2019冠状病毒病封锁措施对1型和2型糖尿病患者血糖控制的影响：一项系统评价
Impact of COVID-19 lockdown on glycemic control in patients with type 1 and type 2 diabetes mellitus: a systematic review.
作者信息
Eberle Claudia, Stichling Stefanie
机构信息
Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda-University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany.
出版信息
Diabetol Metab Syndr. 2021 Sep 7;13(1):95. doi: 10.1186/s13098-021-00705-9.
BACKGROUND
In 2019, a new virus known as severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has emerged. Coronavirus disease 2019 (COVID-19) was classified as a pandemic in a short period of time. In order to reduce the spread of COVID-19, many countries have imposed a lockdown with movement restrictions, social distancing and home confinement, which has affected routine healthcare activities and everyday life. The aim of this systematic review was to examine the impact of the COVID-19 lockdown on glycemic control in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D).
METHODS
We systematically identified studies by searching the databases Cochrane Library, MEDLINE via PubMed, Web of Science Core Collection, EMBASE, and CINAHL until April 2021. We included n = 33 observational studies of which n = 25 investigated T1D and n = 8 T2D.
RESULTS
Overall, we analyzed n = 2881 T1D patients and n = 1823 T2D patients. Glycemic values in patients with T1D improved significantly during lockdown. Overall, n = 18 (72%) T1D studies indicated significant improvements in glycemic outcomes. Meta-analysis revealed a mean difference in HbA1c of - 0.05% (95% CI - 0.31 to 0.21) due to lockdown, and in time in range (TIR) of + 3.75% (95% CI 2.56 to 4.92). Lockdown determined a short-term worsening in glycemic values in patients with T2D. Overall, n = 4 (50%) publications observed deteriorations in glycemic control. Meta-analysis demonstrated a mean difference in HbA1c of + 0.14 (95% CI - 0.13 to 0.40) through the lockdown. Moreover, n = 3 (75%) studies reported a not significant deterioration in body weight.
CONCLUSIONS
Glycemic values in people with T1D significantly improved during COVID-19 lockdown, which may be associated with positive changes in self-care and digital diabetes management. In contrast, lockdown rather determined a short-term worsening in glycemic parameters in patients with T2D. Further research is required, particularly into the causes and effective T2D management during lockdown.
背景
2019年，一种名为严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）的新型病毒出现。2019冠状病毒病（COVID-19）在短时间内被列为大流行病。为了减少COVID-19的传播，许多国家实施了封锁措施，包括行动限制、社交距离和居家隔离，这影响了常规医疗活动和日常生活。本系统评价的目的是研究COVID-19封锁对1型糖尿病（T1D）和2型糖尿病（T2D）患者血糖控制的影响。
方法
我们通过检索Cochrane图书馆、通过PubMed检索的MEDLINE、科学网核心合集、EMBASE和CINAHL等数据库，系统地识别研究，直至2021年4月。我们纳入了n = 33项观察性研究，其中n = 25项研究调查了T1D，n = 8项研究调查了T2D。
结果
总体而言，我们分析了n = 2881例T1D患者和n = 1823例T2D患者。封锁期间，T1D患者的血糖值显著改善。总体而言，n = 18项（72%）T1D研究表明血糖结果有显著改善。荟萃分析显示，由于封锁措施，糖化血红蛋白（HbA1c）的平均差异为-0.05%（95%置信区间-0.31至0.21），血糖达标时间（TIR）的平均差异为+3.75%（95%置信区间2.56至4.92）。封锁导致T2D患者的血糖值短期内恶化。总体而言，n = 4项（50%）出版物观察到血糖控制恶化。荟萃分析表明，在整个封锁期间，HbA1c的平均差异为+0.14（95%置信区间-0.13至0.40）。此外，n = 3项（75%）研究报告体重无显著增加。
结论
在COVID-19封锁期间，T1D患者的血糖值显著改善，这可能与自我护理和数字糖尿病管理的积极变化有关。相比之下，封锁反而导致T2D患者的血糖参数短期内恶化。需要进一步研究，特别是关于封锁期间T2D的病因和有效管理。
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