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2019年冠状病毒病封锁措施对1型糖尿病患者血糖控制的影响。

Impact of lockdown in COVID 19 on glycemic control in patients with type 1 Diabetes Mellitus.

作者信息

Verma Anjali, Rajput Rajesh, Verma Surender, Balania Vikas K B, Jangra Babita

机构信息

Department of Pediatrics, PGIMS, Rohtak, India.

Department of Endocrinology, PGIMS, Rohtak, India.

出版信息

Diabetes Metab Syndr. 2020 Sep-Oct;14(5):1213-1216. doi: 10.1016/j.dsx.2020.07.016. Epub 2020 Jul 13.

Abstract

BACKGROUND AND AIMS

COVID 19 is a novel pandemic affecting globally. Although no reliable data suggests that patients of well controlled Type 1 Diabetes Mellitus (T1DM) being at increased risk of becoming severely ill with SARS-CoV2, but lockdown may impact patients with T1DM requiring regular medications and follow up. Hence this study was planned to see the impact of lockdown on glycemic control in patients with T1DM.

METHODS

A cross sectional study was done in T1DM patients in whom a structured questionnaire was administered on follow up within 15 days after lockdown. Data regarding hypoglycemic and hyperglycemic episodes, Diabetic ketoacidosis (DKA), insulin dose missed, regular glucose monitoring, dietary compliance, physical activity, hospitalization during the phase of lockdown was taken. Average blood glucose and HbA1C of lockdown phase was compared with the readings of prelockdown phase.

RESULTS

Out of 52 patients, 36.5% had hyperglycemic and 15.3% had hypoglycemic episodes. Insulin dose was missed in 26.9%, glucose monitoring not done routinely in 36.5% and 17.4% were not diet compliant during lockdown. Average blood glucose during lockdown phase was 276.9 ± 64.7 mg/dl as compared to 212.3 ± 57.9 mg/dl during prelockdown phase. Mean HbA1c value of lockdown (10 ± 1.5%) which was much higher that of pre lockdown (8.8 ± 1.3%) and the difference was statistically significant (p < 0.05).

CONCLUSION

Glycemic control of T1DM patients has worsened mainly due to non availability of insulin/glucostrips during lockdown period. There is a need for preparedness in future so that complications can be minimised.

摘要

背景与目的

2019冠状病毒病(COVID-19)是一场影响全球的新型大流行病。虽然没有可靠数据表明,病情得到良好控制的1型糖尿病(T1DM)患者感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)后患重病的风险会增加,但封锁措施可能会影响需要定期用药和随访的T1DM患者。因此,本研究旨在观察封锁措施对T1DM患者血糖控制的影响。

方法

对T1DM患者进行了一项横断面研究,在封锁措施实施15天内随访时,向患者发放了一份结构化问卷。收集了有关低血糖和高血糖发作、糖尿病酮症酸中毒(DKA)、错过的胰岛素剂量、定期血糖监测、饮食依从性、身体活动以及封锁期间住院情况的数据。将封锁阶段的平均血糖和糖化血红蛋白(HbA1C)与封锁前阶段的读数进行比较。

结果

在52例患者中,36.5%出现高血糖发作,15.3%出现低血糖发作。26.9%的患者错过胰岛素剂量,36.5%的患者未常规进行血糖监测,17.4%的患者在封锁期间饮食不依从。封锁阶段的平均血糖为276.9±64.7mg/dl,而封锁前阶段为212.3±57.9mg/dl。封锁阶段的平均HbA1c值为(10±1.5%),远高于封锁前(8.8±1.3%),差异具有统计学意义(p<0.05)。

结论

T1DM患者的血糖控制恶化,主要原因是封锁期间无法获得胰岛素/血糖试纸。未来需要做好准备,以便将并发症降至最低。

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