Over 31 million people are living with diabetes in the International Diabetes Federation (IDF) South and Central America (SACA) Region, which includes 20 countries and territories. These countries have not been spared by the COVID-19 pandemic and, like in other parts of the world, various restrictive measures have been put in place by the national authorities to prevent the spread of the virus.
People with diabetes and health professionals in the region have been impacted in many ways. We asked IDF SACA Region Chair, Dr. Douglas Villarroel to share his insights on what the impact has been and how, in the longer term, COVID-19 will shape the lives of people with diabetes and health professionals in the region.
What has been the impact of COVID-19 on people living with diabetes in your region?
We do not currently know the number of people with diabetes who have contracted COVID-19. What we do know is that many have been infected and are currently dying. People with diabetes are feeling anxious at the risk of contracting the virus and its potentially serious consequences, which they are more vulnerable to. As a result, they are not doing their regular check-ups due to the lockdown measures. There is uncertainty regarding how they will be able to connect with their doctor and whether it is safe to go to a health clinic. People with diabetes complications have been the most affected because of the lack of care provided by hospitals and health clinics. The priority is COVID-19, not diabetes, and the most affected have been people with chronic complications, particularly those with diabetic foot and requiring dialysis. In the SACA region, COVID-19 has particularly affected the elderly and vulnerable, but many cases have also been recorded in young people.
What has been the impact of COVID-19 on diabetes health professionals in your region?
From a personal point of view, it has been complicated not being able to go to my practice, welcome my patients and establish a physical contact with them. The impact of COVID-19 on diabetes health professionals has been significant. From one moment to the next, health professionals have had to close their offices and hospitals have had to focus on the virus. Therefore, most health professionals have had to reinvent themselves, providing care by video call. Many are doing online courses and making educational videos through diabetes associations. The management of people with diabetes at higher risk, or with less optimal control is what worries us most, since they are not receiving the regular procedures that are important to prevent complications. For example, laser treatment for diabetic retinopathy or catheterization for people with cardiovascular complications.
How have national authorities responded to the situation?
With some exceptions, the response of national authorities has been insufficient at the start and improving later. There have been many deficiencies, particularly in the health system, in terms of personal protective equipment, the number of artificial ventilators in hospitals and the number of COVID-19 tests to be carried out. On the other hand, the economic impact on countries in the region has been significant, with thousands of people lacking sufficient food. This is getting worse as the lockdowns continue, with no signs of improvement in most countries.
How has the pharmaceutical industry and civil society responded?
The response of the pharmaceutical industry in the region has been virtually none. We have not seen a reduction in the prices of diabetes medicines and supplies. What we have seen is the engagement of IDF SACA members. They have reached out to their members and the wider society with educational materials, informing people with diabetes about the risks of the virus and how they should look after themselves and manage their diabetes at home. This has been very important.
What do you think will be the longer-term impact of the COVID-19 pandemic on people with diabetes and health professionals?
I think we are going to see an increase in acute and chronic complications among people with diabetes. This is due to the current lack of timely care for their complications, resulting from the fear of visiting health clinics because of COVID-19. I also think that the way health professionals and their patients interact will change, at least until there is a vaccine for COVID-19. Telemedicine will continue to develop and become more widespread and I believe we will continue to practice physical distancing.
Another very important concern is that COVID-19 will result in communicable diseases getting even more attention, putting non-communicable diseases (NCDs) like diabetes in the shadows. It is important not to forget that NCDs are a global pandemic as well, impacting every country. Therefore, we must continue to give them the required attention and funding.
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