Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, U.K.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, U.K.
Diabetes Care. 2020 Aug;43(8):1695-1703. doi: 10.2337/dc20-1192. Epub 2020 Jun 16.
Evidence relating to the impact of COVID-19 in people with diabetes (PWD) is limited but continuing to emerge. PWD appear to be at increased risk of more severe COVID-19 infection, though evidence quantifying the risk is highly uncertain. The extent to which clinical and demographic factors moderate this relationship is unclear, though signals are emerging that link higher BMI and higher HbA to worse outcomes in PWD with COVID-19. As well as posing direct immediate risks to PWD, COVID-19 also risks contributing to worse diabetes outcomes due to disruptions caused by the pandemic, including stress and changes to routine care, diet, and physical activity. Countries have used various strategies to support PWD during this pandemic. There is a high potential for COVID-19 to exacerbate existing health disparities, and research and practice guidelines need to take this into account. Evidence on the management of long-term conditions during national emergencies suggests various ways to mitigate the risks presented by these events.
关于 COVID-19 对糖尿病患者（PWD）影响的证据有限，但仍在不断出现。PWD 似乎面临着更严重 COVID-19 感染的风险增加，尽管量化风险的证据非常不确定。临床和人口统计学因素在多大程度上调节这种关系尚不清楚，但有迹象表明，更高的 BMI 和更高的 HbA 与 COVID-19 相关的 PWD 预后更差有关。COVID-19 不仅对 PWD 构成直接的即时风险，而且由于大流行造成的干扰，包括压力和常规护理、饮食和身体活动的改变，也有可能导致糖尿病患者的病情恶化。各国在这一大流行期间使用了各种策略来支持 PWD。COVID-19 极有可能加剧现有的健康差距，研究和实践指南需要考虑到这一点。关于国家紧急情况下管理长期疾病的证据表明了各种减轻这些事件带来的风险的方法。
