Much has changed since our last newsletter. COVID-19 has changed everything in our world. And diabetes has emerged as being a significant risk factor for doing poorly with the disease. However, the good news is that well controlled diabetes is much less of a risk than poorly controlled diabetes. People with access to healthcare and the ability to stay home and safe, practicing social distancing, hand washing and wearing masks are doing well. Even with the sudden switch from in-person to telemedicine visits I believe I can keep each of my Westside patients appropriately treated and protected from harm, at least from diabetes worsening COVID-outcomes.


Personally, I have come to enjoy telemedicine visits because I still get to interact with all of you, in just a slightly different format. I believe that it keeps us safer, reducing unnecessary visits to a medical facility. In Los Angeles County our rates of hospitalization for COVID are increasing (we are not seeing the end of the “first wave”, in fact an increase) so we all need to avoid exposure as much as possible. Personally, out of a concern for safety for all, I plan on doing primarily telemedicine visits until we have a vaccine or effective treatment for COVID-19.


However, there are some caveats.  First, our office is open for blood drawing, A1C measurements, vaccinations (obviously not COVID), etc. Dr. Orrange does in-person primary care appointments. I will be available to see people in-person every Monday if there is a reason that a telemedicine visit won’t work. We have very strict infection-control standards in the office and all visits must be scheduled in advance. Everyone is expected to wear a mask.


If you need your labs drawn we can do it in the office or I can send a request to Quest or Lab Corps. This is very simple to do (thanks to COVID). I send in the order electronically and receive the result on-line. All you have to do is make an appointment to have your blood drawn.


To prepare for your telemedicine appointment it is important that you have downloaded all your device data to the Cloud—whether it is to Tidepool, LibreView, Clarity, Tandem or some other system. That way we can review the data together and make treatment decisions, just like we do it in-person.  For many of you, who don’t normally wear a device, I am prescribing a Libre continuous glucose monitor that you can get from your pharmacy which allows you and I to both get BETTER than usual data on your diabetes control (another positive about COVID).


Heartbreakingly COVID-19 has worsened health care disparities throughout Los Angeles to a level I never imagined possible. I have worked in underserved communities throughout my career and have never seen such suffering, both from the virus and well as its economic fallout. I have not stopped physically going to work in East LA (the epicenter for COVID-19 in Los Angeles County) once weekly, because those patients lack the smart phones and computers needed for effective telemedicine. We are working hard to create systems to provide them better remote care.


We need to work to help each other through this crisis, which isn’t going away anytime soon. It is incredibly gratifying to see how well my Westside patients are all doing, because it is possible to stay safe even though I know there are challenges for each of us. However, now, more than ever we need to help those less fortunate, who are being hospitalized for COVID and dying due to a wide range of causes, diabetes among them.


Please stay safe and know that I am here to help.




Message from the Director