key: cord-0861122-jud875xc authors: García-Villasante, Eilhart; Baca-Carrasco, Víctor; Gutierrez-Ortiz, Claudia; Pinedo-Torres, Isabel title: Diabetes care during COVID 19: Experience in telemedicine from a developing country date: 2020-08-04 journal: Diabetes Metab Syndr DOI: 10.1016/j.dsx.2020.07.046 sha: dd6e63e8cd731d9cd4d0c1d80754de4c31e6a990 doc_id: 861122 cord_uid: jud875xc nan Please cite this article as: García-Villasante E, Baca-Carrasco Ví, Gutierrez-Ortiz C, Pinedo-Torres I, Diabetes care during COVID 19: Experience in telemedicine from a developing country, Diabetes & Metabolic Syndrome: Clinical Research & Reviews (2020), doi: https://doi.org/10.1016/ j.dsx.2020.07.046. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Dear Editor, We have read with interest an article published in this journal (1) . The authors detail with accuracy the main telemedicine problems and most of them are being seen in our country. We work at Endocrinology department in a reference hospital in Perú which is in fifth position of confirmed cases of COVID 19 worldwide (2) . Our main concern is about diabetic patients because they are at major risk to get infected and develop severe forms of disease (3). The use of telemedicine in Peru is incipient. On March 2020, the Peruvian Ministry of Health stablish the official pathway for its implementation. Since then, teleconsultations have been developing slowly and not uniformly in the health centers. According to our national data, almost 60% of the population belongs to the lowest socioeconomic strata (4) and they gain less than 240 dollars per month, so many patients do not have smartphones and, if they do, are lacking technology skills. Therefore, some of them prefer to speak on regular cellphone line or even on landline which make difficult to see patients' expressions and use non-verbal communication. On this last point, gestures are a basic tool to express very useful thoughts for patients with few language skills or fear and insecurity to express their doubts. This aspect of communication can also be ignored in the different platforms used for teleconsultations, so health professionals should be trained in compensatory strategies to overcome the physical distance (5). Also, in the publication is not been considered the importance of the health institution creating systems for the safe delivery of medications avoiding COVID-19 infection. We coordinate with the insurance office and pharmacy department so that a family member can approach to receive the medications. Currently, we have a project in place to decentralize the delivery of medications to primary care centers where viral load by COVID 19 is lower. Pitfalls in telemedicine consultations in the era of covid 19 and how to avoid them Reported Cases and Deaths by Country, Territory, or Conveyance Risk factors for mortality in patients with coronavirus disease 2019 (covid-19) infection: a systematic review and meta-analysis of observational studies. The Aging Male. Available at: Taylor & Francis Online Informe Técnico: Evolución de la Pobreza Monetaria J o u r n a l P r e -p r o o f The authors declare no conflict of interest in this publication.