Şirikçi Vehbi, Kiraç Cem Onur, Findikli Hüseyin Avni
Department of Internal Medicine, Necip Fazil City Hospital, Kahramanmaras, Turkey.
Department of Internal Medicine, Division of Endocrinology and Metabolism, Necip Fazil City Hospital, Kahramanmaras, Turkey.
Medicine (Baltimore). 2024 Dec 6;103(49):e40873. doi: 10.1097/MD.0000000000040873.
The impact of COVID-19 lockdown on glycemic control in patients with diabetes mellitus (DM) remains unclear. This study aimed to investigate the effects of lockdown measures on the metabolic parameters of patients with DM, with particular emphasis on geriatric populations. In this retrospective, longitudinal cohort study, 1224 patients were analyzed. Three periods were identified to examine the effects of the lockdown: pre-lockdown, lockdown, and post-lockdown. Each period spanned 1-year. Within each 1-year period, at least 2 measurements were taken at least 3 months apart, and their arithmetic mean was calculated. Only patients who presented to the hospital for DM management during all 3 periods were included in the study. While HbA1c levels significantly increased in patients over 65 years old during the lockdown period (P = .017), we observed a significant decrease in HbA1c levels in patients under 65 years old (P = .014). Upon further stratification of patients over 65 by age groups, HbA1c levels increased the most among those aged 75 to 85 years, with a significant rise also observed in those aged 65 to 75 years during the lockdown. However, there was no change in HbA1c levels for patients over 85 years old during the lockdown. These findings highlight the need for careful monitoring of elderly patients with DM during lockdown periods, facilitated via home care or telehealth services. Structured diet and exercise programs should also be provided for at home adherence.
2019冠状病毒病封锁措施对糖尿病(DM)患者血糖控制的影响尚不清楚。本研究旨在调查封锁措施对DM患者代谢参数的影响,尤其侧重于老年人群。在这项回顾性纵向队列研究中,对1224例患者进行了分析。确定了三个时期来考察封锁的影响:封锁前、封锁期间和封锁后。每个时期跨度为1年。在每个1年期间,至少相隔3个月进行至少2次测量,并计算其算术平均值。本研究仅纳入在所有三个时期均因DM管理而到医院就诊的患者。虽然65岁以上患者在封锁期间糖化血红蛋白(HbA1c)水平显著升高(P = 0.017),但我们观察到65岁以下患者的HbA1c水平显著下降(P = 0.014)。按年龄组对65岁以上患者进一步分层后,75至85岁患者的HbA1c水平升高最多,封锁期间65至75岁患者的HbA1c水平也显著升高。然而,85岁以上患者在封锁期间的HbA1c水平没有变化。这些发现凸显了在封锁期间通过家庭护理或远程医疗服务对老年DM患者进行仔细监测的必要性。还应提供结构化的饮食和运动计划,以促进在家坚持。