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新冠疫情时代糖尿病和肥胖患者的管理:来自南欧、东欧、中东和非洲的经验与教训。

Management of patients with diabetes and obesity in the COVID-19 era: Experiences and learnings from South and East Europe, the Middle East, and Africa.

机构信息

Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

Department of Diabetes, Endocrine and Metabolism, Internal Medicine, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.

出版信息

Diabetes Res Clin Pract. 2021 Feb;172:108617. doi: 10.1016/j.diabres.2020.108617. Epub 2020 Dec 10.

Abstract

The COVID-19 pandemic has had a major effect on healthcare during 2020. Current evidence suggests that, while individuals with diabetes and obesity are no more prone to SARS-CoV-2 infection than those without, the risk of hospitalisation if someone has diabetes or obesity and then contracts COVID-19 is three times higher - and 4.5 times higher if they have diabetes and obesity. We assembled a panel of experts from South and East Europe, the Middle East, and Africa to discuss the challenges to management of diabetes and obesity during and post the COVID-19 pandemic. The experience and learnings of this panel cover a heterogeneous patient population, wide range of clinical settings, healthcare organisations, disease management strategies, and social factors. We discuss the importance of timely and effective disease management via telemedicine, providing reassurance and guidance for patients unable or unwilling to visit healthcare settings at this time. We address the use of novel therapies and their role in managing diabetes and obesity during the pandemic, as well as the importance of controlling hypoglycaemia and preventing cardiovascular complications, particularly in vulnerable people. Finally, we consider post-COVID-19 management of diabetes and obesity, and how these learnings and experiences should impact upon future clinical guidelines.

摘要

2020 年,COVID-19 大流行对医疗保健产生了重大影响。目前的证据表明,虽然糖尿病和肥胖症患者与非糖尿病和肥胖症患者相比,感染 SARS-CoV-2 的风险并无增加,但如果糖尿病或肥胖症患者感染 COVID-19 ,其住院风险则增加了两倍 - 如果同时患有糖尿病和肥胖症,住院风险则增加了四倍。我们召集了来自南欧、东欧、中东和非洲的专家小组,讨论 COVID-19 大流行期间和之后管理糖尿病和肥胖症的挑战。该小组的经验和教训涵盖了异质的患者人群、广泛的临床环境、医疗保健组织、疾病管理策略和社会因素。我们讨论了通过远程医疗进行及时有效的疾病管理的重要性,为此时无法或不愿前往医疗机构的患者提供安慰和指导。我们还探讨了新型疗法的应用及其在大流行期间管理糖尿病和肥胖症的作用,以及控制低血糖和预防心血管并发症的重要性,特别是在弱势群体中。最后,我们考虑了 COVID-19 后的糖尿病和肥胖症管理,以及这些经验教训应如何影响未来的临床指南。

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