Department of Internal Medicine, Diabetes Unit, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Faculdade de Ciências Médicas, FCM, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Endocrine. 2022 Sep;77(3):455-460. doi: 10.1007/s12020-022-03137-1. Epub 2022 Jul 15.
To investigate the effect of restrictive measures the COVID-19 pandemic imposed on glycemic control of patients with type 2 diabetes (T2D) and its associated factors.
Outpatients with T2D who had an appointment scheduled during the social distancing period were eligible for telemonitoring. Clinical and laboratorial data were collected from medical records in the last consultation before and from the first visit after the COVID-19 pandemic lockdown period.
From the 1241 eligible patients, 816 (65.7%) could be contacted by phone, 137 (11%) attended the unit for consultation during the social distancing period, and 1040 (83.8%) returned up to 12 months after the end of the lockdown period. We observed a meaningful reduction of glycated hemoglobin (HbA1c) (7.9 [7-9] vs. 7.7 [6.9-8.8] p = 0.004) and no difference in body mass index (29.5 [26-33.7] vs. 29.6 [26.2-34.1], p = 0.17) before and after the social distancing period. According to insulin use at baseline, the HbA1c variation was +0.6 (-0.7 to +2) and -0.6 (-2.1 to +0.7) in patients without and with insulin, respectively (p < 0.001). In the multivariate model, insulin therapy was the only independent significant predictor of HbA1c reduction.
This study observed an improvement in glycemic control after the lockdown. The only independent predictor found was previous insulin use. Probably, the longer time available to perform frequent blood glucose self-monitoring at home and adjustments in insulin therapy could explain our findings.
调查 COVID-19 大流行对 2 型糖尿病(T2D)患者血糖控制的限制措施及其相关因素的影响。
在社会隔离期间有预约的 T2D 门诊患者有资格接受远程监测。从社会隔离前的最后一次就诊和 COVID-19 大流行封锁期后的第一次就诊的病历中收集临床和实验室数据。
从 1241 名合格患者中,通过电话联系到 816 名(65.7%),137 名(11%)在社会隔离期间到单位就诊,1040 名(83.8%)在封锁期结束后 12 个月内返回。我们观察到糖化血红蛋白(HbA1c)显著降低(7.9[7-9] vs. 7.7[6.9-8.8],p=0.004),社会隔离前后体重指数(BMI)无差异(29.5[26-33.7] vs. 29.6[26.2-34.1],p=0.17)。根据基线时是否使用胰岛素,无胰岛素组的 HbA1c 变化为+0.6(-0.7 至+2),有胰岛素组为-0.6(-2.1 至+0.7)(p<0.001)。在多变量模型中,胰岛素治疗是 HbA1c 降低的唯一独立显著预测因素。
本研究观察到封锁后血糖控制有所改善。唯一发现的独立预测因素是先前使用胰岛素。可能是因为有更多的时间在家进行频繁的血糖自我监测,并调整胰岛素治疗,这可以解释我们的发现。