Guidance for COVID-19 among people with diabetes living in care homes is launched

A COVID-19 Response Action plan has been drafted to support clinical decision-making in care homes in a bid to reduce morbidity and mortality among residents with diabetes.

The document, A Covid-19 Response Action – Diabetes Management in Care Homes, was drafted by a multidisciplinary stakeholder group with input from the Joint British Diabetes Societies (JBDS) for Inpatient Care group, the Association of British Clinical Diabetologists (ABCD), Diabetes UK and Diabetes Frail.

Professor Alan Sinclair, who has an international reputation in the field of older people and founded Diabetes Frail which explores the emerging importance of frailty, co-chaired the document.

He said: “Care homes represent a major challenge to ensuring that COVID-19 prevention and control issues are optimal.

“We know from research that the epidemiology of COVID-19 incidence, severity of illness and mortality seem to be shifted towards older people particularly those with multiple comorbidities such as diabetes, hypertension, and cardiovascular disease.

“Residents of care homes (both residential and nursing) are a highly co-morbid population who are particularly vulnerable to Covid-19 infection. A quarter of residents have diabetes and two-thirds may have frailty which is a better predictor of intensive care unit (ICU) outcomes than age or other factors.

“Some parts of the guidance expect care homes to provide a higher level of diabetes care than would normally be expected. But in view of the severe impact of COVID-19 in care homes, perhaps we should be reviewing the needs for more clinical support within these settings.”

The document lays out the effect coronavirus may have on individual residents such as increasing the risk diabetes-related conditions, such as called diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) and the increasing susceptibility to other infections including pneumonia, chest and foot infections, and sepsis.

The guidance also recommends care home residents receive plenty of oral fluids to maintain good hydration, maintain a daily appropriate exercise and nutritional plan with regular meals, they continue to receive their usual diabetes treatment  and regular, twice daily capillary blood glucose testing should be carried out.

To access the document, click here.

Picture credit: Elien Dumon