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1. Digitally enabled flash glucose monitoring for inpatients with COVID-19: Feasibility and pilot implementation in a teaching NHS Hospital in the UK

Author

Tim Robbins, Adam Hopper, Jack Brophy, Elle Pearson, Risheka Suthantirakumar, Maariyah Vankad, Natalie Igharo, Sud Baitule, Cain CT Clark, Theodoros N Arvanitis, Sailesh Sankar, Ioannis Kyrou, and Harpal Randeva

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Abstract

Background COVID-19 placed significant challenges on healthcare systems. People with diabetes are at high risk of severe COVID-19 with poor outcomes. We describe the first reported use of inpatient digital flash glucose monitoring devices in a UK NHS hospital to support management of people with diabetes hospitalized for COVID-19. Methods Inpatients at University Hospitals Coventry & Warwickshire (UHCW) NHS Trust with COVID-19 and diabetes were considered for digitally enabled flash glucose monitoring during their hospitalization. Glucose monitoring data were analysed, and potential associations were explored between relevant parameters, including time in hypoglycaemia, hyperglycaemia, and in range, glycated haemoglobin (HbA1c), average glucose, body mass index (BMI), and length of stay. Results During this pilot, digital flash glucose monitoring devices were offered to 25 inpatients, of whom 20 (type 2/type 1: 19/1; mean age: 70.6 years; mean HbA1c: 68.2 mmol/mol; mean BMI: 28.2 kg/m 2 ) accepted and used these (80% uptake). In total, over 2788 h of flash glucose monitoring were recorded for these inpatients with COVID-19 and diabetes. Length of stay was not associated with any of the studied variables (all p-values >0.05). Percentage of time in hyperglycaemia exhibited significant associations with both percentage of time in hypoglycaemia and percentage of time in range, as well as with HbA1c (all p-values

Published
2022
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2. Impact of the COVID-19 pandemic on neuroendocrine tumour services in England

Author

Eilish Pearson, Harpal S. Randeva, Thomas M. Barber, Gregory Kaltsas, Martin O. Weickert, Tim Robbins, Ioannis Kyrou, and Adam Hopper

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Service delivery framework, media_common.quotation_subject, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Health Services Accessibility, Centres of Excellence, RC0254, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Virtual patient, Neuroendocrine tumours, Belgium, Excellence, Surveys and Questionnaires, Pandemic, Epidemiology, medicine, Humans, Israel, Surgical treatment, Pandemics, media_common, Netherlands, Greece, business.industry, SARS-CoV-2, COVID-19, Service disruption, Neuroendocrine tumour, Neuroendocrine Tumors, England, Italy, 030220 oncology & carcinogenesis, Family medicine, Original Article, France, business, RA, Delivery of Health Care, RC
Abstract

Purpose During the COVID-19 pandemic, there have been particular concerns regarding the related impact on specialist tumour services. Neuroendocrine tumour (NET) services are delivered in a highly specialised setting, typically delivered in a small number of centres that fulfil specific criteria as defined by the European Neuroendocrine Tumour Society (ENETS). We aimed to address the COVID-19-related impact on specialist NET tumour services in England and other countries. Methods Electronic survey addressing patient access and delivery of care distributed to all ENETS Centres of Excellence (CoE) in England and matching number of ENETS CoE elsewhere. Semi-quantitative and qualitative analyses of survey responses were performed. Results Survey response of ENETS CoE in England was 55% (6/11). Responses from six non-UK ENETS CoE elsewhere were received and analysed in a similar manner. Relevant disruption of various NET services was noted across all responding Centres, which included delayed patient appointments and investigations, reduced availability of treatment modalities including delayed surgical treatment and a major negative impact on research activities. The comparison between English and non-UK ENETS CoE suggested that the former had significantly greater concerns related to future research funding (p = 0.014), whilst having less disruption to multidisciplinary meetings (p = 0.01). A trend was also noted towards virtual patient appointments in ENETS CoE in England vs. elsewhere (p = 0.092). Conclusions Restoration of highly specialised NET services following COVID-19 and planning for future service delivery and research funding must take account of the severe challenges encountered during the pandemic.

Published
2021

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