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社会经济地位和长期大流行隔离对 2 型糖尿病成人人体测量和血糖结果的影响。

Socioeconomic status and the effect of prolonged pandemic confinement on anthropometric and glycaemic outcomes in adults with type 2 diabetes mellitus.

机构信息

Macquarie University Faculty of Medicine and Health Sciences, Australia.

Healthy Weight Clinic, Macquarie University Hospital, Macquarie Park, Australia.

出版信息

Prim Care Diabetes. 2024 Jun;18(3):308-318. doi: 10.1016/j.pcd.2024.02.002. Epub 2024 Mar 6.

Abstract

AIM

This systematic review and meta-analysis aimed to investigate the impact of COVID19 lockdown on the anthropometric and glycaemic outcomes of adults with type 2 diabetes mellitus (T2DM) and assess whether socioeconomic status (SES) was relevant to these changes.

METHODS

A search of three databases was conducted. Meta-analyses using random effects models were undertaken to combine anthropometric and glycaemic measures pre- and post-confinement. Subgroup analyses according to SES were also conducted.

RESULTS

This systematic review of 19 articles demonstrated that prolonged pandemic-related confinement is associated with a deterioration in both anthropometric and glycaemic outcomes among adults with T2DM. Furthermore, SES was found to be relevant to these changes. Specifically, BMI (kg/m) showed an increase in mean difference of 0.72 (95% CI; 0.13, 1.31; p<0.05) between pre and post lockdown cohorts. High income countries displayed a greater increase in BMI compared to their lower middle-income counterparts. Regarding, fasting blood glucose (FBG), a statistically significant difference was observed in the upper middle-income group (mean difference: 5.10; 95% CI: 2.92, 7.27), and high-income group (mean difference: 6.03; 95% CI: 0.04, 12.02). There were no significant changes to weight, waist circumference, or HbA1C over the lockdown period.

CONCLUSION

Our findings suggest adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. Clinics and care providers may need to adopt more intensive contact and treatment plans in the post lockdown period to prevent lasting impacts on disease progression and metabolic sequelae.

摘要

目的

本系统评价和荟萃分析旨在研究 COVID19 封锁对 2 型糖尿病(T2DM)成年患者的人体测量和血糖结果的影响,并评估社会经济地位(SES)是否与这些变化相关。

方法

对三个数据库进行了检索。使用随机效应模型进行荟萃分析,以合并隔离前后的人体测量和血糖测量值。还根据 SES 进行了亚组分析。

结果

对 19 篇文章的系统评价表明,与大流行相关的长期禁闭与 T2DM 成年患者的人体测量和血糖结果恶化有关。此外,SES 与这些变化有关。具体而言,BMI(kg/m)的平均差异在封锁前后的队列中增加了 0.72(95%CI;0.13,1.31;p<0.05)。与中低收入国家相比,高收入国家的 BMI 增加幅度更大。至于空腹血糖(FBG),在上中等收入组观察到统计学显著差异(平均差异:5.10;95%CI:2.92,7.27),高收入组(平均差异:6.03;95%CI:0.04,12.02)。在封锁期间,体重、腰围或 HbA1C 没有显著变化。

结论

我们的研究结果表明,T2DM 成年患者在封锁期间可能接受的治疗效果较差,尤其是在高收入国家。诊所和护理提供者可能需要在封锁后采用更密集的接触和治疗计划,以防止对疾病进展和代谢后果产生持久影响。

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