Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
IRCCS MultiMedica, Milan, Italy.
J Diabetes Complications. 2020 Sep;34(9):107671. doi: 10.1016/j.jdiacomp.2020.107671. Epub 2020 Jul 6.
The COVID-19 pandemic has added an enormous toll to the existing challenge of diabetes care world-wide. A large proportion of patients with COVID-19 requiring hospitalization and/or succumbing to the disease have had diabetes and other chronic conditions as underlying risk factors. In particular, individuals belonging to racial/ethnic minorities in the U.S. and other countries have been significantly and disproportionately impacted. Multiple and complex socioeconomic factors have long played a role in increasing the risk for diabetes and now for COVID-19. Since the pandemic began, the global healthcare community has accumulated invaluable clinical experience on providing diabetes care in the setting of COVID-19. In addition, understanding of the pathophysiological mechanisms that link these two diseases is being developed. The current clinical management of diabetes is a work in progress, requiring a shift in patient-provider interaction beyond the walls of clinics and hospitals: the use of tele-medicine when feasible, innovative patient education programs, strategies to ensure medication and glucose testing availability and affordability, as well as numerous ideas on how to improve meal plans and physical activity. Notably, this worldwide experience offers us the possibility to not only prepare better for future disasters but also transform diabetes care beyond the COVID-19 era.
COVID-19 大流行给全球糖尿病护理带来了巨大挑战。很大一部分需要住院治疗和/或因该疾病而死亡的 COVID-19 患者都患有糖尿病和其他慢性疾病作为潜在的风险因素。特别是,美国和其他国家的少数族裔个体受到了显著且不成比例的影响。多种复杂的社会经济因素长期以来一直是增加糖尿病风险的因素,现在也是 COVID-19 的风险因素。自大流行开始以来,全球医疗保健界在 COVID-19 环境下提供糖尿病护理方面积累了宝贵的临床经验。此外,人们对将这两种疾病联系起来的病理生理机制的理解也在不断发展。目前的糖尿病临床管理仍在不断发展,需要在诊所和医院之外改变医患互动方式:在可行的情况下使用远程医疗、创新的患者教育计划、确保药物和血糖测试可用性和可负担性的策略,以及许多关于如何改善膳食计划和体育活动的想法。值得注意的是,这种全球范围内的经验不仅使我们有可能为未来的灾难做好更好的准备,而且还使我们有可能在 COVID-19 时代之后改变糖尿病护理。