The public health emergency caused by COVID-19 is as worrying as chronic diseases such as diabetes, cancer, or epilepsy. By definition, these are long-lasting, slowly progressive diseases and, according to the World Health Organization (WHO), responsible for the main causes of global mortality. However, those diseases can be prevented by up to 80 percent.
According to the International Diabetes Federation, 463 million people worldwide have this chronic disease; in other words, 1 of 11 people has type I or type II diabetes. Ten percent of the world’s health budget is spent to face this disease. In Latin America, according to the Federation, 31.6 million adults (20 to 79 years old) have diabetes, that is, 9.4 percent of the population.
With the arrival of the pandemic, patients with diabetes had to continue their treatments and medicines as there is no pause and restart for this disease. Then, how have patients with diabetes lived through the global pandemic? To discuss this topic, the European Federation of Pharmaceutical Industries and Associations (EFPIA) held a webinar on June 11th, 2020 about “Diabetes and COVID-19: when two pandemics meet – rethinking health systems: integrated care and empowerment of primary care”.
Experts such as Chantal Mathieu, Vice-President of the European Association for the Study of Diabetes (EASD); Xavier Cos, Chairman of Primary Diabetes Care Europe; Maurizio Guidi Co-Chair of EFPIA Diabetes Platform; Sara Cerdas, Member of the European Parliament; and Bastian Hauck, CEO of Dedoc Labs GmbH, an online diabetes community were invited to participate in this webinar.
For Bastian Hauck -CEO, Dedoc Labs GmbH- at the beginning of the pandemic, the greatest challenge was distributing medicines to people with diabetes, but at the end it did not involve any difficulty as all patients received their medicines on time. However, there were emotional-related challenges Hauck did not expect: because of the chronic illness, people with diabetes were considered “at-risk population”, which made them feel vulnerable. According to Hauck, the treatments of some patients were delayed because they stopped attending their medical appointments for fear of contracting the virus. Thus, effects of lost medical appointments will be seen in a few months.
“There was a lot of data (about COVID-19 effects) that were not checked or data that were wobbly (…) so our patients were terrified (….) So, we switch to tele consulting but the dependency of our patients, it was almost an emotional bond”, explained EASD Vice-President Chantal Mathieu, during the virtual forum. That being so, the pandemic has shown the importance of adopting telemedicine, because it is a tool that helps patients from home and provide them with clear and precise information, especially in times of crisis.
On the other hand, Maurizio Guidi -Co-Chair EFPIA Diabetes Platform- considers that diabetes requires more attention than in the past because coronavirus has impacted many people with this chronic disease. In that sense, he suggested to work in a better prevention of the disease during a near future. For this purpose, he recommended three pillars: having reliable and replicable information; more care centers to report the disease; and enable empowerment of those who are already diabetic through technology and self-management.
An integral health system
Something in common for all countries worldwide is that coronavirus has tested healthcare systems, which in part was beneficial because it showed the gaps in the systems. For Primary Diabetes Care Europe Chairman, Xavier Cos, a gap that arose to the surface was that “care systems are not having good bridges between them”. For example, what happens in an emergency room is not always well recorded for primary care later, which does not allow identifying high-risk people.
“Artificial intelligence and machine learning having all of this data in the same database allow these systems to create a kind of stratification that allow the clinicians and the healthcare professionals wherever they are to be more proactive”, Cos mentioned in the webinar. In addition, he stressed the importance of having electronic medical records, so doctors can consult it from their homes and thus be able to attend to more patients. “We are in a new era of providing care”, concluded Cos.
Lessons for Europe
The European Union has been very active in the fight against coronavirus. An example of this is the 8 billion dollars they have collected to put “at the service of all humankind”, as Ursula von der Leyen, President of the European Union, explained in her virtual speech during the World Health Assembly.
Although memorable, Sara Cerdas, member of the European Parliament, explained during the webinar that the European Union did not have enough planning about the way to manage non-related coronavirus diseases. The lesson the pandemic leaves for the European health systems, according to Cerdas, is that ” The lesson the pandemic leaves for the European health systems, according to Cerdas, is that “we need more focus in primordial and primary prevention” and it must be guaranteed that people who already have chronic diseases can live longer and better, considering that “we have good technology and good methods to achieve a healthy live”.
In addition, for Chantal Mathieu at EASD they learned to “bring messages from experts that were controlled and that we were sure that what was being said was correct”. While for Bastian Hauck of Dedoc Labs GmbH, it is important that “we need translation (of coronavirus information) for people with diabetes (and other diseases). In order to spread the information, he recommended making alliances with local diabetics’ organizations, that can replicate information quickly and transparently.
In conclusion, it is necessary to rethink health systems for them to have integrated care and empower people who do primary care. Although diabetes is a complicated disease, it is also a self-managing disease, so it is essential to provide diabetics accurate information about coronavirus, to promote powerful tool such as telemedicine and not leaving aside their mental health.
Diabetes and COVID-19: when two pandemics meet
IDF Diabetes Atlas
IMPROVING OUTCOMES FOR PEOPLE WITH DIABETES
Overview – Preventing chronic diseases: a vital investment
President von der Leyen addresses the 73rd World Health Assembly