COVID-19: Diabetes and Endocrinology service guide

April 2020

Scope

This information provides guidance on the management of Diabetes and Endocrinology patients across South Devon & Torbay during the COVID-19 pandemic. The information is based on national guidance from various national sources which includes regularly updated resources for patients and health care professionals.

National guidance

Excellent information is available on:

Society for Endocrinology (SFE) website for COVID 19 and endocrine conditions

COVID-19 resources for managing endocrine conditions

Adrenal crisis information

Diabetes UK website

Updates: Coronavirus and diabetes

Association of British Clinical diabetologists (ABCD) website

Clinical guide for the management of acute diabetes patients during the coronavirus pandemic

COVID-19 Advice for Patients

Same day referrals

Urgent referrals

  • Rapidly worsening diabetes control with severe hyperglycaemia
  • Recurrent severe hypoglycaemia and hypoglycaemia unawareness
  • New diagnosis of or strongly suspected Addison's disease, hypopituitarism, phaeochromocytoma, neuro-endocrine tumour, Cushing's syndrome
  • Hyperthyroidism
  • Severe symptomatic Hypercalcemia with Calcium greater than 2.85 mmol
  • New onset rapidly progressing hirsutism

Routine referrals

All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given.

Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.

Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.

Existing new and follow-up routine appointments have been cancelled and changed to telephone / video consultation where appropriate.

Urgent advice

Please contact the Torbay & South Devon NHS Foundation Trust consultant phone via the hospital switchboard: 01803 614567 and ask to be put through to consultant on call

To urgently contact the diabetes specialist nursing team please call mobile number: 07769305452 available Monday to Sunday inclusively, 9am to 5pm.

Risk factors for face-to-face review will be decided on case by case basis. Reviews may be conducted telephonically or over video chat.

Mobile messaging may be used to communicate, including commercial applications where there is no practical alternative, or when there is a need to share information quickly (see NHSX advice)

NHSX COVID-19 Information Governance Advice

UHP inpatient/daycase risk stratification for Diabetes and Endocrinology

Advice & Guidance

Advice and Guidance services aim to maintain operation for urgent and non-urgent patients. This is through DRSS referral system which is reviewed everyday.

Covid 19 High risk patient advice for diabetes and endocrinology

High risk patient advice can be obtained from:

Public Health England: Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19

Extremely vulnerable and require shielding:
  1. Patients on immunosuppression including steroid treatment for underlying endocrine condition example Thyroid eye disease
  2. Patients with cystic fibrosis and advance lung disease with diabetes
At increased risk of severe illness from coronavirus (COVID-19) to be particularly stringent in following social distancing measures:
  1. Patients on steroid replacement – Addison's disease, Congenital Adrenal Hyperplasia, hypopituitarism
  2. Patients with Diabetes in pregnancy
  3. Patients with diabetes and other co-morbidities

Pathway Group

This guideline has been signed off by Western locality on behalf of the NHS Devon Clinical Commissioning Group

Last updated: 29-04-2020

 

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