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NOVEL CORONAVIRUS PREPAREDNESS AND SUPPORT

The coronavirus affects all of us and comes with enormous challenges for people and communities. We recognise the important role our therapies play in supporting your diabetes management needs and appreciate you may be worried and may have some questions. Therefore, we wanted to provide you with an update on the steps we are currently taking.

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What we are doing:

  • Impact of COVID-19 on our activities
    We are keeping all our manufacturing facilities and call centres open. At present, there hasn’t been a significant impact to our operations from the virus. We have robust business continuity plans in place and are closely working with our partners and suppliers to help ensure ongoing support and delivery of our products reaches those who need it most. We have taken all measures we could to minimise the spread and the impact of the virus as much as possible for our customers and our employees. As we are working diligently to continue to serve everybody on time, we are facing some challenges which unfortunately could cause shipping delays. This is the case for our MiniMedTM QuicksetTM infusion sets and our GuardianTM Sensor 3 lines.

    There are 2 main reasons for this:

    • Huge order volumes - similarly to what is happening in supermarkets today, many patients globally have been ordering bigger quantities and earlier than usual. Medtronic has enough supply to service patients across the globe with their normal orders, but not enough in local warehouses to cover this extra demand.

    • Other operational issues – we have had delays in the approvals of some line changes by official bodies, resulting in late deliveries to our warehouses.

  • Provide updates
    We will continue to monitor the situation closely and will give important updates, as needed, via social media (hyperlink to social media site) and email.

What we ask from you:

  • Continue with normal order patterns
    We understand that the situation is probably stressful and that you might want to have additional safety stocks at home. Our goal is to remain fair and to continue to service all patients with their normal order levels for continuous therapy. Thank you for understanding that, in the current situation, if you order more than what you normally use, other patients might not be able to receive what they need. We therefore would like to ask you not to change the way you order infusion sets, reservoirs or sensors, but only to place your next order with normal volumes when you are down to a one-month supply. This will allow enough time to receive your next delivery.
    If needed our team can assist you with identifying alternative infusion sets.

  • Guidance for contacting our service teams
    We always look forward to speaking to our customers. Due to the current situation, you may experience longer waiting times than usual when you are reaching out to us. To help us serve you better and place orders in a more efficient manner, we recommend these steps:

  • Use online tools to stay updated
    For reliable and accurate information, please refer to sites such as World Health Organization. You can also find helpful advice on how to manage sick days on our website.

We hope this message gives you the clarity you need during this time of uncertainty. We truly appreciate the trust you place in us and thank you for continuing to give us the opportunity to support you. Please know that as this situation evolves, one thing will remain constant: Our decisions will be guided by our Mission and our collective commitment to the customers we serve.

Always by your side,
Medtronic MEA Diabetes Group

Ohad Cohen

ASK THE EXPERT PROFESSOR OHAD COHEN

Clinical Professor of Medicine and Director of Medical Affairs at Medtronic Diabetes EMEA, shares some of the most frequently asked questions on COVID-19 and its effect on type 1 diabetes.

Question

Publication are emphasising that diabetes is a risk factor for contracting the COVID-19 and suffering from complications.
What does it mean for persons with type 1 diabetes? Am I in danger?

  • What we need to remember is that COVID-19 is a new disease, and because it’s a new disease we don’t have detailed epidemiological information.
  • From what we have seen so far, it seems that people with diabetes are not at a higher risk in getting the disease.
  • When we are talking about complications, or having bad outcomes, we are referring to people with type 2 diabetes. People in this group are more likely to be hospitalised and suffer complications. It must be made clear that higher risk of complications in type 2 diabetes has always been there, even before COVID-19. People in this group are usually older, and have secondary diseases, such as heart and kidney disease, making them more vulnerable.
Question

I have type 1 diabetes. Should I consider taking any protective measures during this COVID-19 pandemic?

  • Everyone should be taking protective measures at this stage.
  • The virus can spread through droplets up to 1 metre 1. This is why everyone must keep a social distance of 1-2 metres 1,2.
  • I would also recommend wearing a face mask when you are around other people when possible. Please follow the regional recommedations as well.
  • The virus can stick to surfaces and clothing so washing your hands with soap is very important. Cleaning surfaces with >60% containing alcohol gels will also destroy the virus. You should follow the regional recommendation as well.
Question

Should I be expecting a change in my glucose control during COVID-19?

Yes, you can expect a change in glucose control. This pandemic has caused the closure of schools, academic centres and gyms. There is also a restriction on using parks. We have had to adapt to spending more time indoors. Our physical activity is reduced, our stress levels can increase, and our eating habits can change, all these factors influence our glucose levels.

WHAT I WOULD RECOMMEND:

  • Anticipate some decrease in glucose control
  • Create and stick to a routine
    Your routine should include regular mealtimes, rest time and exercise. You should avoid frequent snacking (especially carbs). If you need help in choosing healthy foods, consult your health care professional.
  • Adjust your therapy

    I would recommend adjusting the basal rate first. Many clinics have been adjusting to the current situation of limited travel and quarantine, by providing telemedicine services- if possible, connect with your healthcare professional in this way.

    For users of sensor augmented pumps such as MiniMedTM 640G system, I would recommend changing the insulin pump setting (with the supervision of your Health Care Professional, after looking at your current pattern for 3-4 days. Please allow some time for the changes to take effect. Until then, use correction boluses if needed. These correction boluses should also be taken into consideration when implementing the changes to your settings.

    When using MiniMedTM 670G system- let the algorithm correct glucose levels on daily basis and then periodically asses with your Health Care Professional to determine the need to adjust the pump settings. No need to exit Auto Mode, but, more frequent correction might be required while the algorithm is adapting to the new daily circumstances.

Question

What if I have COVID-19? How do I take care of my glucose levels?

What we need to remember is that most cases are mildly symptomatic. If you are COVID-19 positive, you need to assess how severe your symptoms are and act accordingly. Of course- always consult your medical care team.

  • If you have mild symptoms

    This may include having a fever, dry cough, loss of smell and taste senses, general ill feeling, such as loss of appetite, muscle aches. At this stage, you do not need to make major changes to your ongoing insulin routine. You should continue to follow your normal recommended insulin therapy. You should also count carbs, and bolus using the Bolus WizardTM for meals and corrections. Remember to drink lots of water and stay hydrated. You will need to monitor you blood glucose closely. Discuss immediately with your health care professional if you are taking non-insulin antidiabetic medications, notable SGLT-2 inhibitors and GLP-1 agonists.

  • Measure Ketones

    COVID-19, does not, usually, effect the gastrointestinal tract, but if you experience vomiting and diarrhoea measure ketones and follow the appropriate care. It might not be related directly to COVID-19.

  • If you have trouble breathing

    Rarely, mild cases can deteriorate rapidly into a respiratory disorder called ARDS. The two most common symptoms to look for are an increase in fever and shortness of breath (beyond the dry cough). In this case please seek immediate medical attention.

  • Make use of basal/ bolus regimens

    Right now, the medical facilities in your area may be functioning in an emergency mode. This may include reducing regular working times or closing a few services. This means your usual endocrinological consult service could be unavailable. It may also mean that the available treating staff may not be familiar with the device you are using. If this happens, please be prepared to carry out your back-up basal/bolus routines. If you do not have a basal/bolus routine, please consult your Health Care Professional.

 

We hope that this has answered some of questions you may have had on COVID-19 and its impact on diabetes management. You can also find useful tips on how to manage your diabetes on our website https://www.medtronic-diabetes-mena.com/en

  1. World Health Organization. Advice for public. April 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public [Accessed April 2020].
  2. Public Health England. Staying at home and away from others (social distancing). April 2020. https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others/full-guidance-on-staying-at-home-and-away-from-others [Accessed April 2020]