Ramalho Diogo, Rouxinol-Dias Ana, Tavares Patrícia, Correia Sara, Almeida Lúcia, Alves Helena, Rocha Gustavo, Oliveira Maria João
Endocrinology and Nutrition Department, Centro Hospitalar de Vila Nova de Gaia/Espinho (CHVNG/E), Rua Conceição Fernandes, S/N, 4434-502 Vila Nova de Gaia, Portugal.
Center for Health Technology and Services Research, the Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal.
Endocrinol Diabetes Nutr. 2022 Aug-Sep;69(7):476-482. doi: 10.1016/j.endinu.2021.10.015. Epub 2022 Jan 31.
In a person with type 1 diabetes, any change concerning daily routine may lead to changes in glycaemic control. This study aimed to evaluate the impact of work and lockdown on glycaemic control in adults with type 1 diabetes.
A retrospective cohort was stratified into three activity groups (g1-students/telework/laid-off; g2-unemployed/retired; g3-work without lockdown). Continuous and categorical variations (reductions ≥ 0.4%) in glycated haemoglobin were obtained in 2020 (t3:December/2019-March/2020; t4:April/2020-July/2020) and in homologous periods of 2019. Intragroup comparisons between years and intergroups in the same year were made. Regression models were developed to predict the variation of glycated haemoglobin in 2020.
241 participants were included, with a significant reduction between t4 and t3 (vs. t2 and t1) in g1 ( < 0.001) and g2 ( = 0.025) and in 2020 in g1 (vs. g2, < 0.001; vs. g3, < 0.001). Only g1 presented superiority in the reduction ≥0.4% in glycated haemoglobin in 2020 (vs. 2019, < 0.001; vs. g2, < 0.001; vs. g3, < 0.001). The insulin regimens were comparable and the development of hypoglycaemia was found to be superimposed between t3 and t4, except for g1, which was higher at t3 ( = 0.029). G1 correlated with continuous reductions (vs. g2, = 0.001; vs. g3, < 0.001) and ≥0.4% in glycated haemoglobin in 2020 (vs. g2, OR 3.6, < 0.001; vs. g3, OR 12.7, < 0.001), regardless of the age and duration of type 1 diabetes.
A more stable and better glycaemic control was observed in participants who transitioned from face-to-face work to total lockdown.
在1型糖尿病患者中，日常生活的任何变化都可能导致血糖控制的改变。本研究旨在评估工作和封锁对1型糖尿病成年患者血糖控制的影响。
将一个回顾性队列分为三个活动组（g1-学生/远程工作/下岗；g2-失业/退休；g3-正常工作且未封锁）。在2020年（t3：2019年12月至2020年3月；t4：2020年4月至2020年7月）以及2019年的同期获取糖化血红蛋白的连续和分类变化（降低≥0.4%）。进行了年份间的组内比较以及同一年份内组间的比较。建立回归模型以预测2020年糖化血红蛋白的变化。
纳入了241名参与者，g1组（P<0.001）和g2组（P = 0.025）在t4和t3之间（与t2和t1相比）以及2020年g1组（与g2组相比，P<0.001；与g3组相比，P<0.001）糖化血红蛋白有显著降低。只有g1组在2020年糖化血红蛋白降低≥0.4%方面表现出优势（与2019年相比，P<0.001；与g2组相比，P<0.001；与g3组相比，P<0.001）。胰岛素治疗方案具有可比性，除g1组在t3时低血糖发生率较高（P = 0.029）外，t3和t4之间低血糖的发生情况相似。g1组与糖化血红蛋白的持续降低相关（与g2组相比，P = 0.001；与g3组相比，P<0.001）以及2020年糖化血红蛋白降低≥0.4%相关（与g2组相比，OR 3.6，P<0.001；与g3组相比，OR 12.7，P<0.001），与1型糖尿病的年龄和病程无关。
从面对面工作转变为完全封锁的参与者中观察到血糖控制更稳定且更好。
