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Setting up a Tandem insulin pump. Image via DiabetesMine

As doctors are forced to cancel face-to-face appointments due to the COVID-19 outbreak, people are still starting on new diabetes devices, like continuous glucose monitors (CGMs) and insulin pumps.

But how will they get the setup help and training they need?

Not surprisingly, physicians and diabetes device trainers are turning to video conferencing, phone calls, and other creative methods for supporting new patients.

Traditionally, to start on a new insulin pump, Medicare required in-person office visits, but the federal rules have now been relaxed on allowing telemedicine due to COVID-19.

While the device companies are pretty much unanimous in stating that supply chains aren’t interrupted, some speed bumps have surfaced from third-party distributors in terms of shipment delays.

Some people with diabetes (PWDs) have also been sharing frustrations online about long wait times and delayed responses from both device-makers and health insurers (whose process is slow and cumbersome even in the best of times).

“We are still seeing new pump starts,” says Danielle Karsten, director of product marketing at Tandem Diabetes Care, which makes the t:slim pump and new connected Control-IQ automated insulin delivery system. “We’re still ramping up capacity for shipping products and supplies since our medical devices are considered ‘essential business.’”

Tandem is not alone. Here’s what we’re being told by various diabetes device companies about how they’re handling new and existing customers during the COVID-19 pandemic.

For the United Kingdom and Ireland, Roche decided in March to extend by 3 months all customer warranties for Accu-Chek Combo and Insight insulin pumps, which were due to expire before the end of June.

Recognizing that PWDs approaching the end of their insulin pump warranties often evaluate device choices and ask for guidance from their healthcare professionals, the company wanted to allow for more time in light of the COVID-19 crisis.

Extending warranties means they’ll continue providing needed repairs and customer service if a device isn’t working as it should.

In the United States, where Roche discontinued selling new insulin pumps in 2017 and handed off customer service to Medtronic Diabetes, the company tells DiabetesMine it’s providing free home delivery of its Accu-Chek glucose monitoring products via their online store.

Roche is also offering customers the mySugr Pro version of its mobile app for free from both iOS and Google Play stores.

Starting April 20, the Pro features can be unlocked with the special code 2020-2020-2020 via this website. That offer is valid until Sept. 30, 2020.

In mid-March, the San Diego–based national sales director for Tandem Diabetes issued an order for sales reps across the country to stop all face-to-face meetings of any kind — whether that be in clinics, with patients in their homes, or at another location.

Michigan regional sales manager Dan Boyle says, “As you probably know, the situation is constantly changing. We are doing many upgrade trainings for patients via FaceTime, Microsoft teams, etc. Every HCP/medical office has different protocols for training… many are holding off on new-to-pump trainings, but not all. It really depends on the patient’s ability to understand.”

Tandem’s corporate office shared a blog post updating customers, noting that “our business is continuing to fully operate” even while their teams are forced to work remotely.

“Our manufacturing and warehouse facilities continue to operate as normal, as healthcare operations are deemed critical by the state, so that we can provide products and supplies to Tandem customers around the world,” Boyle confirms.

Tandem also touts its “remote upgrades” program as a benefit during these difficult times.

To get the latest pump capabilities, existing users can simply go to their online device updater site and click through to update their device with no need to order new hardware or visit a doctor’s office.

In mid-March, Southern California–based Medtronic Diabetes instituted work from home (WFH) guidance until further notice for all of their clinical and field sales team.

This means all face-to-face interactions with healthcare providers and patients were shifted to remote options as much as possible.

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A patient learns to fill her Medtronic insulin pump reservoir for the first time. Getty Images

“As part of the healthcare community, serving patients and healthcare providers require us to remain fully operational to produce and deliver our products and services to those who need them,” Kim Larson, U.S. national clinical director for Medtronic Diabetes, tells DiabetesMine.

Their sales and clinical teams are supporting patients via video and phone calls with the help of physicians’ offices, we’re told. Specific examples include:

  • All patient trainings, one-on-one and group sessions, have been moved to a virtual format to include product onboarding, virtual demos, and troubleshooting.
  • They’re partnering with clinics and doctors’ offices to identify telehealth needs, i.e., when staff time is minimal and most valuable. The aim is to eliminate “fluff” and focus on what’s truly necessary for these settings: ensuring paperwork and prescriptions are handled efficiently and don’t disrupt a patient’s care, offering doctors’ offices how-to advice for making the most of virtual interactions, and having patients upload their pump/CGM data in advance.
  • Assisting with emergency supplies and offering financial assistance for patients in need.

The company has rolled out a newly updated website to help patients place supply orders and track their shipments, which also helps keep the sales and tech support phone lines open for more urgent care needs.

Medtronic Diabetes is also posting COVID-19 updates online, where they duly note: “While we are doing our best to minimize disruption, you may experience longer than normal wait times due to the increased volume of calls that we are experiencing.”

Clinical Director Larson says, “We’ve received several emails, texts, and calls from our customers and providers thanking our team for this level of support during this challenging time and helping them ‘manage the chaos and clinic flow through the disruption’ in these challenging times.”

Insulet, Massachusetts-based makers of the Omnipod tubeless insulin pump, is also following suit.

Employees have been working from home since mid-March, including their global IT department of more than 2,100 people, who’ve conducted thousands of online WebEx meetings in just the last few weeks.

Insulet tells us they’ve actually created and implemented a video-teleconferencing platform specifically for web-based training of Omnipod users across the world.

Through that platform, they offer trainings using secure WebEx video-conferencing for both patients and providers. Since this public health emergency reached crisis point in mid-March, Insulet has conducted more than 1,000 training sessions worldwide.

In addition, on April 16, Insulet announced an expansion of its U.S. financial assistance program for current Podders who’ve been affected by COVID-19.

Those who meet financial eligibility criteria can get up to a 6-month supply of products (60 Pods) free of charge. Details about that program are available by calling 800-591-3455. This program runs through Dec. 31, 2020.

There’s no doubt that all things healthcare-related bring new challenges during this unprecedented time. The point is that diabetes device manufacturers are “firing on all cylinders” to keep their pipelines moving and support customers.

Many PWDs have been sharing their experiences on social media about working to get onboarded with new diabetes tech — which seem to differ starkly by patient needs.

Longtime type 1 Sam Coffin in Vermont, for example, experienced a frustrating monthlong delay. He tells DiabetesMine he was set up to start on a new Tandem t:slim X2 with Control-IQ in early March. But as the public health emergency escalated and travel restrictions took effect nationwide, the three doctor appointments he’d scheduled were all canceled.

Coffin says he had never been on an insulin pump before. Since he was also dealing with severe stomach complications from diabetes for the past year, he needed his doctor’s approval and orders for basal rate and pump settings before he could start on Control-IQ.

Fortunately, by early April he was able to schedule virtual training with a Tandem rep and a follow-up with his doctor to set up Control-IQ. He’s been using it since.

On the other hand, Kelly Lynn Davis, a type 1 living in Northern California, says she was able to get her new Tandem system up and running by just reading the user manual online and watching YouTube videos for how-to instructions.

She had previously used a Medtronic MiniMed insulin pump for many years. She also works as an ER nurse, so Davis says she’s “experienced enough to manage without a training session.”

She’s also turned to the diabetes online community and Facebook groups to ask any remaining questions that came up as she got going with her new system. She says fellow PWDs have been incredibly helpful.

The takeaway seems to be that it’s possible to get started on new diabetes technology at this time, but as a patient you’ll have to be persistent.