Delivering evidence-based interventions for Type 1 diabetes in the virtual world – a review of current UK practice.

Abstract

This review considers the impact of the SARS-COV-2 pandemic on access to evidence-based interventions for those living with Type 1 diabetes in the UK and discusses the novel solutions which have been considered and actioned to ensure ongoing access to high quality care. Methods: We performed a focussed review of the published literature, and the guidelines for changes that have been effected during the pandemic. We also drew from expert recommendations and information about local practice changes for areas where formal data have not been published. Results: Evidence based interventions which support the achievement of improved glucose levels and/or reduction in hypoglycaemia include group structured education to support self-management, insulin pump therapy and continuous glucose monitoring. However, the SARS-CoV-2 pandemic had impacted the ability of diabetes services to deliver these interventions, transforming services into a virtual world. Multiple adaptations have been put in place – transition to online delivery of education and care, and increased usage of diabetes technology in management. Conclusions: Although various adaptations have been made during the pandemic that have positively influenced uptake of services, there are many areas of delivery that need immediate improvement in the UK. We recommend a proactive approach in recognising the digital divide and inequity in distribution of these changes and we recommend introducing measures to reduce them.