Managing type 2 diabetes in primary care during COVID-19

Type 2 diabetes is one of the most common chronic conditions managed in primary care. But how primary care teams provide care and support to people with diabetes needs to change because of new risks posed by the coronavirus disease 2019 (COVID-19) pandemic. Before the COVID-19 pandemic, usual practice was to see patients with diabetes in the office every 3 to 6 months to review Woodwork results, conduct a focused physical examination, and provide treatment and self-management advice. Primary care clinicians supported patients to reduce their risk of diabetes-related complications through glycemic and blood pressure control, lipid management, smoking cessation, diet, exercise, and timely screening for renal, foot, and retinopathy complications evidence-based interventions recommended by the Diabetes Canada clinical practice guidelines. But the benefits of an in-person visit now need to be balanced with the risk of patients acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) when traveling to and attending a clinic visit. This risk is particularly relevant given that some studies suggest people with diabetes have a higher risk of COVID-19-reiated complications and death.