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 (Engl Ed). 2022 Aug-Sep;69(7):476-482. doi: 10.1016/j.endien.2022.08.003.
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 (p<0.001) and g2 (p=0.025) and in 2020 in g1 (vs. g2, p<0.001; vs. g3, p<0.001). Only g1 presented superiority in the reduction ≥0.4% in glycated haemoglobin in 2020 (vs. 2019, p<0.001; vs. g2, p<0.001; vs. g3, p<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 (p=0.029). G1 correlated with continuous reductions (vs. g2, p=0.001; vs. g3, p<0.001) and ≥0.4% in glycated haemoglobin in 2020 (vs. g2, OR 3.6, p<0.001; vs. g3, OR 12.7, p<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，任何日常例行活动的改变都可能导致血糖控制的变化。本研究旨在评估工作和封锁对 1 型糖尿病成人血糖控制的影响。
回顾性队列研究分为三组活动（g1-学生/远程办公/下岗；g2-失业/退休；g3-无封锁工作）。在 2020 年（t3：2019 年 12 月/3 月；t4：2020 年 4 月/7 月）和 2019 年同期的类似时间段内，获得糖化血红蛋白的连续和分类变化（降低≥0.4%）。在同一年内进行组内比较和组间比较。建立回归模型预测 2020 年糖化血红蛋白的变化。
共纳入 241 例患者，g1（p<0.001）和 g2（p=0.025）以及 2020 年 g1（与 g2 相比，p<0.001；与 g3 相比，p<0.001）在 t4 与 t3 之间、g1 和 g2 在 2020 年均显著降低。只有 g1 在 2020 年（与 2019 年相比，p<0.001；与 g2 相比，p<0.001；与 g3 相比，p<0.001）糖化血红蛋白降低≥0.4%方面表现出优势。胰岛素方案相似，仅 g1 在 t3 时低血糖发作更为严重（p=0.029）。g1 与连续降低（与 g2 相比，p=0.001；与 g3 相比，p<0.001）和 2020 年糖化血红蛋白≥0.4%相关（与 g2 相比，OR 3.6，p<0.001；与 g3 相比，OR 12.7，p<0.001），与 1 型糖尿病的年龄和病程无关。
从面对面工作到全面封锁的参与者血糖控制更稳定、更好。
