Greater Glasgow and Clyde Child & Adolescent Diabetes Service 

COVID-19

Coronavirus (COVID-19) update

Tuesday 17th March 2020

The most talked-about topic of the time is undoubtedly the coronavirus pandemic.  With government advice around staying indoors and social distancing, many have asked what this means for young people with diabetes and what the risks are to them if they should catch the virus.


We continue to do all we can to provide the best possible care and review these plans daily.  Even so, the situation can change unexpectedly, and expert advice must also adapt.  We are in frequent contact with specialists in the Children’s and Adult Hospitals, and other Health Service advisors.  We are also preparing for our staff to be affected or redeployed (e.g. helping maintain service by working from home).


Having diabetes does not appear to increase the risk of catching Coronavirus, but you may become more unwell from this virus if you have diabetes.  The risk increases with higher average blood glucose results or a higher HbA1c.

General advice on Illness Management

If you are feeling unwell always test blood glucose more often.  You should also test for ketones whenever you feel unwell or your blood glucose is above 14 mmol/l.  It is always important to know your Ketone Dose, how to work it out and when to use it:


A Ketone Dose is always given as well as usual Background and Carb insulin doses.

  • A Correction Dose is not given if a Ketone Dose needs to be taken.

A Ketone Dose can be worked out by:

  • Adding all the insulin usually taken in one day (Background/Basal and Carbs doses) and
  • Dividing this "Total Daily Dose" of insulin by 6, and then giving this dose
  • Using fast-acting insulin (e.g. NovoRapid, FiAsp or Humalog) every 4 hours as needed.

Ketone Dose and Sick Day guidance are found:

  • On the back page of your Blood Glucose Diary
  • In the "Diabetes Best Ideas: My Health Record" given at diagnosis (Page G 07)
  • On this website here.

If you need to take 3 or more Ketone Doses in a row, call for further advice.

Routine and Review Outpatient Clinics

To protect those with diabetes it is now even more important for blood glucose results to be as stable as possible.  We believe clinic contact remains important but will use telephone, e-mail and “Near Me” video-conferencing.  (“Near Me” is as convenient as a telephone call but allows online face-to-face communication.  A user guide can be found here.)


We will telephone you a few days before your clinic appointment to arrange whether this will be

carried out by telephone or Near Me.


On the day of your clinic, we will aim to contact you within 30 minutes of your scheduled appointment time.


If you use a Blood Glucose Diary and have a smartphone, please e-mail us a photograph of the diary before clinic, showing or telling us in the text of the e-mail the last 2 weeks of glucose results and insulin doses, including:

  • Basal (Background) insulin doses (e.g. Levemir, Tresiba or Lantus)
  • Carb Doses and Carb Ratios
  • Correction Doses and Insulin Sensitivities.

Please send this to childrenwithdiabetes@ggc.scot.nhs.uk, with the e-mail Subject Heading:

  • The Surname of the young person, followed by
  • The First Name of the young person, and then
  • The Date of Birth of the young person, so that we can easily identify the information.

Before clinic please also upload any devices, if used, to the following websites:

  • CareLink for Medtronic insulin pumps and continuous glucose monitors
  • Diasend for Omnipod and Tandem insulin pumps, and most blood glucose monitors
  • Dexcom Clarity for Dexcom continuous glucose monitors
  • LibreView for Freestyle Libre.

It may be we do not have the most up-to-date contact details for you, so if you think this is the case please confirm them by e-mail (if available to you) for accuracy and to prevent blocking of telephone lines.


Group Teaching Sessions

At present we are suspending all Group Teaching sessions, including:

  • Insulin pump starts
  • Insulin pump upgrades
  • Insulin pump extended training
  • New Starts recent diagnosis group
  • New Diagnosis psychology group.


New Patients and Complex Patients

If you are the parent of a recently-diagnosed child, or a child with other complex issues, we will plan and discuss with you how best to keep in touch.  If it is felt necessary to attend the Diabetes Service office, please let us know before your arrival if any of your immediate household has:

  • A persistent cough
  • A high temperature
  • A confirmed diagnosis of coronavirus (COVID-19).


Contacting You

Our Diabetes Service App, "HealthZone UK", is the easiest way to provide all with the most up-to-date information.  If you have a smart phone, please download our App.  Details on how to do this can be found here.




It may be we do not have the most up-to-date contact details for you, so if you think this is the case please confirm them by e-mail (if available to you) for accuracy and to prevent blocking of telephone lines.  We would appreciate you sharing:

  • Your home telephone number
  • Mobile telephone numbers (for each parent/guardian and, if agreed, the young person if over 16 years old)
  • E-mail addresses (for each parent/guardian and, if agreed, the young person if over 16 years old).


Contacting Us

An increased volume of calls is expected, and we would appreciate patience with our response times.  During the current crisis we will review e-mails each working day and attempt to respond to all enquiries within 48 hours (and hopefully much sooner).  If your enquiry is urgent, please telephone instead of using email.  If making a non-urgent enquiry, please send us an email when possible.


Telephone:

                                       0141 201 0331            for routine, non-urgent enquiries

                                       0141 201 0000            for emergencies and urgent queries

(Switchboard will redirect your call as shown here)


E-mail:

                                       childrenwithdiabetes@ggc.scot.nhs.uk

Sharps Bins

Due to people not being able to come up to the Diabetes Clinic at the moment, you may find your Sharps Bin is becoming full.  We would recommend the following solutions:

  • The next time you request a repeat prescription from your GP, ask for a needle clipping device called a "BD Safe Clip" (PIP code 002-9116).  This device is designed to remove the needle from your insulin pen, allowing you to place the plastic hub into your domestic waste.
  • You can collect a Sharps Bin at the West Glasgow Ambulatory Care Hospital reception area, at the Main Entrance on the ground floor.  Please keep your full bins and bring them for disposal when clinics return to normal.
  • For patients using pump cannulas, we would recommend replacing the plastic lid back over the cannula inserter after use and storing them.  They can be deposited next time you come to clinic.


Resources

We are not responsible for the content of other websites.  Any advice given may also be different to our own.


NHS UK Coronavirus Advice

                                                               https://www.nhs.uk/conditions/coronavirus-covid-19/


Diabetes UK Coronavirus Advice

                                                                      https://www.diabetes.org.uk/about_us/news/coronavirus


Scottish Government Advice

                                                                      https://www.gov.scot/coronavirus-covid-19/