2019 年冠状病毒病疫情对 1 型糖尿病患儿的影响。
Impact of Coronavirus Disease 2019 Outbreak on Children and Adolescents with Type 1 Diabetes Mellitus.
机构信息
Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Pediatrics, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
出版信息
J Res Health Sci. 2021 Nov 14;21(4):e00534. doi: 10.34172/jrhs.2021.67.
BACKGROUND
This study aimed to investigate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on daily routines and health of patients with type 1 diabetes mellitus (T1DM).
STUDY DESIGN
A cross-sectional study.
METHODS
This study included 98 children and adolescents with type 1 diabetes who were regularly followed up in the Endocrinology outpatient clinic of Besat Hospital, Hamadan, Iran, in 2020. The primary measurements included body mass index, glycemic control, number of hypoglycemic events, number of hospitalizations, as well as bedtime and availability of insulin six months pre and post COVID-19 outbreak. The obtained data were analyzed in SPSS software (version 16). A p-value less than 0.05 was considered statistically significant.
RESULTS
Out of 98 participants (mean±SD age: 13.5±49), 51% of the cases were male, and %81.6 of the patients were urban residents. Furthermore, most participants (43.9%) were in the age group of 11-15 years, and the mean±SD duration of diabetes was 4.64±3.31 years. In addition, 2.04% of the participants developed COVID-19. There was a statistically significant difference among average duration of night sleep (P<0.001), bedtime (P<0.001), time of waking up (P<0.001), amount of insulin intake (P=0.003), daily exercise (P<0.001), and availability of the insulin (P<0.001) before and during COVID-19 crisis. The frequencies of hospitalizations and hypoglycemic events were lower after the COVID-19 outbreak (P=0.005 and P=0.034, respectively). Morning insulin dose was omitted in 22.2% of participants. No differences were found between hemoglobin A1c and daytime sleep pre and post COVID-19 outbreak.
CONCLUSIONS
The key challenges due to COVID-19 pandemic restrictions for Iranian T1DM patients were the need to take more insulin, lower physical activity, non-availability of insulin, and missed morning insulin dose. However, it is worth mentioning that the patients' blood glucose control did not worsen in this period.
背景
本研究旨在探讨 2019 年冠状病毒病（COVID-19）大流行对 1 型糖尿病（T1DM）患者日常生活和健康的影响。
研究设计
横断面研究。
方法
本研究纳入了 2020 年在伊朗哈马丹 Besat 医院内分泌科定期就诊的 98 例 1 型糖尿病儿童和青少年。主要测量指标包括体重指数、血糖控制、低血糖事件次数、住院次数，以及 COVID-19 爆发前后睡前和胰岛素供应情况。采用 SPSS 软件（版本 16）分析获得的数据。P 值小于 0.05 被认为具有统计学意义。
结果
在 98 名参与者中（平均年龄±标准差：13.5±49 岁），51%为男性，81.6%为城市居民。此外，大多数参与者（43.9%）年龄在 11-15 岁之间，糖尿病平均病程为 4.64±3.31 年。此外，2.04%的参与者患有 COVID-19。夜间睡眠时间（P<0.001）、就寝时间（P<0.001）、起床时间（P<0.001）、胰岛素摄入量（P=0.003）、日常运动（P<0.001）和胰岛素供应（P<0.001）在 COVID-19 危机前后存在统计学差异。COVID-19 爆发后住院和低血糖事件的频率较低（分别为 P=0.005 和 P=0.034）。22.2%的参与者遗漏了早晨胰岛素剂量。COVID-19 爆发前后血红蛋白 A1c 和日间睡眠时间无差异。
结论
COVID-19 大流行限制对伊朗 T1DM 患者带来的主要挑战是需要更多的胰岛素、降低身体活动、胰岛素供应不足和遗漏早晨胰岛素剂量。然而，值得注意的是，在此期间患者的血糖控制并未恶化。
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