Virtual consultations: are we missing anything?

The COVID-19 pandemic has resulted in a rapid transfer of most diabetes care from face to face clinics to virtual consultations, and in general the response from people with diabetes and health professionals is positive. Advantages include saving time, travel and time off work. Disadvantages relate mainly to technological barriers but include increased difficulty in recognising and addressing emotional distress if non-verbal clues are lost. People report that there is more focus on glucose levels and in this sense the consultations are more ‘efficient’. However, emotional issues may be more difficult to identify, particularly if the consultation is phone-based. Diabetes distress and other diabetes-related psychological issues are well recognised but people may be wary about discussing them remotely with a health care professional. To address this, the consultation should focus on the agenda of the person with diabetes, in particular life events or emotional difficulties that may be a barrier to good glucose control. Virtual consultations are certain to become a mainstay of future diabetes care but will not be suitable for everyone. First meetings should be face to face wherever possible to establish rapport; continuity of care is essential to maintain this. Access to technology, safeguarding issues and personal preference all influence suitability for virtual follow up. Training should be offered to diabetes professionals to help them get the most out of a virtual consultation. Copyright © 2020 John Wiley & Sons.