The Centers for Disease Control recently held a call for providers to review the effects COVID-19 is having on those with multiple comorbidities. One of the most prevalent comorbidities in the long-term care setting is diabetes. While we still have much to learn about COVID-19 and the effects it has on individuals with diabetes, we do know those with chronic conditions are at an increased risk for severe COVID-19 illness, which includes hospitalizations, ICU admittance, ventilator use and death. Patients hospitalized for COVID-19 were more likely to have diabetes and obesity than non-hospitalized patients, suggesting a relationship between these underlying conditions and increased severity of illness.
The ongoing COVID-19 pandemic has only emphasized the importance of type II diabetes prevention and proper diabetes management; however, managing diabetes can be challenging, even under the best of times. As a provider there are steps you can take to help your patients with diabetes during this crisis:
- Educate patients about the virus and ways to reduce their risk of getting sick with COVID-19 by washing hands often, staying at least six feet from other people, using a mask when around others, and monitoring their health for symptoms.
- Reinforce the importance of timely care.
- Refer patients with diabetes to a diabetes self-management education and support service, known as DSMES.
DSMES supports individuals with diabetes by empowering them to have a broader knowledge base to feel better equipped to handle their diabetes care. Education specialists provide these much-needed services to help individuals develop and practice the behaviors necessary for managing blood glucose, blood pressure, lipids and all aspects of diabetes. The CDC is really focused on advancing the use of DSMES because it has proven to be an effective service in preventing additional short- or long-term complications related to diabetes while reducing the number of visits to the emergency room or hospital. DSMES services include technology-based services, including web-based programs, telehealth, mobile applications and remote monitoring. Each program being tailored to the patient’s needs.
Medicare covers telehealth delivery of DSMES and Medicare part B covers diabetes initial and subsequent follow-up, and outpatient services. CMS issued an emergency blanket waiver including flexibilities for telehealth services by healthcare providers which was effective March 1st of 2020 and lasts through the duration of the COVID-19 public health epidemic. Providers including nurses and pharmacists can provide DSMES services to Medicare beneficiaries when the beneficiary is in their home or other location. In addition, one-on-one telehealth services provide by any healthcare practitioner working for a rural health center or a federally qualified health center can bill for telehealth services.
The CDC and the American Medical Association have resources for providers that offer information about the National Diabetes Prevention Program, eligibility criteria, and tools for easy referrals at https://nccd.cdc.gov/DDT_DPRP/Programs.aspx
Additional resources can be found at:
- National Diabetes Prevention Program
- National Diabetes Prevention Program Registry of All Recognized Organizations
- Diabetes Self-Management Education and Support Toolkit
- National Diabetes Prevention Program Information for Health Care Professionals
- Increasing Referrals and Overcoming Barriers to Participation