key: cord-0888740-29z5fvyi
authors: Elnaem, Mohamed Hassan; Cheema, Ejaz
title: Caring for patients with diabetes during COVID-19 pandemic: Important considerations for pharmacists
date: 2020-05-31
journal: Res Social Adm Pharm
DOI: 10.1016/j.sapharm.2020.05.030
sha: 0c519711f10d18ebe51567550bc92e592c88991a
doc_id: 888740
cord_uid: 29z5fvyi

The current pandemic of the COVID-19 infection, coupled with the increased global burden of diabetes, has imposed significant challenges to the healthcare providers in providing effective and sustained care to patients with diabetes care during the ongoing pandemic. It is, therefore, important for healthcare providers to understand and follow the recommended changes in the delivery of care, lifestyle modifications, and pharmacotherapy to ensure optimal care to the patients during and post-pandemic era. This commentary aims to discuss the impact of COVID-19 on diabetes care and the important considerations for pharmacists during this pandemic.

At the time of intercurrent illness, patients with diabetes are at a higher risk of developing 24 hyperglycemia and therefore, more prone to the development of dehydration, diabetic 25 ketoacidosis (DKA) or Hyperosmolar hyperglycemic state (HHS). 4 Consequently, 26 pharmacists need to educate patients to help them manage these symptoms. The pharmacists' 27 support is crucial for the patients in reducing their risk of developing acute complications and 28 associated hospital admissions. The majority of clinical guidelines endorse metformin as a first choice antidiabetic due to its 44 efficacy, lower hypoglycemia risk, and medication-induced weight loss. 7 Nevertheless, the Gliclazide is known to be associated with the risk of hypoglycemia, particularly in case of 54 poor appetite, so a dose reduction should be considered. 6 However, as hyperglycemia is more with the use of GLP-1 receptor agonists. However, recent evidence from a meta-analysis did 96 not support any increased risk among patients with type 2 diabetes. 16 Nevertheless, patients 97 should be adequately educated to recognize the associated symptoms that are also 98 overlapping with DKA clinical presentation. 4 As such, if DKA or pancreatitis is suspected, 99 this medication should be discontinued, and patients should be referred to seek medical 100 consultation. 

Pharmacists-led support for patients with diabetes in the post-pandemic era 144 Pharmacy professionals are critical in the preparation of an optimal response to the COVID-145 19 pandemic. 24 The following recommendation can help pharmacists deliver effective care to 146 patients with diabetes during and post-COVID-19 era. 

GLP-1 receptor agonists and pancreatic safety concerns in 230 type 2 diabetic patients: data from cardiovascular outcome trials. Endocrine. February on the clinical, humanistic and cost outcomes of high-risk patients with type 2 diabetes 274 (IMPACT): a randomized controlled trial

The influence of pharmacist-led adherence support on 277 glycaemic control in people with type 2 diabetes