Kuwajima Shingo, Itoh Takahito, Sato Tatsuya, Ino Shoya, Shibata Satoru, Ohno Kouhei, Hotta Hiroyuki, Matsumoto Tomoaki, Ooiwa Hitoshi, Kubo Hirofumi, Miki Takayuki
Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan.
Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan.
Diabetol Int. 2024 Apr 8;15(3):507-517. doi: 10.1007/s13340-024-00715-8. eCollection 2024 Jul.
In this study, we investigated whether the COVID-19 pandemic affected achievement of guideline targets for HbA1c, blood pressure (BP), and low-density lipoprotein (LDL) cholesterol in people with diabetes mellitus (DM).
Data for 556 people with DM who were treated regularly for 4 years before and during the COVID-19 pandemic in Japan were analyzed in this retrospective study. Achieved targets were defined as HbA1c < 7.0%, BP < 130/80 mmHg, and LDL cholesterol < 100 or < 120 mg/dL depending on the presence or absence of coronary artery disease.
In 2019, before the start of the COVID-19 pandemic, achievement rates of guideline targets for HbA1c, BP and LDL cholesterol were 53.4%, 45.9% and 75.7%, respectively. In 2020, the achievement rates for HbA1c and BP targets were significantly decreased to 40.8% and 31.3%, respectively. The achievement rates for the HbA1c target gradually recovered to 49.3% in 2021 and to 51.1% in 2022. However, recovery in achieving the BP target was slow, remaining at 40.5% even in 2022. On the other hand, the achievement rate for the LDL cholesterol target was not affected and remained relatively high during the COVID-19 pandemic.
The rates of achieving therapeutic targets for HbA1c and BP have not been high enough in people with DM, and the rates were further reduced by lifestyle changes due to the COVID-19 pandemic. Although there has been a trend toward improvement with the lifting of behavioral restrictions, more intensified treatment is necessary to achieve good control.
The online version contains supplementary material available at 10.1007/s13340-024-00715-8.
在本研究中,我们调查了2019冠状病毒病(COVID-19)大流行是否影响糖尿病(DM)患者糖化血红蛋白(HbA1c)、血压(BP)和低密度脂蛋白(LDL)胆固醇的指南目标达成情况。
在这项回顾性研究中,分析了日本556例在COVID-19大流行之前和期间接受了4年常规治疗的糖尿病患者的数据。达成的目标定义为HbA1c<7.0%、血压<130/80 mmHg以及根据是否存在冠状动脉疾病,LDL胆固醇<100或<120 mg/dL。
2019年,在COVID-19大流行开始之前,HbA1c、血压和LDL胆固醇的指南目标达成率分别为53.4%、45.9%和75.7%。2020年,HbA1c和血压目标的达成率显著下降,分别降至40.8%和31.3%。HbA1c目标的达成率在2021年逐渐恢复到49.3%,在2022年恢复到51.1%。然而,血压目标的恢复缓慢,即使在2022年仍保持在40.5%。另一方面,LDL胆固醇目标的达成率未受影响,在COVID-19大流行期间保持相对较高水平。
糖尿病患者HbA1c和血压治疗目标的达成率一直不够高,并且由于COVID-19大流行导致的生活方式改变,这些比率进一步降低。尽管随着行为限制的解除有改善趋势,但仍需要更强化的治疗以实现良好控制。
在线版本包含可在10.1007/s13340-024-00715-8获取的补充材料。