Download PDF
Horm Metab Res 2021; 53(03): 191-196
DOI: 10.1055/a-1352-5023
Endocrine Care

Diabetes Care During COVID-19 Pandemic in Singapore Using a Telehealth Strategy

Xia Lian
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
,
Rinkoo Dalan
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
2   Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
,
Cherng Jye Seow
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
,
Huiling Liew
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
,
Michelle Jong
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
2   Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
,
Daniel Chew
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
2   Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
,
Brenda Lim
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
,
Anita Lin
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
,
Eunice Goh
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
,
Christina Goh
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
,
Noorani Bte Othman
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
,
Lucy Tan
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
,
Bernhard O. Boehm
1   Department of Endocrinology, Tan Tock Seng Hospital, Singapore
2   Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
› Author Affiliations Funding Information: The author(s) received no financial support for the research, authorship, and/or publication of this article.
› Further Information
Also available at
    Permissions and Reprints

Abstract

Singapore currently has one of highest number of confirmed COVID-19 cases in Southeast Asia. To curb the further spread of COVID-19, Singapore government announced a temporary nationwide lockdown (circuit breaker). In view of restrictions of patients’ mobility and the enforcement of safe distancing measures, usual in-person visits were discouraged. Here we describe how diabetes care delivery was ad hoc redesigned applying a telehealth strategy. We describe a retrospective assessment of subjects with diabetes, with and without COVID-19 infection, during the circuit breaker period of 7th April to 1st June 2020 managed through Tan Tock Seng Hospital’s telehealth platform. The virtual health applications consisted of telephone consultations, video telehealth visits via smartphones, and remote patient monitoring. The TTSH team intensively managed 298 diabetes patients using a telehealth strategy. The group comprised of (1) 84 inpatient COVID-19 patients with diabetes who received virtual diabetes education and blood glucose management during their hospitalisation and follow-up via phone calls after discharge and (2) 214 (n=192 non-COVID; n=22 COVID-positive) outpatient subjects with suboptimal glycaemic control who received intensive diabetes care through telehealth approaches. Remote continuous glucose monitoring was applied in 80 patients to facilitate treatment adjustment and hypoglycaemia prevention. The COVID-19 pandemic situation mooted an immediate disruptive transformation of healthcare processes. Virtual health applications were found to be safe, effective and efficient to replace current in-person visits.

Key words

COVID-19 - virtual diabetes education - telehealth strategy - circuit breaker


Publication History

Received: 03 October 2020

Accepted: 05 January 2021

Article published online:
02 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Petrilli CM, Jones SA, Yang J et al. Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. medRxiv 2020; https://www.medrxiv.org/content/10.1101/2020.04.08.20057794v1
  • 2 Perez-Guzman PN, Anna Daunt A, Mukherjee S et al. Clinical characteristics and predictors of outcomes of hospitalised patients with COVID-19 in a London NHS Trust: A retrospective cohort study (29-04-2020), doi: https://doi.org/10.25561/78613
  • 3 Villabona CV. Commentary: COVID-19 and diabetes. Diabetes Res Clin Pract 2020; 162: 108138
    CrossrefPubMedGoogle Scholar
  • 4 The OpenSAFELY Collaborative. OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. medRxiv 2020; https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1
  • 5 Holman N, Knighton P, Kar P. et al. Type 1 and Type 2 diabetes and COVID-19 related mortality in England: a cohort study in people with diabetes (5/17/2020). SSRN 2020; DOI: 10.2139/ssrn.3605226.
    CrossrefPubMedGoogle Scholar
  • 6 Stokes EK, Zambrano LD, Anderson KN. et al. Coronavirus Disease 2019 Case Surveillance — United States, January 22–May 30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 759-765
    CrossrefPubMedGoogle Scholar
  • 7 Lian X, Ng PL, Dalan R. et al. The Impact of Using Mobile Technology on Diabetes Education and Emotional Distress: A Randomized Controlled Trial. Oral International Diabetes Federation Congress 2019. https://www.morressier.com/event/5d934bf35324a95facb6cf07?eventQuery=Lian%20Xia&page=1
  • 8 Xia L, Ng PL, Chew EK. et al. The Impact of Smartphone-Based Body Cloud Application on Diabetes Self-Care Behaviours and Glycemic Control: A Randomized Controlled Trial. Diabetes 2017; 66: A177
    CrossrefPubMedGoogle Scholar
  • 9 Continuation of essential healthcare services during period of heightened safe distance measures. Ministry of Health (MOH) Singapore; 2020. https://www.moh.gov.sg/news-highlights/details/continuation-of-essential-healthcare-services-during-period-of-heightened-safe-distancing-measures. Last accessed 17th July 2020
  • 10 Ang YG, Heng BH, Saxena N. et al. Annual all-cause mortality rate for patients with diabetic kidney disease in Singapore. J Clin Transl Endocrinol 2016; 4: 1-6
    PubMedGoogle Scholar
  • 11 Lando HM, Samson SL. Telehealth Adoption Is a Challenge Worth Meeting-AACE leaders on embracing technology in medicine. https://www.medpagetoday.com/practicemanagement/telehealth/88695. Last assessed 26/10/2020