people with diabetes and COVID-19. I have highlighted some key questions and summarized responses from the broadcast of this expert panel. Here is the link to the complete broadcast.

Question: If a person with diabetes gets COVID-19 and is admitted to the hospital, what should they bring with them?

Answer: People with diabetes need to bring extra supplies so they can monitor glucose levels in between nursing check-ins and alert the staff of any urgent issues. The more people with diabetes can participate in their care, the better.

Supplies people with diabetes need to bring to the hospital include:

  • Glucose meter with extra strips and lancets
  • Continuous glucose monitor (CGM) and supplies
  • Insulin Pump and supplies

Question: What are recommendations for people with type 1 who are using SGLT-2 Inhibitors or other medications (off-label) as an adjunct to insulin therapy?

Answer: Since SGLT-2 Inhibitors are associated with increased risk of Diabetes Ketoacidosis (DKA) and people with type 1 diabetes and COVID are at a higher risk of DKA, the panel recommended that during this epidemic, people with type 1 do not use SGLT-2 Inhibitors.

Basal bolus insulin therapy is the best and safest strategy to manage diabetes.

Question: What is the link between type 2 diabetes, body weight and outcomes with COVID infection?

Answer: Most hospital admissions with COVID are for people with type 2 diabetes. Although more research is needed, there seems to be an inter-relationship between excess weight, dyslipidemia, coronary disease proinflammatory state, plus the cytokine storm from the COVID-19 infection, that is contributing to worse outcomes for people with type 2 diabetes.

In addition, those with diabetes and excess weight are at risk of decreased lung function due to restrictive lung disease. And people with hyperglycemia are at higher risk of infection due to diminished white blood cell activity and depressed immunity. All of these combined factors are impacting recovery from COVID infection.

Have your hospitals experienced more DKA in people with type 2 diabetes and COVID?

Answer: There has been an alarming number of people with type 2 diabetes and COVID-19 presenting with DKA. This is possibly due in part to a combination of the overwhelming infection and the cytokine storm.

It is important that DKA in type 2’s is quickly recognized and aggressively treated to get blood glucose target as soon as possible.

Question: How do the nursing staff safely monitor blood glucose levels and deliver insulin therapy to people with diabetes and COVID-19?

Nursing staff is combining multiple activities along with blood glucose checks (vitals, med administration, and check-ins) to limit unnecessary exposure.

In addition, in the non-critical care units, nursing is partnering with patients and having them check their blood sugars using their own meters or CGMs, in between nursing checks, to determine if action is needed. Of course, treatment is based on the hospital point of care device results, but patients can self-monitor and alert the nursing staff of blood sugars that need attention.

As a matter of fact, the FDA is supportive of the inpatient’s use of CGMs in the non-ICU setting during the COVID, especially considering the benefits of alarms that alert staff and patients of highs or lows.

One creative idea for inpatients using CGM, who may be too ill to keep track of glucose levels, is to place a patient near the nursing station and put the CGM receiver outside the door, so the nursing staff can visualize blood sugars levels and monitor trends. This strategy was well received by the nursing staff and was a win-win for safety while limiting exposure.

There is lots more to this webinar and here is the link to the complete broadcast. I personally want to thank the American Diabetes Association for their expansive and timely COVID resources that are available during this crisis. More free ADA Webinars on Diabetes and COVID are available here.

Here is an article published in Endocrine Today that explores outcomes for people with diabetes and COVID-19.

The Panel of Experts Town Hall Experts Include:

Shivani Agarwal, MD, MPH
Albert Einstein College of Medicine

Jennifer Clements, PharmD, FCCP, BCPS, CDE, BCACP
American Pharmacists Association

Robert Eckel, MD
ADA President, Medicine & Science

Irl Hirsch, MD
University of Washington

Melanie Mabrey, DNP
Co-Chair – American Association of Nurse Practitioners – Endocrine Specialty Practice Group

Jane Jeffrie-Seley, DNP, BC-ADM, CDCES
Association of Diabetes Care and Education Specialists


Diabetes 2020 – Virtual Conference!
Now with COVID-19 Update
7.5 CEs | $89 | April 23-30th

The COVID Pandemic is taking a toll on people with diabetes. What is the critical information Diabetes Care and Education Specialists need as we navigate this pandemic? How can take a leadership role in providing sound recommendations while helping to manage the full range of diabetes issues, including hypertension, hyperlipidemia, and cardiovascular risk reduction?

Coach Beverly has created this four-session virtual course so that participants can delve deep into the topics that are most pressing for diabetes care now and in the future. We will focus on improving population health and then drill down to individual intervention through case studies. We will discuss implementing cardiovascular risk screening and treatment in the clinical setting and more!

Download the Diabetes 2020 flyer here.

Course Schedule: Each session airs from 8:30 am—10:00 a.m. PST

Session 1 – Getting to the Heart of Care – 1.5 CEs – Recorded & Ready for Viewing!

  • Our role as Diabetes Care and Education Specialists
  • Diabetes and the COVID Pandemic
  • ADA and 2020 Medication Management Algorithm –

Session 2 – Cardiovascular Risk Reduction Strategies – 1.5 CEs – Airs April 24th

  • ADA and AACE Guidelines for CV Risk Reduction
  • Implement Risk Reduction Strategies
  • Addressing Hypertension, Lipids and Weight – A Case Study Approach

Session 3 – Lower Extremity Assessment and Intervention – 1.5 CEs – Airs April 28th

  • Peripheral Arterial Disease vs Vascular Disease
  • Lower extremity assessment techniques
  • Prevention strategies and education

Session 4 – Making meaningful Connections and a Vision for the Future – 1.5 CEs – Airs April 30th

  • Adverse Child Experiences – ACE and Impact of Diabetes and other Health Outcomes
  • Improving health- From individuals to populations

Download the Diabetes 2020 flyer here.


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

DIY Cloth Face-Masks | Mindful Monday

To help prevent the spread of COVID-19, the CDC recommends everyone wears a cloth face-mask when in public.

In addition to washing our hands frequently and maintaining a 6ft. distance from others, cloth masks can help in situations where social distancing is more difficult, such as the grocery store.

Cloth face-masks can easily be made at home with a scarf, bandana, hand towel, or t-shirt, just be sure to wash them frequently. Here are a few tips for making your mask:

Click here to read more.


Diabetes 2020 – Virtual Conference!
Now with COVID-19 Update
7.5 CEs | $89 | Starts April 23

The COVID Pandemic is taking a toll on people with diabetes. What is the critical information Diabetes Care and Education Specialists need as we navigate this pandemic? How can take a leadership role in providing sound recommendations while helping to manage the full range of diabetes issues, including hypertension, hyperlipidemia, and cardiovascular risk reduction?

Coach Beverly has created this four-session virtual course so that participants can delve deep into the topics that are most pressing for diabetes care now and in the future. We will focus on improving population health and then drill down to individual intervention through case studies. We will discuss implementing cardiovascular risk screening and treatment in the clinical setting and more!

Download the Diabetes 2020 flyer here.

Course Schedule: Each session airs from 8:30 am—10:00 a.m. PST

Session 1 – Getting to the Heart of Care – 1.5 CEs – Airs April 23rd

  • Our role as Diabetes Care and Education Specialists
  • Diabetes and the COVID Pandemic
  • ADA and 2020 Medication Management Algorithm –

Session 2 – Cardiovascular Risk Reduction Strategies – 1.5 CEs – Airs April 24th

  • ADA and AACE Guidelines for CV Risk Reduction
  • Implement Risk Reduction Strategies
  • Addressing Hypertension, Lipids and Weight – A Case Study Approach

Session 3 – Lower Extremity Assessment and Intervention – 1.5 CEs – Airs April 28th

  • Peripheral Arterial Disease vs Vascular Disease
  • Lower extremity assessment techniques
  • Prevention strategies and education

Session 4 – Making meaningful Connections and a Vision for the Future – 1.5 CEs – Airs April 30th

  • Adverse Child Experiences – ACE and Impact of Diabetes and other Health Outcomes
  • Improving health- From individuals to populations

Download the Diabetes 2020 flyer here.


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

April Newsletter | COVID-19 & Best Diabetes Care

Click here to read our entire April Newsletter

At a local hospital, a person in their mid-40s, with type 2 diabetes was admitted for treatment of COVID-19 and Diabetes Ketoacidosis (DKA). An insulin drip was started and their SGLT-2 Inhibitor was stopped. Why are people with type 2 and COVID-19 going into DKA and how is this impacting outcomes?

A person with type 1 diabetes calls into a rural health clinic and says they are running a temperature, having difficulty breathing and can’t get their blood sugars below 300. The diabetes specialist instructs them to go to the hospital. What supplies should they take in case they are admitted to the hospital?

How do we help prepare people with diabetes for the possibility of hospitalization and what are best practices to care for people with diabetes and COVID-19 in the hospital setting?

What instruction do we provide for people with diabetes if they get sick and are wondering if they need to go to the hospital?

In this newsletter, our goal is to answer these questions based on the opinions of experts in the field and the best information to date.

In addition, we are excited to share information on drone delivery of insulin, mask making and the opportunity to celebrate the AADE (ADCES) Educator of the Year, Dr. Diana Isaacs.

Lastly, please let CMS (Medicare) know that RNs and Pharmacists need to be considered as providers of DSME telehealth services. Now, more than ever, we need all hands on deck.

Thank you everyone. Take extra good care of yourselves.

Beverly

Click here to read our entire April Newsletter


Diabetes 2020 – Virtual Conference!
Now with COVID-19 Update
7.5 CEs | $89 | April 23-30th

The COVID Pandemic is taking a toll on people with diabetes. What is the critical information Diabetes Care and Education Specialists need as we navigate this pandemic? How can take a leadership role in providing sound recommendations while helping to manage the full range of diabetes issues, including hypertension, hyperlipidemia, and cardiovascular risk reduction?

Coach Beverly has created this four-session virtual course so that participants can delve deep into the topics that are most pressing for diabetes care now and in the future. We will focus on improving population health and then drill down to individual intervention through case studies. We will discuss implementing cardiovascular risk screening and treatment in the clinical setting and more!

Download the Diabetes 2020 flyer here.

Course Schedule: Each session airs from 8:30 am—10:00 a.m. PST

Session 1 – Getting to the Heart of Care – 1.5 CEs – Recorded & Ready for Viewing!

  • Our role as Diabetes Care and Education Specialists
  • Diabetes and the COVID Pandemic
  • ADA and 2020 Medication Management Algorithm –

Session 2 – Cardiovascular Risk Reduction Strategies – 1.5 CEs – Airs April 24th

  • ADA and AACE Guidelines for CV Risk Reduction
  • Implement Risk Reduction Strategies
  • Addressing Hypertension, Lipids and Weight – A Case Study Approach

Session 3 – Lower Extremity Assessment and Intervention – 1.5 CEs – Airs April 28th

  • Peripheral Arterial Disease vs Vascular Disease
  • Lower extremity assessment techniques
  • Prevention strategies and education

Session 4 – Making meaningful Connections and a Vision for the Future – 1.5 CEs – Airs April 30th

  • Adverse Child Experiences – ACE and Impact of Diabetes and other Health Outcomes
  • Improving health- From individuals to populations

Download the Diabetes 2020 flyer here.


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Can DPP-4 Inhibitors Help Treat COVID-19 in People with Diabetes?

Hopeful news.

DPP-4 inhibitors may contribute to a lowered risk and progression of acute respiratory complications for people with type 2 diabetes and COVID-19.

According to commentary in Diabetes Research and Clinical Practice, Endocrinologist Gianluca Iacobellis, MD, Ph.D. suggests that DPP-4 inhibitors could help decrease COVID-19-related immune overreaction in people with diabetes. This immune system calming is due to DPP-IVs anti-inflammatory effects.

All told, DPP-4 “may represent a potential target for preventing and reducing the risk and the progression of the acute respiratory complications that Type 2 diabetes may add to the COVID-19 infection,” Iacobellis wrote in his article.

Based on data from the Chinese city of Wuhan and Italy, people with type 2 diabetes are at higher risk of serious disease in the current pandemic. The data indicates that people with diabetes have accounted for a large proportion of intensive care admission and deaths related to COVID-19.

“The body is overreacting with this inflammatory response to the virus,” Dr. Iacobellis said in a statement. “This could be partially mediated by DPP-4. The virus binds to the enzyme and the enzymatic activity of DPP4 overexpresses inflammatory cytokines, exaggerating the inflammatory response.”

Read more FierceBiotech


Diabetes 2020 – Virtual Conference!
Now with COVID-19 Update
7.5 CEs | $89 | Starts April 23

The COVID Pandemic is taking a toll on people with diabetes. What is the critical information Diabetes Care and Education Specialists need as we navigate this pandemic? How can take a leadership role in providing sound recommendations while helping to manage the full range of diabetes issues, including hypertension, hyperlipidemia, and cardiovascular risk reduction?

Coach Beverly has created this four-session virtual course so that participants can delve deep into the topics that are most pressing for diabetes care now and in the future. We will focus on improving population health and then drill down to individual intervention through case studies. We will discuss implementing cardiovascular risk screening and treatment in the clinical setting and more!

Course Schedule

Session 1 – Getting to the Heart of Care – 1.5 CEs – Airs April 23rd

  • Our role as Diabetes Care and Education Specialists
  • Diabetes and the COVID Pandemic
  • ADA and 2020 Medication Management Algorithm –

Session 2 – Cardiovascular Risk Reduction Strategies – 1.5 CEs – Airs April 24th

  • ADA and AACE Guidelines for CV Risk Reduction
  • Implement Risk Reduction Strategies
  • Addressing Hypertension, Lipids and Weight – A Case Study Approach

Session 3 – Lower Extremity Assessment and Intervention – 1.5 CEs – Airs April 28th

  • Peripheral Arterial Disease vs Vascular Disease
  • Lower extremity assessment techniques
  • Prevention strategies and education

Session 4 – Making meaningful Connections and a Vision for the Future – 1.5 CEs – Airs April 30th

  • Adverse Child Experiences – ACE and Impact of Diabetes and other Health Outcomes
  • Improving health- From individuals to populations

Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

Nutrition & Self-Care Tips During COVID | Free Resource Friday

Photo courtesy of Valeria’s website.

As many of our daily routines have greatly changed, it’s important we are mindful of our newly developing habits. For this week’s Free Resource Friday, we wanted to share Valeria Mallet’s handout on nutritional and self-care tips to follow during the COVID-19 pandemic.

Valeria Mallett, RD, CDCES is the owner of private practice in Portland, OR. Her practice specializes in diabetes prevention and management, as well as weight management. She believes in evidence-based science, sound reasoning, and creative ideas to help individuals reach their healthcare goals.

In the handout below, Valeria offers tips on how to establish healthier routines during this time.

“There is so much uncertainty on the world right now, and we all need guidance on how to stay well both mentally and physically” – Valeria explains.

That is why she suggests building an eating routine, skipping late-night snacks, and other great tips to follow during this pandemic.

Click here to download the handout.

Thank you, Valeria, we are so grateful that you shared this amazing handout with us!

To learn more, visit Valeria’s website.


Ready to advance your diabetes knowledge?
Join our new Virtual DiabetesEd Specialist Conference!
$459 | 30+ CEs

  • Live Q & A Session with the instructor after each webinar
  • Presentations by our team of experts
  • Handouts and Resources for each session
  • Post-test questions
  • A sense of community
  • If you can’t attend the live webinars, a recorded version will be posted later the same day for viewing
  • Click here for more info on our Virtual Diabetes Ed Specialist Program
Enroll Now!

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Insulin Drone Delivery? | Tech Thursday

The world’s first drone delivery of insulin may be a useful model in response to the COVID-19 pandemic.

For people in rural, remote and isolated urban areas, using a drone to deliver much-needed insulin supplies is an option under consideration. A test flight in Ireland used a drone to deliver insulin as a response to people who were stranded without insulin during Hurricane Ophelia and the post-winter storm Emma when people were snowed in.

“Drone delivery has endless possibilities and can help us connect with our patient communities even in the most remote areas during sentinel events such as hurricanes, earthquakes, and pandemics, which have unfortunately become more common,” Spyridoula Maraka, MD, MS told Healio/Endo.

Though drone delivery has endless possibilities, there are also significant regulatory challenges with “aviation, medication dispensing, pharmaceutical dispensing, and cold chain protocols,” that had to be accounted for during this test run. Markara explains that through each phase of the mission, they had to have backup procedures in place.

Even with the obstacles for drone delivery of insulin or life-saving medications, this is an innovative and exciting prospect for people living in remote or isolated areas.

During the current pandemic, endocrinologists and care providers encourage people that use insulin to have enough stores at home for prolonged “Stay At Home” orders. As stated in our recent Question of the Week people with diabetes are not necessarily at increased risk for contracting COVID-19, but are at risk for experiencing worse outcomes and series complications from the virus (click here to review ADA’s Treatment & Care Factsheet). People living with diabetes may also experience a compromised immune system if blood glucose levels are running above target for a prolonged amount of time.

For these reasons, it is of utmost importance to have the necessary supplies and insulin one needs for optimal glucose levels during periods of crisis, like a pandemic.

To read more, click here and here for more valuable information regarding staying prepared in the pandemic with your insulin and diabetes supplies.

Written by Catherine Cullinane RN, CDCES, our resident Tech Thursday Content Writer


Ready to advance your diabetes knowledge ?
Join our new Virtual DiabetesEd Specialist Conference!
$459 | 30+ CEs

Enroll Now!

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Virtual Volunteering for Diabetes Specialists

Maryanne Strobel, RN, MSN, CDCES
Disaster Preparedness Lead, Texas Association of Diabetes Care and Education Specialist (ADCES)

Disaster Preparedness Leader, Maryanne Strobel, RN, MSN, CDCES, believes that Certified Diabetes Education and Care Specialists (CDCES) have a lot to offer even if they are not reporting for their usual job. She has compiled a list of ways to get involved in virtual volunteering for those who are wanting to volunteer their time and expertise to their communities.

As Maryanne explains, “I am hearing from some of CDCES’s that they have been furloughed and are at home due to ‘stay-at-home’ orders or low hospital census days. Some are working reduced hours providing virtual medical visits or telephone consultation.

As professionals, we can continue to contribute and make a difference! Due to our unique inter-professional skill set, we have a lot to offer. We are in this profession out of a genuine desire to care for people, it is not in our character to sit back and watch as this pandemic unfolds.”

Maryanne Strobel

Here is list of ways to get involved in Virtual Volunteering:

  • Connect with your colleagues:
    • Get the word that virtual volunteering is now an option and organize with your professional community.
    • Appoint someone to coordinate with everyone within your group who can organize and plan group ideas.
    • Create a “think tank” with your professional community to brainstorm ideas on how to become a virtual volunteer and address the needs of those in your community both throughout and after the pandemic. The challenges our community will face after this pandemic is over is known as the “second-wave” of a disaster event, which Maryanne suggests that how we deal with that is just as important.
  • Check out your local communities organizations:
    • The www.allforgood.org organization and ww.pointsoflight.org are two organizations that you can learn and model from. 
    • Continue to keep in touch with your local organizations throughout and after the pandemic.
  • Set up an After-Action review team:
    • This is a way to take what you learn from this event and “become better prepared to meet any future challenges.”
    • Continue to keep in contact with your local volunteer organizations.  

For more ways to get involved and learn about virtual volunteering, you can email Maryanne at: maryannecde@gmail.com 


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$459 | 30+ CEs


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