Diabetes Metab J > Volume 44(2); 2020 > Article
Won and Yoon: The Outbreak of COVID-19 and Diabetes in Korea: “We Will Find a Way as We Have Always Done”
..Do not go gentle into that good night. Rage, rage against the dying of the light... - from the movie ‘Interstellar
In this period of COVID-19 pandemic, numerous patients with COVID-19 have occurred in Daegu area, South Korea. However, thanks to the outstanding medical system and great effort of the Korean government, mortality rate is remarkably lower than those of other countries; under 2% [1,2].
Last February, Korean Diabetes Association (KDA) has announced the guidelines to prevent COVID-19 particularly for the diabetic patients with diabetes. Moreover, we have aided medical equipment including anti-contaminating cloths, glucometers, and strips equivalent to 35,000 US dollars to Daegu-Gyeongbuk providence where patients were rapidly soaring. Also, we are planning to hold the 33th KDA symposium through the virtual meeting in South Korea with world's best information and communications technology infrastructure.
Although it is a well-known fact that the patients with diabetes are included in high risk group for COVID-19 infection with high mortality and morbidity rate [3]. In fact, doctors and the government are not paying enough attention to those patients. Given this situation, KDA is offering some proposals for the patients with diabetes who can't afford to visit hospitals.
First of all, we advise them to receive consultation and prescriptions through tele-communication until the development of the right drug to cure COVID-19 and vaccine for COVID-19. In this special COVID-19 pandemic environment, traditional way of healthcare through face-to-face contact so called analogue healthcare system might have a lot of problems. It increases a chances of COVID-19 infection during clinic and hospital visit for only simple consultation or prescription refills and could not cover the patient's and physician's needs. Modern digital healthcare system can provide patients, family members, and healthcare professionals with support during COVID-19 pandemic [4]. Psychological symptoms associated with the pandemic include anxiety-driven panic buying, paranoia about going to community events and fears coming from isolation. These describe how the pandemic can affect people's mental health and how digital healthcare system can decrease patients' COVID-19 related issues without increasing risk of infection of the coronavirus.
Fortunately, Korean government permitted and recommended tele-health to get prescriptions for diabetic patients, and the chronic disease management reimbursement pilot project (reimbursement for the mobile monitoring and coaching for chronic disease patients in primary care clinics from the national health insurance) had been launched already since 2018. However, this pilot project only focuses on monitoring the patient's blood pressure and glucose and then discussing patient's problems by telephone call, SNS, or e-mail. Although there are already advanced digital technologies for monitoring patient's blood pressure, glucose level, pulse, temperature, activity tracking, oxygen saturation, and so on, those technologies appropriately in real clinical practice settings could not be adopted because of the various conservative regulations in the medical field, unreasonable compensation plan for the physicians, absence of clear regulations of legal responsibilities for the physician's recommendations and unclear national blueprint for the digital healthcare in future. However, all the current situations clearly show that immediate changes of analogue healthcare systems into digital systems will help overcome the COVID-19 and other pandemic crises with perspectives to build up best healthcare systems for patients.
Secondly, for the better management of COVID-19 in patients with diabetes, that consist nearly 10% to 20% of the entire population, medical communities and the government will consistently have further discussions on this matter.
KDA is always willing to support patients with diabetes who need help, who are going through difficult times.

NOTES

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

REFERENCES

1. COVID-19 National Emergency Response Center. Epidemiology and Case Management Team. Korea Centers for Disease Control and Prevention. Coronavirus disease-19: the first 7,755 cases in the Republic of Korea. Osong Public Health Res Perspect 2020;11:85-90.
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2. Song JY, Yun JG, Noh JY, Cheong HJ, Kim WJ. COVID-19 in South Korea: challenges of subclinical manifestations. N Engl J Med 2020 4 06 [Epub].
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3. Ha E, Kim N, Moon JS, Lee Y, Choi EY. Acute hyperglycemic crises with coronavirus disease-19 (COVID-19): case series. Diabetes Metab J 2020;44:349-353.
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4. Keesara S, Jonas A, Schulman K. COVID-19 and health care's digital revolution. N Engl J Med 2020 4 02 [Epub].
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Kun Ho Yoon
https://orcid.org/0000-0002-9109-2208

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