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
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Nutrition & Self-Care Tips During COVID | Free Resource Friday
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
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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
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Virtual Volunteering for Diabetes Specialists
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
Want more practice questions?
Join us live today for our new Virtual DiabetesEd Specialist Conference!
$459 | 30+ CEs
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COVID-19, Sick Days & Diabetes | QoW Rationale
Our March 31st Question of the week was a question about COVID-19, sick days and diabetes. Although 40% of respondents chose the correct answer, 60% did not. We thought that this was an important topic to discuss further, so we can pass on correct info to people living with diabetes.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
JR is 27 with Type 1 diabetes and is very worried about getting COVID-19 since they work in a local grocery store. They ask you what they should do if they get COVID-19?
Which of the following statements is accurate regarding sick day management with COVID-19?
Answer Choices:
- Seek immediate medical attention if lips or face become bluish.
- Report to the emergency room if the temperature is 101 degrees or greater.
- Reduce insulin intake by 10-20% if experiencing diarrhea.
- Use glucose fingersticks instead of continuous glucose monitoring (CGM) when febrile to improve accuracy.
As shown above, the most common choice was option 1, the second most common answer was option 4, then option 2, and finally option 3.
Only 39% of participants chose the correct answer number 3, which means there is a learning opportunity!
Answer 1 is Correct! Seek immediate medical attention if lips or face become bluish. Bluish lips or face indicates hypoxia and signals urgent medical care is needed.
From ADA Sick Day Information. If develop emergency warning signs for COVID-19 get medical attention immediately.
In adults, emergency warning signs include:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
Option 2 is incorrect. One-fifth of respondents chose ” Report to the emergency room if the temperature is 101 degrees or greater.” In the case of fever, the next step would to be to contact your provider to evaluate presence of cough, shortness of breath and other symptoms to determine if urgent care is required.
Option 3 is also incorrect. “Reduce insulin intake by 10-20% if experiencing diarrhea.” During periods of illness, inflammation leads to insulin resistance and hyperglycemia. Most people will need to increase insulin dose during illness, including GI distress.
Finally, Option 4 is incorrect. “Use glucose fingersticks instead of continuous glucose monitoring when febrile to improve accuracy.”
Fever by itself does not interfere with CGM accuracy. If a person is taking Tylenol, it can interfere with the accuracy certain CGMs. And, CGM use is not recommended in the Intensive Care setting. But, having a temperature by itself, does not interfere with CGM accuracy.
Here is a COVID and Sick Day Handout that you can share with your community. Thank you for helping us get the word out.
For more information on sick day management and when to seek medical care, please see this ADA Sick Day Information.
We hope you appreciate this week’s rationale and keep studying hard! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
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ADA COVID-19 Resource Page | Free Resource Friday
For this week’s Free Resource Friday, we wanted to share with you the American Diabetes Association’s (ADA) COVID-19 resource page.
This page includes:
- Webinars – a list of COVID-19 related webinars, such as COVID-19 & Diabetes: Considerations for Healthcare Professionals & Planning Sick Days for Your Patients During Covid-19
- Discussion forum*- to connect with other healthcare professionals
* ADA Membership required
Click here for the full list.
Want more information on COVID-19, Sick Days and Diabetes?
“What do I do if I get sick or get COVID-19”?
This is a critical topic to discuss during our during telehealth visits or in-person meetings with people with diabetes. Infections, whether COVID-19 or the flu, can lead to a hyperglycemic crisis if not thoughtfully managed.
Read more about COVID-19, diabetes and sick days, by visiting our recent blog post.
DiabetesEd Specialist Virtual Conference
Earn 30+ CEs | Starts April 7, 2020
This virtual program includes:
10 two-hour live webinar courses (20 CEs) + enrollment in our Bonus Bundle (14.6 + CEs) from now through December 31st, 2020.
- 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
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!
COVID-19, Sick Days and Diabetes | Teaching Handout
“What do I do if I get sick or get COVID-19”?
This is a critical topic to discuss during our during telehealth visits or in-person meetings with people with diabetes. Infections, whether COVID-19 or the flu, can lead to a hyperglycemic crisis if not thoughtfully managed.
Sick Day Plans are crucial.
Free Sick Day and COVID-19 Handout
To help out, we have updated our Sick Day 2-Page handout, to include information of appropriate action in case of illness or COVID-19 infection.
Please feel free to print out or email this handout to colleagues and people living with diabetes.
Virtual Diabetes Ed Specialist Program 2020
This virtual program includes:
10 two-hour live webinar courses (20 CEs) + enrollment in our Bonus Bundle (14.6 + CEs) from now through December 31st, 2020.
- 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
Question of the Week | March 31, 2020
JR is 27 with Type 1 diabetes and is very worried about getting COVID-19 since they work in a local grocery store. They ask you what they should do if they get COVID-19?
Which of the following statements is accurate regarding sick day management with COVID-19?
- Seek immediate medical attention if lips or face become bluish
- Report to the emergency room if temperature is 101 degrees or greater
- Reduce insulin intake by 10-20% if experiencing diarrhea
- Use glucose fingersticks instead of continuous glucose monitoring when febrile to improve accuracy.
Click here to test your knowledge!
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!
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