Nursing interventions for people with type 1 diabetes and frequent hypoglycaemia.

Type 1 diabetes is a lifelong condition which affects all age ranges, for reasons unknown, and the UK has one of the highest incidences of this complex condition in the world. Type 1 diabetes is caused by autoimmune damage to the insulin-producing ß-cells found in the pancreatic islet cells, leading to severe insulin deficiency. People with diabetes need to achieve a target glyosylated haemoglobin level to avoid macro- and microvascular complications, but there is the associated risk of hypoglycaemic events. These can vary in severity and consequences but will likely always cause worry for the person living with diabetes. There are many risk factors and reasons to be explored when looking at hypoglycaemia. This case study explores the nursing interventions that can be safely worked through and prioritised, within the community setting, to allow people with diabetes to be safe from severe hypoglycaemia, thus improving their quality of life and safety, as well as reducing costs for the NHS.

The impact of the COVID-19 pandemic on people with diabetes and diabetes services: A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium.

AIM: To describe diabetes nurses' perspectives on the impact of the COVID-19 pandemic on people with diabetes and diabetes services across Europe. METHODS: An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks. RESULTS: Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n = 504) and 48% (n = 873) of diabetes nurses felt the COVID-19 pandemic had impacted 'a lot' on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased 'a lot': anxiety 82% (n = 1486); diabetes distress 65% (n = 1189); depression 49% (n = 893); acute hyperglycaemia 39% (n = 710) and foot complications 18% (n = 323). Forty-seven percent (n = 771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self-management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID-19 pandemic by 31% (n = 499), 63% (n = 1,027) and 34% (n = 551), respectively. CONCLUSION: The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID-19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID-19 situation continues, we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.

Bridging the Needs of Adolescent Diabetes Care During COVID-19: A Nurse-Led Telehealth Initiative.

Amidst the unprecedented global pandemic of COVID-19, attending to the needs of adolescents with diabetes mellitus became more challenging. They faced the uncertainty of access to care and the attendant problems of a lockdown. We present the nurse-led telehealth initiative for adolescents with diabetes mellitus, leveraging on existing infrastructure and resources with the aim of addressing the anticipated challenges that many of the adolescents might face. The initiative was well received among those who participated, and there were no significant adverse effects noted.