Effect of Covid-19 on people with diabetes 

During the pandemic and into the recovery phase, clinical services have been using well-grounded approaches to ensure the most appropriate care pathways are implemented for patients.

This includes risk stratification to prioritise appointments, the use of video A&E and clinics and support services made available to patients including website self-care content and a nurse-led helpline in case patients’ symptoms change.

This study aims to provide robust and timely information on the effects of treatment interruption for people with DMO and help guide future management.

Diabetic macular oedema (DMO) is a leading cause of visual impairment in diabetes. Early detection and timely treatment form the cornerstones of management, and help prevent permanent visual loss from this condition.

In the UK, people with DMO are routinely treated with periodic intra-ocular injections of anti­VEGF. This procedure works by helping to reduce abnormal fluid build-up caused by leaky blood vessels at the back of the eye.

Several clinical trials have confirmed the effectiveness of such advanced treatments. There is also some evidence to suggest that premature interruption to such treatment can lead to adverse consequences for vision among people with diabetes.

The Covid-19 pandemic caused significant - albeit temporary - disruption to routine clinical services across the UK, including monthly anti-VEGF injections for DMO.

Ranjan Rajendram and colleagues are investigating the effects of this disruption on the visual health of people living with diabetes. 

They will study individuals with DMO who were scheduled to have anti­VEGF injections but who had their treatment deferred due to the pandemic.

They have recruited over a third of the patients needed.

Patients will be assessed at their next clinical appointment and their vision will be assessed using standard clinical tools as well as advanced techniques of investigation such as optical coherence tomography – to visualise the back of the eye.

This study aims to provide robust and timely information on the effects of treatment interruption. It will also establish a strong, scientific rationale to help guide future management of individuals with DMO during extra-ordinary times.

These findings could help serve as a useful benchmark for future risk assessment strategies, enabling appropriate resource allocation and planning. This could in turn pave way for the development of novel clinical pathways of uninterrupted care for these at-risk individuals during pandemic periods - a model that may hold potential to be adapted to other routine clinical services in the NHS.