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Background: My Diabetes My Way (MDMW) is NHS Scotland's interactive website, offering education, structured eLearning and online records access for people living with diabetes. We aimed to analyse user activity during the last 12 months. Method(s): Data were collected during the period from November 2021 to October 2022. Registration and user audit logs were analysed, observing activity across all website content and features. Result(s): An average of 62,853 pages were accessed on the public website each month. Significant activity increases were observed in December 2021 (n = 81,237). There were increased views in September 2022 (n = 76,502) and October (n = 73,039) The top five pages accessed were;Coronavirus: advice for people living with diabetes (n = 12,478), FreeStyle Libre (n = 4325), Emergency advice (n = 1576), Blood pressure-reducing your risks of complications (n = 1559) and Blood glucose monitoring and HbA1c targets (n = 1485). eLearning: During this period, 382 individuals completed one of 11 QISMET-accredited structured eLearning courses. eLearning course usage increased in relation to patient awareness activity. Social Media: There are currently 3919 Facebook and 3600 Twitter followers. Records Access: 67,655 patients had registered to access their data and 35,157 had actively accessed their records by the end of October 2022. Patient feedback remains highly positive. Conclusion(s): MDMW is a consistent and reliable resource for people with diabetes and their families to access at any time online. User statistics continue to rise, while latest development plans include the addition of new Patient Reported Outcome Measures, risk prediction features, and enhanced sharing of data with the healthcare team.
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Purpose of Study As a result of the coronavirus disease 2019 (COVID-19) pandemic and physical distancing, telehealth has been scaled up as a key strategy to address the need for virtual access to medical services. Previous studies have examined use of web-portals for accessing health information, but data on the use of live video telemedicine for disease management across different ethnicities is limited. The objective of this study is to determine if disparities exist among different ethnic groups in accessing live video telemedicine services. Methods Used A literature review was conducted using databases such as PubMed and Google Scholar. Key search terms included: telehealth, telemedicine, ethnicity, and disparities. Studies were included if a) they were conducted in the United States, b) patients used a live video telehealth service with a provider, c) focused on telemedicine use across different racial and ethnic groups, and d) investigated completed access to live video telemedicine at the individual level, and not potential access at the aggregate level. Summary of Results Of 25 articles found, 5 met our inclusion criteria. Overall, white patients had higher rates of telehealth visit completion and video telehealth use than non-white patients. Studies that used telehealth visits for diabetes education and glycemic control showed that self-care improved in all ethnic groups, but despite tailored intervention, minority groups never achieved the same level of self-care as whites. Conclusions Our review suggests that overall white patients have better access to live video telemedicine, and use the services at higher rates compared to non-white patients. However, since this trend was not seen in every study, it is likely that other factors beyond race and ethnicity play a role in access to telemedicine. Effective strategies are needed to mitigate disparities to ensure equitable telemedicine access.
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Background and Aims: The qualification course aims to encourage different health care professionals (HCP) to develop attitudes and educational actions in dealing with people who have diabetes, their families, and caregivers. Since 2008, more than 2000 HCP have been qualified. The activities during the course are workshops and case discussions through debates and awareness. Due to the COVID-19 pandemic, three editions of the qualification were made virtually. Method(s): This case report explores how changed the qualification course Educating Educators, through the explanation of how to apply diabetes education in health services, and teaching processes to the development and implementation of an educational project in diabetes. Result(s): As of the COVID-19 pandemic, the course, which was 50% practical and 50% expository and fully face-to-face, couldn't longer be held in this format. With this continuous demand to qualify HCP in diabetes education, the course during the pandemic had participants of the 39th, 40th, and 41st editions held in a fully online format. The digital model changed the four days of the course in face-to-face modality to two days in two weeks in a virtual way, with a break between the meetings for mentoring and discussion in small groups, some orientations to turn possible the conclusion of elaboration their projects. Conclusion(s): This new model of education appeared can be used to achieving people that don't can participate in face-to-face meetings. Also, the virtual model can provide a constant conversation between tutors and participants to improve their projects.
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There is a consensus that fee-for-service reimbursement does too little to encourage the provision of high-value care. Our Enterprise, an integrated payer-provider based in Pittsburgh, created an alternative compensation model for endocrinologists. Our plan introduces a gradual shift in the role of endocrinologists from clinical duties to a more collaborative role with their primary care colleagues. Considering that most patients with diabetes are managed under primary care, this shift allows endocrinologists to support primary care physicians (PCPs) in managing patients with diabetes and other endocrine-related illnesses while decreasing the number of traditional in-office referrals to endocrinology. Despite the unexpected changes brought on by COVID, in first 9 months of the compensation model, we observed its impact on care delivery as well as the relationship between participating specialists and PCPs. Practice- and provider-level quality data has shown improvement in diabetes-specific quality metrics. In one year, 16 out of 54 target practices earned NCQA recognition for diabetes management. A total of 88% of participating PCPs reported a satisfaction score > 90% with the new plan. Ultimately, our model shows promise as a replacement for fee-for-service compensation, with a likelihood of lowering costs and improved quality of care.Copyright © 2022 The Author(s)
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BACKGROUND: The rate of Type 2 diabetes mellitus (T2DM) among Mexican American individuals is 16.3%, about twice that of non-Hispanic White individuals. While a number of education approaches have been developed and shown to improve diabetes self-management behaviors and glycemic control for Spanish-speaking Latinx patients with T2DM, there is little research to guide health practitioners regarding which interventions to apply and when so that resources are used efficiently, and treatment outcomes are maximized. OBJECTIVE: This study aimed to describe an adaptive intervention that integrates community mental health workers, diabetes nurse educators, family members, and patients as partners in care while promoting diabetes self-management for Mexican American individuals with T2DM. The project incorporates four evidence-based, culturally tailored treatments to determine what sequence of intervention strategies work most efficiently and for whom. Given the increasing prevalence of T2DM, achieving better control of diabetes and lowering the associated medical complications experienced disproportionally by Mexican American individuals is a public health priority. METHODS: Funded by the National Institute of Nursing Research (National Institutes of Health grant R01 NR015809), this project used a sequential multiple assignment randomized trial and included 330 Spanish-speaking Latinx patients with T2DM. In the first phase of the study, subjects were randomly assigned to an evidence-based diabetes self-management educational program called Tomando Control delivered in a group format for 6, biweekly 1.5-hour sessions, led either by a community health worker or a diabetes nurse educator. In the second phase of the study, those subjects who did not improve their diabetes self-management behaviors were rerandomized to receive either an augmented version of Tomando Control or a multifamily group treatment focused on problem-solving. The primary outcome measure was the "Summary of Diabetes Self-Care Activities." Evaluations were made at baseline and at 3, 6, and 12 months. RESULTS: This study was funded in June 2016 for a period of 5 years. Institutional review board approval was obtained in November 2016. Between March 2017 and September 2020, a total of 330 patients were recruited from the outpatient primary care clinics of Olive View-UCLA Medical Center, with a brief hiatus between May 2020 and July 2020 due to COVID-19 restrictions. The study interventions were completed in December 2020. Data collection began in March 2017 and was completed in December 2021. Data analysis is expected to be completed in Spring 2023, and results will be published in Fall 2023. CONCLUSIONS: The results of this trial should help practitioners in selecting the optimal approach for improving diabetes self-management in Spanish-speaking, Latinx patients with T2DM. TRIAL REGISTRATION: ClinicalTrials.gov NCT03092063; https://clinicaltrials.gov/ct2/show/NCT03092063. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44793.
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Diabetes group visits (GVs) have been shown to improve glycemic control, enrich patient self-care, and decrease healthcare utilization among patients with type 2 diabetes mellitus (T2DM). While telehealth has become routine, virtual GVs remain understudied, especially in federally qualified health centers (FQHCs). We conducted a 5-year cluster randomized trial with a waitlist control group to test the impact of diabetes GVs on patients' outcomes in Midwestern FQHCs. Due to COVID-19, the 6 waitlisted FQHCs adapted to virtual GVs. FQHC staff were provided training and support to implement virtual GVs. The GV intervention included 6 monthly 1-1.5-h long education sessions and appointments with a primary care provider. We measured staff perspectives and satisfaction via GV session logs, monthly webinars, and staff surveys and interviews. Adaptations for implementation of virtual GV included: additional staff training, video conferencing platform use, decreased session length and group size, and adjusting study materials, activities, and provider appointments. Sites enrolled a total of 48 adults with T2DM for virtual GVs. Most FQHCs were urban and all FQHCs predominantly had patients on public insurance. Patients attended 2.1 ± 2.2 GVs across sites on average. Thirty-four patients (71%) attended one or more virtual GVs. The average GV lasted 79.4 min. Barriers to virtual GVs included patient technology issues and access, patient recruitment and enrollment, and limited staff availability. Virtual GV facilitators included providing tablets, internet access from the clinic, and technical support. Staff reported spending on average 4.9 h/week planning and implementing GVs (SD = 5.9). On average, 6 staff from each FQHC participated in GV training and 1.2 staff reported past GV experience. All staff had worked at least 1 year at their FQHC and most reported multiple years of experience caring for patients with T2DM. Staff-perceived virtual GV benefits included: empowered patients to manage their diabetes, provided patients with social support and frequent contact with providers, improved relationships with patients, increased team collaboration, and better patient engagement and care-coordination. Future studies and health centers can incorporate these findings to implement virtual diabetes GVs and promote accessible diabetes care.
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Objectives To report a case of new onset Type 1 Diabetes Mellitus (T1DM) and Diabetic Ketoacidosis (DKA) in a 5-month-old female who was positive for SARS-CoV-2 (COVID-19) infection, which may be a novel precipitant for autoimmunity at a very young age. Methods Case Report Results A 5-month-old term Caucasian female with no significant past medical history presented to the emergency department with Kussmaul respirations and altered mental status. She had one day of presumed viral respiratory symptoms and decreased oral intake. She also had a 5% weight loss (0.31 kg) and polyphagia for one month. Her presenting bloodwork included a blood glucose of >600 mg/dL, pH 6.901, bicarbonate 3.8 (22-28 mmol/L), potassium 5.5 (3.3-5.1 mmol/L), white blood cell count 47.9 (6-17.5 x10
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BACKGROUND: It is well documented that telemedicine offers effective accessibility and consistency which are useful in overcoming the barriers associated with the traditional delivery of chronic disease management. Furthermore, home-based telemonitoring approach for managing chronic disease conditions has been shown to break geographical barriers and facilitate provider-to-patient communication. However, the efficacy of telemedicine in reducing HbA1c is debatable. AIM: This systematic review aims to evaluate the effect of telemedicine on glycaemic control in patients with type 2 diabetes. METHOD: This systematic review has been conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Searches were primarily conducted using the EBSCOhost database. Other search engines such as Cochrane Library and Google scholar were also used and search of grey literature was performed using google, NHS.uk website, WHO websites, and gov.uk website. Nine articles were included in this review. RESULTS: Three themes were identified in this review including diabetes education/telemonitoring technology and glycaemic control, the attitude of participants, and cost effectiveness of tele-medicine. While three studies reported improved glycaemic control with statistically significant improvement in HbA1c compared to the control group, three other studies did not find significant improvement in glycaemic control. In addition, the findings suggest that participants' positive attitude to self-care can lead to an improved HbA1c, and finally, several of the selected studies found that telemonitoring is not cost-effective. CONCLUSION: The findings of this review show that telemedicine may be effective in managing blood glucose in patients with type 2 diabetes. However, factors such as educational level of patients, attitude and costs may limit its application in primary care. More studies are required to fully establish the effectiveness of Telemonitoring in managing patients with type 2 diabetes.
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Diabetes Mellitus, Type 2 , Telemedicine , Humans , Diabetes Mellitus, Type 2/therapy , Glycated Hemoglobin , Blood GlucoseABSTRACT
Children with early signs and symptoms of Type 1 Diabetes need to be diagnosed promptly, before they become acutely unwell with diabetic ketoacidosis (DKA). Early diagnosis and optimal management of established DKA is key to reducing morbidity and mortality. To follow the evidence based standards. To assess whether the newly diagnosed type 1 diabetes were in DKA at presentation or not. To assess compliance to guidelines on admission. As per retrospective cohort study, charts of newly diagnosed type 1 diabetes over one year study period reviewed. Proportion of new on- set type 2 diabetes presentating during this COVID-19 pandemic was higher then previously reported. There was an increase in presentation of severe DKA at diagnosis in children and young people under the age of 16 years old.we were not sure what could account for this rise in proportion.Delayed presentation ranging fear from of contracting COVID to an inability to contact or access a medical provider for timely evaluation. Multicultural nature of our study population could also be a factor. More public health awareness and diabetes education should be disseminated to healthcare providers on the timeliness of referrals of children with suspected T1D.
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Introduction: Structured diabetes education (DE) is vital to manage pediatric diabetes (PD) but educators are scarce in developing countries. Due to familiarity with virtual teaching in the COVID pandemic, a virtual PDE course was planned for India. Objective(s): Evaluate outcomes of a virtual PDE course in a limitedresource (LR) setting. Method(s): A 9-member ISPAE (Indian Society for Pediatric & Adolescent Endocrinology) committee, with 47 experienced volunteer faculty planned a 12-week comprehensive curriculum (delivered in English, fee INR 5000 = US$65) basic & advanced skills: diagnosis, pathophysiology, insulin, SMBG, CGMS, CSII, MNT, exercise, psychology, toddlers, adolescents, type 1&2, other special situations: 17 teaching +5 feedback sessions, exit exam;practical assignments for each session. Result(s): Trainees working with T1D selected from across India: semiurban were preferred. Lengthy course with 90%-95% attendance (highly motivated) possible as no leave, travel, or stay costs needed. Easier for women to join. Significant rise in post-test scores that is, knowledge improved. Certification was based on stringent criteria. Other advantages: intense interaction, personal commitment, continued networking, and awareness of resources. Challenges: widely varied resource, language, and social settings: language barriers, limited resources, variable baseline knowledge. Conclusion(s): The IDEAL PDE training model being virtual & intensive is an affordable & accessible alternative to a physical program in LR settings. We hope to make it high quality, sustainable, and replicable.
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The incidence and mortality of diabetic ketoacidosis (DKA) have hardly changed in recent years. Recurrent DKA in particular is characterised by a high mortality rate of about 23%. Young people with type 1 diabetes are more often hospitalised for DKA than for severe hypoglycaemia. COVID-19 probably leads to a higher incidence of DKA - especially in people with type 2 diabetes. Major risk factors for recurrent DKA include female gender, age between 13 and 25 years, higher HbA (1c) , migrant background and mental illness. Education on DKA should create awareness of the dangers of DKA and develop a concrete plan of action in case of emergency. Hypoglycaemia is the limiting factor of insulin therapy and is associated with increased diabetes-related distress and increased risk of cardiovascular events. The incidence of severe hypoglycaemia over 12 months is around 8%. The effective use of diabetes technologies should be an integral part of diabetes education. The most important technology-related education content includes alarm setting limits, the correct use of trend arrows, training in pattern recognition in the ambulatory glucose profile (AGP) and knowledge of automatic (predictive) low glucose suspend functions in automated insulin delivery (AID) systems. Hypoglycaemia unawareness occurs when the body becomes accustomed to low glucose levels and the autonomic response to low glucose levels weakens. The basis of hypoglycaemia-awareness training is systematic self-observation of one's own physical symptoms at different glucose levels.
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BACKGROUND: Diabetes group visits (GVs) or shared medical appointments have been shown to improve clinical outcomes, but few have reported results from virtual diabetes GVs. No studies have evaluated virtual GVs among community health center patients across a region of the U.S. METHODS: Six health center sites across five states conducted six monthly virtual GVs with up to 12 adult patients with type 2 diabetes and suboptimal glycemic control (glycosylated hemoglobin (A1C) ≥8%). Virtual group visits consisted of six monthly 60 to 90 minute-long diabetes education sessions led by health center staff via a videoconferencing platform. GV patients enrolled at the site also had an appointment with their primary care physician within two weeks of each monthly virtual group visit. Primary outcome was change in patients' A1C from baseline to 6- months. Secondary outcomes were changes in patients' blood pressure, low density lipoproteins (LDL) and weight. Patients also completed surveys at baseline and 6-months describing their diabetes self-care behaviors and satisfaction with the virtual GVs. Generalized linear mixed models and linear mixed models were used to test the effects of GVs, time points and their interaction. RESULTS: Forty eight patients were enrolled (mean age 55 ± 12 years, 67% female, 63% black/African American, 32% white/Caucasian, and 8% Hispanic/Latino, 88% had public health insurance, mean baseline A1C of 9.84% ± 1.78%, 35% with A1c <9%). 34 patients completed one or more virtual GVs;14 patients attended no virtual group visits. At 6-months, average A1C was 8.96 ±1.82;A1C decreased by -0.56% ± 0.31 compared to baseline which was borderline significant (p=0.08). At 6-months, 58% of patients had an A1C < 9% which was borderline significantly decreased (p=0.055) compared to baseline. For patients with an A1C at baseline >9%, there was a significant decrease in A1C at 6 months (-1.06 ±0.45, p=0.03). There was no significant difference in blood pressure, LDL or weight from baseline to 6- months or association of number of visits attended and change in A1C. There were no significant changes in foot self-exams, blood sugar testing, nor exercise, but patients did report more days of healthy eating in the past week at 6-months compared to baseline (4.5 ±2.3 vs. 3.2 +2.7 days, p=0.02). Overall satisfaction with the virtual GVs was high with 90%of participants being very satisfied and 95% saying they would attend GVs in the future. CONCLUSIONS: Virtual GVs show high patient satisfaction and promise for improving A1C among patients with poor glycemic control who receive care in community health centers. Future studies are needed with a larger patient sample size and a control comparison group to determine which patients and health centers are best suited for virtual GVs.
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STATEMENT OF PROBLEM/QUESTION: Improve diabetes quality and equity during the pandemic. DESCRIPTION OF PROGRAM/INTERVENTION: Elmhurst hospital center is one of 11 acute care hospitals in the NYC H+H network, the largest public health care system in the United States. Elmhurst hospital was at the epicenter of the COVID 19 pandemic in March 2020;providing care for immigrant, uninsured and underinsured patients, including more than 5000 patients with diabetes. As NYC emerged from the first surge, the primary care clinic assessed and addressed care gaps. Difficulties in accessing in-person visits, lab, and the social and economic impact on patients added to the challenges of managing diabetes during the pandemic. Disproportionately burdened were ethnic and racial minorities. An assessment of the diabetes outcome revealed that the control rate of diabetes defined as Hemoglobin A1c (A1c) less than 8% dropped by 8% compared to the pre-pandemic rate. There was a 4% difference in diabetes outcomes between the insured and uninsured patient populations.The clinic leadership implemented a collaborative care model. The collaborative care model consists of clinical pharmacists, registered nurses, a diabetes education-certified dietitian, and the population health team that provides outreach and data analytics support. Patients referred to the collaborative team by the primary care provider who assists in setting the treatment plan and goals. The collaborative care team screens every patient for barriers and social needs, provides diet education and a self-management plan. Each patient receives medication management in either the RN led treat-totarget clinic or by the clinical pharmacist. The referral criteria follow an algorithm based on the A1c level of control, number of medications, and the use of injectables. Cases are discussed weekly in collaboration with the primary care provider. The level of care is adjusted to address patient needs. The team determines the number of visits and time between visits based on the clinical progress. Visits are conducted in person and virtually;tailored to the patient's ability to use telehealth. MEASURES OF SUCCESS: Diabetes control improved by 10% in 8 months. The gap between insured and uninsured was reduced from 4% to 1% at the end of the study project period. FINDINGS TO DATE: A team-based approach using risk stratification that incorporates clinical outcomes and patient social barriers led to significant improvement in diabetes outcomes and closed the inequity gap. KEY LESSONS FOR DISSEMINATION: - High-quality diabetes care requires a multi-disciplinary team approach. - Treat-to-target RN visits improved access and equity in diabetes care. - Clinical Risk algorithms must incorporate social barriers. - Team-based approaches require continuous training and evaluation, with team members empowered for decision making.
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Background and Aims: Background: The care of pediatric patients with new-onset type 1 diabetes in remote areas of Patagonia presents multiple challenges. The current pandemic has presented additional difficulties. We describe the follow-up through telemedicine by an interdisciplinary team of pediatric patients living in rural areas after two years from the start of the SARS COV2 pandemic. Aims: Report on the follow-up of 20 new-onset type 1 diabetes cases in children. The cases were diagnosed in different areas of Patagonia Argentina located more than 200 km from the referral center and were treated through a mixed method : face-to-face and virtual. Methods: Telemedicine was used from the first day to contact the specialist. The management included diabetes education for the patient and family. The patients used multiple daily insulin injections and used software to generate ambulatory glucose profiles. Subsequently, the follow-up was carried out in a mixed modality. Results: The patients achieved adequate glycemic control and reached the diabetes education goals;the management of the cases did not require transfers to the referral center during the first year. Conclusions: These cases show the usefulness of telemedicine to guarantee accessibility to the health systems when the patient's attendance at the referral centers it's not possible. Telemedicine can be used to achieve glycemic control of the patient, for diabetes education in a safe, efficient way and with the satisfaction of the users.The mixed method allows to strengthen the relationship between the team and the patient and the meeting of families in educational workshops.
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Background and Aims: Mobile health management platform is a potential way to achieving effective glycemic control in type 2 diabetesmellitus (T2DM) patients, especially during the Covid-19 pandemic. Lilly Connected Care Program (LCCP) is a smartphone-based app providing blood glucose monitoring and diabetes education services to improve diabetes management. This study aimed to evaluate the real-world effectiveness of LCCP platform in glycemic control among Chinese T2DM patients. Methods: This retrospective study included Chinese T2DM patients (age ≥18 years) from January 1, 2015, to January 31, 2020. Data was drawn from mobile app and electronic medical records. Propensity score matching (PSM) was used to match LCCP group and non-LCCP group to reduce confounding, with covariates including age, sex, duration of diabetes, baseline HbA1c, and number of oral diabetes medication classes. We analyzed HbA1c reduction within an average of 4 months and compared the proportions of patients achieving HbA1c reduction ≥0.5% or ≥1% between LCCP and non-LCCP groups. Comparisons were made using independent t-test and Chi-square test. Results: A total of 923 patients were included, among whom 303 pairs of patients were well-matched after PSM (Standardized Mean Difference of covariates <15%). The HbA1c reduction during 4-month follow-up was significantly larger in LCCP group than non-LCCP group (Mean±SD: 2.21 ± 2.37% vs. 1.65 ± 2.29%, P = 0.003). LCCP group had higher proportions of patients with HbA1c reduction ≥1% (69.0% vs. 57.4%, P = 0.003) and ≥0.5% (75.6% vs. 68.0%, P = 0.038). Conclusions: LCCP mobile platform was effective in glycemic control among Chinese T2DM patients in the real world.
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Background: Diabetes education is an essential element to achieve treatment objectives in children with type 1 diabetes mellitus (T1D) and it often involves group educations. Due to government group gathering restrictions during the Covid-19 pandemic, face-to-face group education were not possible. An alternative means of delivering group education is needed in this special time. With that, a series of virtual education workshops were designed. Aim: The study aimed to review the experience in conducting virtual education workshops for children and families with T1D during the Covid-19 pandemic. Method: The virtual workshops consisted of warm-up and ice-breaking games led by play therapists, followed by diabetes-related education workshops conducted by diabetes nurses, paediatric endocrinologists, and dietitians. Patients and families were invited to fill in a standard feedback questionnaire afterwards. Results: In the period of July 2020 to June 2021, a total of 10 virtual workshops were organised. A total of 33 children (13 boys and 20 girls) attended the workshops. The mean age of these patients was 9.5 +/- 3.8 years and the duration of T1D was 4.0 +/-3.3 years. Their mean HbA1c were 8.2 +/- 1.5%. A total of 22 responses on the feedback questionnaires were received. Among those who responded, 68% respondents had attended the virtual workshops for more than 2 times. The majority (86%) agreed that they had acquired new diabetes related knowledge from the workshops and 86% found the workshops interesting and enjoyable. Most (95%) reported that they could listen to instruction clearly and communicate causally in the virtual workshops. Only 32% strongly agreed that virtual workshops were the same as face-to-face workshops and 27% reported that they would prefer zoom to face-to-face workshop in the future. The commonest reasons for not joining virtual workshop in the future included unstable internet connection and feeling uneasy in virtual environment. Discussion: A safe, socially distanced method of delivering group education for children and families with T1D during the pandemic was possible and well-received. Virtual education workshops could be an alternative tool in delivering diabetes education. However, this could not totally replace face-to-face therapy.
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Background: Education of self-management skills in children with type 1 diabetes mellitus is essential for their care. A few studies were conducted to assess glucose control of children with type 1 diabetes during camp. Bahrain Diabetes Society (BDS) has been the pioneer in the Gulf region in diabetes camps and during COVID-19 pandemic, we transitioned the program using an online delivery method. Aim: 1. Creating a live diabetes education program for children with diabetes. 2. Assessing parents’ satisfaction of this method of delivery of diabetes education. Method: Cross-sectional study in the form of a survey that was sent to parents of children enrolled in the online diabetes education program. Data from the survey was analyzed to evaluate the satisfaction of parents with the program. Results: An invitation was sent to advertise for the program and 40 children and adolescents were enrolled. Participants were divided into two groups depending on age (7-11 years and 12-16 years). The sessions were conducted weekly as live session. The content included carbohydrate counting, techniques of insulin injection, and meetings with adults who had diabetes as children. 29 parents responded. Parents responded favorably to the format and content of the sessions and preferred 15 participants instead of 25 per session. Overall the parents provided positive comments requesting to continue such activities beyond COVID-19. Discussion: Bahrain Diabetes Society successfully conducted an online diabetes education program for children and adolescents with diabetes. This model of delivery of education and self-empowerment and motivation was appropriate during the current pandemic and can be considered in the long term as one of the options to provide such education. We intend to follow these children and adolescents and study the impact of the program on their health and glycemic profile as well.
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Objective: To adapt Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) structured education programmes for virtual delivery during covid-19. Methods: Face-to- face structured education programmes stopped in March 2020 due to covid-19. A multi-disciplinary stakeholder group adapted the existing evidence-based DESMOND curriculums and resources to support a new model of virtual delivery, while remaining congruent to the theoretical and philosophical underpinnings. Version 1 was released in May 2020. Educator training was provided to increase confidence in delivering virtually. An iterative process of stakeholder feedback, and review of resources led to two updated versions of the adapted programmes being released;version 3 was made available in October 2021. New Educators are now trained virtually. In August 2021 the first Educator completed their pathway of training, mentorship and quality assessment virtually. Results: Between May 2020 and August 2021, 529 attendees rated their DESMOND programme 8.8/10 for how much they felt part of the group and able to engage with others and 94% set a goal during their programme. 95% of attendees rated their overall experience as 4 or 5 stars with 97% recommending the programme to friends and family. Feedback from Educators indicated low drop out rates between sessions and virtual delivery had increased the opportunity for evening and weekend sessions enabling more people to attend. Educators found the virtual resources easy to use. Conclusions: The adaptation of face-to- face to virtual delivery is acceptable to participants and Educators. Virtual delivery should continue to be included as an option in the future.
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Diabetes services have undergone significant changes during the pandemic. Anne Phillips highlights the opportunities this provides for improving care for people living with diabetes