Alcántara-Garcés María Teresa, Rodríguez-Ramírez Alejandra Monserrat, García-Ulloa Ana Cristina, García-Alanis Mario, Martínez-Reyes Gabriela Nazareth, Del Moral Vidal Lupita Paola, Arizmendi-Rodríguez Rodrigo Eduardo, Hernández-Jiménez Sergio, Almeda-Valdes Paloma
Centro de Atención Integral del Paciente con Diabetes (CAIPaDi) Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Neurology and Psychiatry Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
PLOS Glob Public Health. 2024 Feb 13;4(2):e0002793. doi: 10.1371/journal.pgph.0002793. eCollection 2024.
Diabetes and poor glycemic control are significant predictors of severity and death in the COVID-19 disease. The perception of this risk in individuals with type 2 diabetes (T2D) could modify coping styles, leading to behaviors associated with better self-care and metabolic control. Theoretically, active coping is associated with better glycemic control in patients with T2D. Nonetheless, information during extreme risk like the COVID-19 pandemic is still limited. Our objective was to evaluate the association between coping styles and risk perception in the COVID-19 pandemic and the change in metabolic parameters. This is a prospective study that included individuals with T2D treated in a tertiary care center during the COVID-19 outbreak who returned to follow-up one year later. We assessed coping styles and risk perception with the Extreme Risk Coping Scale and the risk perception questionnaire. Clinical characteristics and metabolic parameters were registered in both visits. Groups were compared using Kruskal Wallis tests, and changes in metabolic parameters were assessed with Wilcoxon rank sum tests. Our sample included 177 participants at baseline, and 118 concluded the study. Passive coping was more frequent in women. Low-risk perception was associated with higher age, lower psychiatric comorbidities, and lower frequency of psychiatric treatment compared with other risk perception groups. Patients with active coping plus high-risk perception did not have a change in metabolic parameters at follow-up, whereas patients with other coping styles and lower risk perception had an increase in total cholesterol, LDL-cholesterol, and triglycerides. There were no differences by coping group or by risk perception in glycemic control.
糖尿病和血糖控制不佳是新冠病毒疾病严重程度和死亡的重要预测因素。2型糖尿病（T2D）患者对这种风险的认知可能会改变应对方式，从而导致与更好的自我护理和代谢控制相关的行为。从理论上讲，积极应对与T2D患者更好的血糖控制相关。然而，在像新冠疫情这样的极端风险期间，相关信息仍然有限。我们的目的是评估新冠疫情期间应对方式与风险认知之间的关联以及代谢参数的变化。这是一项前瞻性研究，纳入了在新冠疫情爆发期间于三级护理中心接受治疗且一年后返回进行随访的T2D患者。我们使用极端风险应对量表和风险认知问卷评估应对方式和风险认知。在两次就诊时均记录临床特征和代谢参数。使用Kruskal Wallis检验对组间进行比较，并用Wilcoxon秩和检验评估代谢参数的变化。我们的样本在基线时有177名参与者，118人完成了研究。女性更常采用消极应对方式。与其他风险认知组相比，低风险认知与更高年龄、更低的精神疾病共病率以及更低的精神科治疗频率相关。积极应对加高风险认知的患者在随访时代谢参数没有变化，而采用其他应对方式且风险认知较低的患者总胆固醇、低密度脂蛋白胆固醇和甘油三酯有所升高。在血糖控制方面，应对组或风险认知组之间没有差异。
