COVID-19 and Diabetes - Diabetes WA

COVID-19 and Diabetes

Critical information for people living with diabetes and their direct contacts

COVID-19 (coronavirus) advice for people living with diabetes 

Since 27 June 2020, WA has been in phase 4 of the WA Government’s roadmap out of COVID-19 restrictions. WA border restrictions have played a significant role in managing the risk to community, but as community infection rates remain low across Australia, we can now expect a loosening of travel restrictions to travellers within Australia.

14 November 2020 will see a ‘cautious’ re-opening of WA’s borders to other States and Territories for the first time in six months.  Read more about the move to a controlled border with other States and Territories and what that means for traveling into and out of WA.

Diabetes WA understands that these changes may cause anxiety for some people including those with chronic health conditions, such as diabetes. Diabetes WA advises those who feel at risk should continue to stay aware and to take reasonable precautions.

The following advice is intended to inform and support people living with diabetes, their loved ones and their health professionals to understand what the latest government advice means for them. 

Commentary is developed by Diabetes WA, based on advice from the Western Australian Government – aligned to the COVID19 coronavirus: WA Roadmap and the Commonwealth Government’s Advice for people with chronic conditions  

 

For people living with diabetesthere is currently no evidence to date that they are at an increased risk of being infected with COVID-19.    

Anyone could develop serious or severe illness from COVID-19, but those with chronic health conditions or weakened immune systems are at greater risk. The Commonwealth Government identifies that people living with diabetes are at moderate risk of severe illness from COVID-19.

Having two or more conditions might increase your risk, regardless of your age. If your condition is severe or poorly controlled, this might also increase your risk of serious illness from COVID-19. However, the risk is not the same for everyone living with diabetes.  

Because community transmission of the virus is still possible, the Government has issued general advice for vulnerable people living with diabetes or another chronic conditions, or for those who are unwell, to continue to take reasonable precautions. 

This doesn’t necessarily mean everyone should keep self-isolating. The risk of contracting the virus has reduced considerably, and the risk of getting ill if you contract COVID-19 is different for everyone.   Diabetes WA recommends that you consider your own situation and assess your own risk by speaking with your doctor.

The Commonwealth Government identifies that you are at high risk of severe illness from COVID-19 if you:

  • have had an organ transplant and are on immune suppressive therapy
  • have had a bone marrow transplant in the past 2 years
  • are on immune suppressive therapy for graft versus host disease
  • have had blood cancer, in the past 5 years, including leukaemia, lymphoma or myelodysplastic syndrome
  • are having chemotherapy or radiotherapy

You are at moderate risk of severe illness from COVID-19 if you have:

  • chronic kidney (renal) failure
  • heart disease (coronary heart disease or failure)
  • chronic lung disease, excluding mild or moderate asthma
  • had cancer in the past 12 months
  • diabetes
  • severe obesity with a body mass index of 40 kg/m2 or more
  • chronic liver disease
  • some neurological conditions such as stroke or dementia
  • some chronic inflammatory conditions and treatments
  • another primary or acquired immunodeficiency
  • poorly controlled hypertension (may increase risk)

Your level of risk also depends on other factors, including your age, gender and whether you smoke.

Reasonable precautions to take includes considering how you can protect yourself and others from coronavirus. No matter what your level of risk you should:

For anyone living with diabetes, we recommend that you remain prepared in case of infection – see ‘Be Prepared’ section below. 

If you are concerned about your risk, we recommend you talk to your health care team or call the Diabetes WA Helpline and Telehealth service on 1300 001 880.

 

 

GPs are reporting that many Western Australians have been delaying regular checks – a fact supported by a recently reported 40% reduction in blood testing in pathology labs across Australia and a 75% reduction in HbA1c testingThat’s understandable because of COVID-19 concerns but is also a health risk.  

If you have put your regular health checks on hold during the pandemic, now’s the time to see your GP or specialist. Right now, it’s important to stay healthy and get the prescriptions, screening or care you need.  

We know many people are nervous about COVID-19 and that might mean you have not visited your GP. Diabetes WA’s advice is to contact them to find out the steps they have taken to keep you safe.  

General practices are open and safe to visit in person, and while some things might look a little different on arrival, changes such as social distancing in the waiting room, screens at reception, some staff wearing masks or being asked to wait in your car until your appointment time, are all designed to keep everyone safe and well. 

GPs are working hard on two fronts to keep their patients safe. Firstly, consultations via telehealth are being widely used, and many issues can be managed safely this way. The GP clinics reception can advise on how to connect. 

However, not all health issues can be treated via telehealth and some people will need to visit their GP to be examined. For those situations, practices are ensuring they are safe for patients and staff with readily available hand gel, ensuring patients can maintain a safe distance from each other, and careful cleaning. 

Accessing health care in regional areas 

Most regional travel restrictions have been lifted, except into remote communities. This may help some people travel to seek support and care which may not have been previously possible. 

If you are still finding it difficult to access the support and advice you need, you can call the free Diabetes WA Helpline and Telehealth service which connects you with a diabetes educator, dietitian, nurse, exercise physiologist or pharmacist over the phone or on your computer.  

  • Phone for a chat, ask a question or choose an extended free telehealth appointment. We connect you to local and online services, including MyDESMOND, our new type 2 diabetes online education program. 
  • If you are new to telehealth, our support team will walk you through the process and will keep your GP updated. 
  • Phone 1300 001 880 Monday to Friday. 
  • Or visit the website to request a call back.  

If you have been or continue to self-isloate, it is important to look after yourself both physically and mentally.  Many people have found the experience of prolonged periods away from friends and family difficult and found exercising increasingly tricky and healthy eating habits may have taken a temporary break.  The risk for people living with diabetes is that diabetes management can be impacted

Diabetes WA strongly encourages everyone, including those living with diabetes, to be physically active and to eat a healthy, balanced diet. The benefits of numerous:

  • Helps you to manage your blood glucose levels and may reduce the amount of insulin required, for those using insulin. 
  • Lowers the risk of cardiovascular disease such as a heart attack or stroke  
  • For people with type 2 diabetes, helps combat insulin resistance. 
  • Improves energy levels and mental health. 

If you would like advice on increasing your activity or healthy eating, either: 

  • visit your GP, or 
  • phone the Diabetes WA Helpline and Telehealth service on 1300 001 880 where you can speak with a dietician, diabetes educator or exercise physiologist.  

If you’re looking to find your 30 minutes of exercise while physically distancing try Diabetes WA’s Get on Track Challenge – a free, online program that pits teams against each other in a race around a virtual track.   

 Useful links 

Read our recent article on the benefits of running here, or tips on how to eat healthily if you are still isolating here. 

Signup to our Health Bites newsletter for regular exercise and food tips, or one of our other newslettershere. 

Even though the risk of contracting COVID-19 has reduced, Diabetes WA recommends being prepared in case there is an additional outbreak which may require further community restrictions. For people living with diabetes it is very important to have a sick day plan and to make additional preparations in case you become unwell. 

The restrictions in the first half of 2020 produced a growth in use of telehealth services by GPs and other health professionals because of changes to Medicare which now allows bulk-billed telehealth services from your doctor, nurse or mental health professional via phone or videoconference. If you haven’t already, find out if you can access telehealth services through your normal health care team. Find out more about accessing healthcare services in case of a further COVID-19 outbreak.

Ensure you have sufficient supplies for 14 days in case you need to self-quarantine. This includes ensuring you have adequate prescriptions, medications and diabetes supplies, your chosen hypoglycaemia treatment which may be needed to manage your blood glucose levels, as well as adequate supplies of food in your pantry, fridge and freezer. 

We also recommend checking that your blood glucose meter works if you haven’t used it for a while and that you have a backup battery and enough strips.  

You can buy medications and other supplies from your local pharmacy or your local NDSS product stockist. The Diabetes WA online shop is also stocked with diabetes products (other than medications), including blood glucose monitors, lancets, test strips, needles and syringes and other related products. You can order online by  visiting the online shop or by calling the Diabetes WA Helpline on 1300 001 880.  

Ordering supplies  

Reports from NDSS Access Points across Australia is that despite some temporary issues with wholesaler supply of NDSS products, there are no current known issues. 

The Diabetes WA online shop is an NDSS Access Point, along with your local pharmacy. You can order online for home delivery at www.shop.diabeteswa.com.au 

Diabetes WA does not supply insulin or other medicines.  Please contact your local pharmacy for supplies.  You should also visit the NDSS website  for more specific advice. 

If you are in WA and experiencing difficulties accessing your NDSS product supply, please telephone the Diabetes WA Helpline on 1300 001 880 

Please note that due to previous concerns about supply of some products, the NDSS currently has temporary measures to ensure availability for everyone: 

  1. People can now order three (3) boxes of NDSS products including blood glucose monitoring strips, urine monitoring strips, pen needles, and syringes.  
  1.  There is also a limit of two (2) boxes for insulin pump consumables (IPCs) for any order. This includes: 
  • 2 x boxes of infusion setsor cannulas (an average supply for two months) 
  • 2 x boxes of reservoirs/ cartridges (an average supply for two months). 

Access to continuous glucose monitoring (CGM) and Flash GM (FreeStyle Libre) products through the NDSS remain unchanged.  

For the vast majority of people living with diabetes, these limits represent well over one month’s supply.  

  • There may be some exceptions where people may need more than these supply amounts, such as people living remotely. People who need to order more than these amounts should contact the NDSS Helpline on 1800 637 700.  

For the latest information on COVID-19 and the NDSS, please visit the NDSS website

 

People living with diabetes need a plan to closely manage their blood glucose levels and adjust their medication when they are unwell. 

Blood glucose levels change when your body is fighting an infection or illness.  You may require medication to manage your blood glucose levels or adjustments to your current medications.  People that require insulin may notice a more significant effect on their blood glucose levels than others. 

Higher blood glucose levels may occur when you have a high temperature >37.5 degrees and/or with illnesses such as the flu.  Your immune system may require more energy to fight off the infection and your liver will release more glucose into your blood stream.  Additionally, stress hormones released during periods of illness may stop your insulin from doing its job.   For people on insulin or some oral diabetes medications, lower blood glucose levels may also occur if they have a poor appetite or experience vomiting or diarrhoea. 

If you do not have a sick day plan, or to review your plan, please read: 

 If you want help with reviewing your Sick Day Plan, you can speak with a Credentialled Diabetes Educator on the Diabetes WA Helpline on 1300 001 880. 

Practical Considerations 

  • Ensure you have current contact details for your health care team and a reliable way to communicate with them if you need to self-isolate. 
  • Keep your Medicare, NDSS, Private health, Concession Cards and Numbers together. 
  • Write down the names and doses of all your medications. 
  • If you have type 1 diabetes, record your correction and carbohydrate ratios to assist health providers in giving advice on medication adjustments. 
  • If you are on an insulin pump, record your basal rate, correction and carbohydrate ratios, together with your average total daily dosage of insulin. These may be useful if you need to change to insulin injections for any reason. 
  • Vaccinations – to reduce your risk of having to cope with both COVID-19 and other illnesses at the same time, the WA Department of Health advice is that people should continue to get flu and pneumonia vaccinations as applicable and when they are made available. As always if you have any concerns about any of this information you should consult your doctor. 
  • If you live alone make sure someone you can rely on knows you have diabetes as you may require assistance if you get ill. This could be a family member, friend or health professional. 

Being isolated can be stressful and hard to manage. Learn more about how to manage isolation. 

Looking after your mental health is an important part of staying healthy. The Commonwealth Government’s Head to Health website is the best place to start if you need some help coping with anxiety and worry about coronavirus. 

You can also visit the new Coronavirus Mental Wellbeing Support Service being provided by Beyond Blue. 

In addition to support from your usual health care team, you can access free advice from Diabetes WA over the phone or online. 

Diabetes WA Helpline and Telehealth service 

The free service connects you with a diabetes educator, dietitian, nurse, exercise physiologist and pharmacist over the phone or on your computer.  

  • Phone for a chat, ask a question or choose an extended free telehealth appointment. We connect you to local and online services, including MyDESMOND, our new type 2 diabetes online education program. 
  • If you are new to telehealth, our support team will walk you through the process and will keep your GP updated. 
  • Just phone 1300 001 880 between 8.30am to 4.30pm Monday to Friday 

Diabetes WA LIVE 

A series of educational webinars covering many relevant topics and presented by our health professional team. See what’s on or book online.  

MyDESMOND 

MyDESMOND is a new online type 2 diabetes self-management education program now available at Diabetes WARegister online or call 1300 001 880 to get started. 

Further information on COVID-19 and diabetes 

Diabetes WA has helped the WA Department of Health to produce an information sheet about COVID-19 for people living with diabetes and other endocrine conditionsGo to information sheet. 

The NDSS also has updated information about how the scheme is supporting people living with diabetes at this time. 

The Commonwealth Government has also published Advice for people with chronic conditions 

WA Health also has a range of advice for taking precautions and staying healthy.

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