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Diabetic foot

The COVID-19 pandemic has resulted in hospitals facing difficult challenges in delivering diabetic foot service to patients. In many cases, public health guidelines and the risk of virus transmission, have led to changes in their policies in regards to the support and management of patients with diabetic foot issues, including remote consultations.

The coronavirus outbreak has, in some cases, led to the suspension of routine clinical work as all healthcare resources are mobilised to fight the pandemic. A recent Italian study showed that people with diabetes admitted for diabetic foot ulceration during the COVID-19 lockdown in Italy had a more than 3-fold risk for amputation, versus patients seen in 2019.

Diabetic Foot Australia has developed a guide to support clinicians to consider key diabetic foot disease elements to assess the suitability, preparation, consultation and documentation needed to help ensure an effective telehealth consultation.

T1DM new presentations unchanged

On a more positive note, doctors from the Royal Children’s Hospital Melbourne and Monash Children’s Hospital, which manage about 80% of paediatric T1DM cases in Victoria, showed that there was no change in annual number of new presentations of T1DM in 2020 compared to previous years, with 58 cases recorded (although there had been an unexplained increase in numbers for the single year of 2019).

Similarly, they report no obvious change in the proportion of cases who presented with DKA (an indicator of the severity of T1D at presentation) or in the severity of DKA.

This is in contradiction to reports from Italy and the US, where teams have described delayed hospital presentations with severe diabetic ketoacidosis (DKA) at first presentation with T1DM during the COVID‐19 pandemic.