PATIENTS with diabetes have revealed fears for their sight as screening services were cut and how the risk of Covid left them too scared to go to hospital.
In the first study to evaluate the experiences of people in Scotland with Type 1 diabetes during the pandemic, researchers at Glasgow University heard how lockdown “led to changes to their usual activities and foods”.
A blog summarising of the findings so far states: "Some of those we spoke to described how this led to fluctuations in their blood glucose levels which they struggled to contain.
"Some increased their insulin consumption, but others accepted higher levels, preferring not to risk hypoglycaemia [a potentially dangerous drop in blood sugar] at a time when they feared the potential consequences of hospitalisation."
The preliminary findings have been shared with the Scottish Government's Chief Scientist Office, who funded the study.
Dr Chris Bunn, a sociologist specialising in chronic long-term conditions who is leading the research and authored the blog, told the Herald he was shocked by some of the testimonies.
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This included a patient who was worried that diabetes-related eye and nerve complications were "no longer being monitored, telling me that they feared this leading to preventable damage being missed".
A study from Italy found that foot amputations as a result of diabetic foot ulcers had tripled during the pandemic compared to 2019, but no similar data is currently available for the Scotland or the UK.
“It is a truly astonishing figure," said Dr Bunn. "I see this kind of finding as a warning sign.
"All of these patients spend a lot of time in their medical encounters being told how important it is to monitor themselves carefully, to have all of the check ups put in place annually to make sure that various complications aren’t coming or getting worse.
“But now all of that provision has just been dropped. The checks aren’t there.
"That creates a lot of anxiety for patients."
Research from Public Health Scotland indicates that diabetes was the main underlying condition for 4% of patients (170 people) who had died from Covid by the end of August.
Between March 16 and June 21, the rate for diabetes-related deaths in Scotland was also 33% higher than in previous years.
So far researchers have interviewed 15 Type 1 diabetics, but aim to speak to ten to 15 more after being surprised by the "huge number" of participants who came forward desperate to share their frustrations.
All but one interviewee told researchers they had been offered no access to a remote consultation via telephone or video or given information on how to access care if needed, with most also saying their specialist appointments "have been cancelled and no new appointment date has been provided".
Two had been due to receive insulin pumps, but the procedures to fit them were halted amid lockdown measures.
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"What we’re hearing in these interviews is that people are making trade-offs," said Dr Bunn.
"They’re having to work out if they’re more concerned about Covid or potentially losing their eyesight, for example.
“There’s been a lot of frustration: with clinicians, the Government, diabetes charities.
"Patients feel that not enough is being done to help them understand what they should do in relation to these risks.
"Their routine care - all of the things that are put in place to make sure people with diabetes don’t get the worst kinds of complications - have been pulled, without any follow up or reassurance from the service providers."
Dr Bunn added: "The epidemiological data for the UK isn't there yet, but I do expect that in the coming year we'll start to see the impact of complications and avoidable conditions - I think that's next.
"Not just in relation to diabetes, but other chronic conditions."
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Angela Mitchell, national director at Diabetes Scotland, said: “People living with Type 1 diabetes face daily challenges as they navigate the careful balancing act of managing their condition well and reducing their risk of serious complications.
"We know that people with diabetes are more likely to experience anxiety and depression and with the coronavirus pandemic throwing even more uncertainty into the mix, people will understandably feel even more stressed and anxious.
“The NHS is open and it’s vital that people with diabetes access healthcare support when needed.
"While screening appointments have been disrupted, if people are feeling unwell or notice new symptoms of complications, they should seek medical advice as soon as possible.
"Our Diabetes UK helpline is also available Monday to Friday 9am-6pm on 0345 123 2399 or email helpline@diabetes.org.uk if anyone would like to chat about any diabetes related issues."
Ms Mitchell said she hoped diabetes services would be redesigned "to include making video and telephone healthcare appointments more readily available across Scotland".
A Scottish Government spokeswoman said: “We recognise the challenges faced on a daily basis by people living with Type 1 and Type 2 Diabetes. Their safety and the continued provision of care and treatment remain a priority for the Scottish Government and NHS Scotland.
“The NHS in Scotland is currently dealing with an unprecedented health situation that has meant that some scheduled procedures and care have had to be postponed.
"We keep all clinical guidance under review including our Coronavirus (COVID-19) guidance which offers tailored advice for people living with diabetes and includes important information about how COVID-19 might affect those with the condition.
"If anyone with diabetes has any concerns about their condition, they should contact their GP or their diabetes clinical team.
"They will be able to provide specific advice and support based on their individual circumstances."
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