What could the longer impact of COVID-19 mean for people with diabetes?

18 June 2021
Delayed, cancelled and missed appointments are inevitable when the world is dealing with a pandemic.

From a protection perspective, the pandemic might have got more people thinking about their own mortality and making a discussion about protection more palatable, however the longer-term implications of missing what could have been an early diagnosis is still to be seen.

The long-term impact

In what might be the first UK-wide study to look at the indirect effects of the COVID-19 pandemic and Type 2 diabetes, a team of researchers from Manchester University have estimated there to have been 60,0001  missed or delayed diagnosis of Type 2 diabetes in the UK during 2020.

And this isn’t just linked to diabetes. Cancer Research UK have also recently published concerning figures which suggest around 350,0002 fewer referrals for Cancer symptoms than before lockdown.

The study by Manchester University has also highlighted a significant drop in the number of people with Type 2 diabetes attending regular diabetic clinics – a 77%drop in England and an 84%1 reduction in Scotland, Wales and Northern Ireland.

Despite the challenges the last 18 months have brought, such a large decrease in attendance at diabetic clinics is very concerning.

Despite the challenges the last 18 months have brought, such a large decrease in attendance at diabetic clinics is very concerning. Particularly because these clinics are most often where an individual’s Hba1c level is checked. This reading allows their GP to ascertain how the condition is being managed and chance to adjust medication doses if needed.

Why is an HbA1c test so important?

HbA1c is your average blood glucose (sugar) levels over a period of months, typically the last two to three. In medical lingo, it’s known as glycated haemoglobin. Glycated haemoglobin is produced when the glucose in your body attaches to your red blood cells. Because people with diabetes are unable to produce enough or sometimes any insulin to stabilise glucose levels within the body, more glucose starts to stick to the red blood cells. Over time if there's too much glucose in the blood, it can damage blood vessels leading to serious long-term health problems.

Where does protection fit in?

As people become more comfortable going back to their GP either face-to-face or virtually, it’s inevitable that we’re going to see the number of people being diagnosed with diabetes increase, possibly at a faster rate than pre-pandemic. When you consider that a huge portion of the UK already live with a diagnosis of Type 1 or Type 2 diabetes, estimated to be over 4.8 million3. That’s a lot of people who, at some point in time, might engage with an adviser and where there is a real need for protection. Thankfully, these days, most protection providers have taken steps to make protection accessible to clients who have chronic health conditions such as diabetes.

A huge portion of the UK already live with a diagnosis of Type 1 or Type 2 diabetes.

At Royal London we developed Diabetes Life Cover, which is a product designed specifically for people living with Type 1 and Type 2 diabetes.

The product offers Life Cover to your clients who have high HbA1c results, who might otherwise be subject to substantial loadings or declined elsewhere. Clients receive immediate acceptance through a simplified application process, and they can even see their premiums reduce over time if their HbA1c results improve.

Diabetes Life Cover during the pandemic

As the Manchester University research highlighted, many people with diabetes have found it difficult to attend their regular diabetic clinic during the pandemic which is why we introduced some temporary changes to make it easier for those applying for protection.

For new Diabetes Life Cover applications, a recent HbA1c reading (the results must be dated within the last 12 months) needs to be sent to us within three months of the plan starting. To give clients more flexibility we have extended the three-month window to six months.

To give clients more flexibility we have extended the three-month window to six months.

We’ve also relaxed the rules on the types of evidence we’ll accept when a client is disclosing their HbA1c results, meaning we will now accept an email from the clients GP, and/or a recorded phone call from the client advising what their GP has told them was their last HbA1c result alongside the date it was taken.

How can you provide extra support for diabetic clients?

For clients who have a Diabetes Life Cover policy and have found their HbA1c results have worsened, remember that while premiums can reduce if HbA1c results improve over time, they will never increase above the initial premium. So why not reach out to clients to remind them about how their policy works, it might even encourage them to look at ways of improving how they manage the condition.

While premiums can reduce if HbA1c results improve over time, they will never increase above the initial premium.

Added value benefits are a commonplace amongst protection providers these days, offering comprehensive tailored support, often these services can be accessed at any time during the policy term meaning clients don’t need to make a claim to benefit. So, if you’ve arranged protection policies for clients with diabetes, why not check if they have access to these valuable services.

Finally, as the 14–20 June was National Diabetes Awareness Week, I thought I’d finish with a reminder that if you, a member of your family, a friend or even a client appears to be experiencing symptoms linked to diabetes – think ‘4Ts’, that’s Toilet – frequent urination, Thirst – a unquenchable thirst, Tiredness, and Thinner – a sudden loss of weight, then they should make contact with their GP as soon as possible.

For more information on Diabetes Life Cover and Helping Hand please get in touch with your usual Royal London contact or visit our adviser website.

This article first appeared in COVER magazine.

Sources:
1 - Type 2 diabetes missed or diagnosis delayed for 60,000 UK people in 2020. Manchester University, 17 May 2021. Also "Impact of COVID-19 on diagnoses, monitoring and mortality in people with Type 2 diabetes in the UK" published in The Lancet Diabetes Endocrinology 2020, 13 August 2020.
2 - Cancer Research UK, What’s happened to cancer services during the COVID-19 pandemic?, September 11, 2020
3 - Diabetes.org, Number of people with diabetes hits 4.8 million, 2 October 2020.

About the author

Gregor Sked

Protection Development and Technical Manager

Gregor’s exposure to financial services began back in 2011. Most of his early career was spent at Standard Life where he was a presenter in the workplace pension engagement team. He joined Royal London in 2018 to spend more time on protection in the Intermediary market. Gregor is involved in developing adviser facing content, presenting, writing articles and commenting for the press. Gregor is also studying towards a Diploma in Financial Planning through the CII.

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