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A number of you have been in touch looking for advice relating to the global Coronavirus (also known as COVID-19) outbreak. The information about the coronavirus is based on advice from NHS England, NHS Improvement and Public Health England.

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We have received queries about whether people with diabetes fit into the ‘clinically vulnerable’ category and therefore should be ‘shielding’.

Having diabetes does not automatically mean that you fit into the clinically vulnerable category, this only applies to people who have received a letter telling them they are in this group or if they have been told by their GP.

The guidance is for people who are clinically extremely vulnerable, including children and it also applies to their family, friends and carers. It applies to people living at home, with or without additional support, and to clinically extremely vulnerable people living in long-term care facilities for the elderly or people with special needs.

Who is ‘clinically extremely vulnerable’?
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This is just a reminder for all of us. There are general principles you should follow to help prevent the spread of airway and chest infections caused by respiratory viruses, including:

• wash your hands more often with soap and water for at least 20 seconds or use a hand sanitiser. Do this after you blow your nose, sneeze or cough, and before you eat or handle food,
• avoid touching your eyes, nose, and mouth with unwashed hands,
• avoid close contact with people who have symptoms,
• cover your cough or sneeze with a tissue, then throw the tissue in a bin,
• clean and disinfect frequently touched objects and surfaces in the home.

The World Health Organisation (WHO) has some clear guidance on how we should wash our hands and it can be found at the following link: https://www.who.int/gpsc/clean_hands_protection/en/

During lockdown many routine appointments, many standard screening appointments are being cancelled. This includes routine podiatry appointments to check the health of your feet, therefore it is more important than ever that you regularly check your feet for any changes.

Foot problems are one of the common complications of diabetes and are caused by nerve damage (neuropathy) or damage to blood vessels in the feet and legs.

Our booklet ‘Looking After Your Feet’ tells you what to look for and is available online by clicking on:
https://www.iddt.org/publications/looking-after-your-feet

If you are concerned about the development of any changes to your feet or lower limbs, you should contact your GP or your usual podiatrist as help is available to prevent the development of serious complications.

One way or another, many of us are using various devices and screens for many hours of the day through working from home or in our leisure time. Spending long periods looking at computer, phone, or tablet screens can strain the eyes. Using the 20-20-20 rule can help to prevent this problem.

The rule says that for every 20 minutes spent looking at a screen, a person should look at something 20 feet away for 20 seconds. Read more:
https://www.medicalnewstoday.com/articles/321536

We are all being advised to take exercise once a day and this is particularly important for people with diabetes as the treatment of both types of diabetes is medication (whether insulin or tablets) diet and exercise.

Click here for advice and some exercises to get you started

Some of our members sponsor children and young people at the Dream Trust in Nagpur, India and they will be concerned about the health and wellbeing of these vulnerable young people as a result of the lockdown in India.

This article emphasises his advice that they should not lower their insulin doses because of fears of lack of availability of insulin. This link provides you with te English translation of Dr Pendsey’s newspaper article offering advice to families.

Our booklet, ‘Diabetes – Everyday Eating’ provides menus for breakfast, lunch and evening meal for 28 days. The menus are for everyday eating, so ideal for this difficult time when sometimes we can only buy essential items.

As we have lots of time on our hands at the moment, now might be the time to try something different to eat! You can access this booklet on our website at: https://www.iddt.org/wp-content/uploads/2011/10/A4_Health_Nutrition_Booklet.pdf

We are always very grateful for the donations of unwanted, in-date and unused insulin and other diabetes supplies, such as needles, lancets and test strips. This is a great help to people with diabetes in developing countries. However, in view of the coronavirus situation, we have had to reconsider the various practicalities of this at the present time.

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Medicines
Now that the BREXIT situation is clearer, well a little, the three main insulin manufacturers – Lilly, Novo Nordisk and Sanofi have confirmed that the previous arrangements are still in place. This means that they are keeping at least 16 weeks of additional stock. People should continue to get prescriptions and use their medicines in the normal way.

Pork insulin, which is made in the UK, will continue to be available as usual.

Devices
The government has said that the key medical technology companies have confirmed that they are in regular discussions with all the major companies who provide continuous glucose monitors (CGM), FreeStyle Libre, insulin pumps and blood glucose monitors and strips. The majority of tech companies have confirmed to the DHSC that they have alternative transport routes in place if disruption occurs and have built up buffer stocks.

During the 12-month implementation period, the UK will continue to stay aligned to EU law, and existing regulatory and customs procedures will remain in place. The government expect that supplies, including medicines and medical goods, will continue as usual.

Travel
If you are a UK national travelling to the EEA or Switzerland, you can continue to access healthcare as you do now until at least the end of the implementation period at the end of December 2020.

If you have an EHIC, this will be valid until the end of the implementation period.

More information about the EHIC card can be found at:

https://www.nhs.uk/using-the-nhs/healthcare-abroad/apply-for-a-free-ehic-european-health-insurance-card/

Parliamentary Question Answered on: Wednesday 19 February 2020

Department of Health & Social Care

Paul Girvan (South Antrim): To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect on people with diabetes of the slow-down in production and shipping of Freestyle Libre glucose monitoring sensors from Abbott; and if he will make statement. [745]

Jo Churchill (Bury St Edmunds) The Department is aware of current supply issues with the Freestyle Libre glucose monitoring sensors and it is maintaining regular contact with the supplier Abbott to re-establish the reliable supply of this product.

This is a temporary disruption caused by increases in demand and we have already seen steady progress to improve the situation over the recent weeks.

The information provided refers to the National Health Service in England only.

NHS England: Tens of thousands given life-changing diabetes monitors thanks to the NHS Long Term Plan

This is the title of a press release issued on 22nd October 2019 and its key statement is: “Nearly 30,000 people across the country with Type 1 diabetes have received life-changing diabetes monitors through the NHS Long Term Plan.”

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One of our Type 1 members phoned today to warn other people of his experience with the DVLA online driving licence application.

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Please click here to read more about this important announcement

FreeStyle Libre – the latest not-so-good news!!!

Diabetes care in nursing homes still remains “fragmented” and urgent steps need to be taken to restore the “health and dignity” of older people, leading experts have said.

A review of multiple studies carried out across 25 years involving residents with diabetes has slammed care home provision saying that care homes “often do not meet national standards” of diabetes care and staff training is “patchy”. 

Lead author Professor Alan Sinclair, from the Foundation for Diabetes Research in Older People and University of Aston, said: “Our findings show the level of diabetes care remains fragmented which is quite worrying because figures suggest over a quarter of care home residents are believed to have the condition. Without proper management, it can lead to frailty, dependency, disability and reduced life expectancy.

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Talking meter removed

Meter for the visually impaired removed from the market
The SuperCheck2 blood glucose meter for visually impaired people has been withdrawn from the market by the manufacturer, Apollo Medical Technologies Ltd. This meter provided blood glucose readings through a voice system.

There is another glucose meter on the market to help visually impaired people with diabetes, the GlucoRx Nexus Voice Meter. This meter uses GlucoRx Nexus test strips and GlucoRx Nexus Lancets.

“The number of adults and older teens with diabetes in the UK has more than doubled over the past 20 years, with 3.7 million people aged 17 or older now known to be living with the disease, campaigners say.”

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