2019冠状病毒病大流行期间糖尿病护理与管理实践的变化

Changes in diabetes care and management practices during the COVID-19 pandemic.

作者信息

Vashist Kushagra, Frediani Jennifer K, Weber Mary Beth, Ali Mohammed K, Narayan K M Venkat, Patel Shivani A

机构信息

Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Atlanta, GA 30322, USA.

Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA 30322, USA.

出版信息

J Public Health (Oxf). 2025 Feb 28;47(1):e20-e27. doi: 10.1093/pubmed/fdae287.

DOI:10.1093/pubmed/fdae287

PMID:39521444

Abstract

BACKGROUND

We examined changes in diabetes care and management practices before and during the COVID-19 pandemic.

METHODS

Population-based data regarding four diabetes-related healthcare engagement and four self-management indicators were obtained from adults with diabetes surveyed in 19 US States and Washington DC through the Behavioral Risk Factor Surveillance System. Using logistic regression, we estimated changes in the prevalence of each indicator, overall and by sociodemographic subgroups in 2019 (before the pandemic) and 2021 (during the pandemic).

RESULTS

Between 2019 and 2021, the prevalence of biannual HbA1c tests reduced by 2.6 percentage points (pp; 95% confidence interval: -4.8, -0.4), from 75.4% to 73.1%, and prevalence of annual eye exams fell by 4.0 pp (-6.2, -2.8), from 72.2% to 68.7%. The composite indicator of engagement with healthcare for diabetes control fell by 3.5 pp (-5.9, -1.1), from 44.9% to 41.9%. Of self-management behaviors, avoidance of smoking increased by 2.0 pp (0.4, 3.6) from 84.7% to 87.1%.

CONCLUSIONS

The findings suggest a deterioration of the uptake of evidence-based, preventive health services requiring laboratory services and clinical examination for diabetes control during the pandemic. On the other hand, smoking rates decreased, suggesting potential positive impacts of the pandemic on health behaviors in people with diabetes.

摘要

背景

我们研究了2019冠状病毒病大流行之前及期间糖尿病护理与管理实践的变化。

方法

通过行为危险因素监测系统，从美国19个州和华盛顿特区接受调查的成年糖尿病患者中获取了与四项糖尿病相关医疗保健参与度及四项自我管理指标相关的基于人群的数据。我们使用逻辑回归估计了2019年（大流行之前）和2021年（大流行期间）各指标总体及按社会人口学亚组划分的患病率变化。

结果

2019年至2021年期间，半年一次糖化血红蛋白（HbA1c）检测的患病率下降了2.6个百分点（95%置信区间：-4.8，-0.4），从75.4%降至73.1%，年度眼科检查的患病率下降了4.0个百分点（-6.2，-2.8），从72.2%降至68.7%。糖尿病控制医疗保健参与度的综合指标下降了3.5个百分点（-5.9，-1.1），从44.9%降至41.9%。在自我管理行为方面，戒烟率从84.7%升至87.1%，上升了2.0个百分点（0.4，3.6）。