社会结构变化对糖尿病自我管理及糖化血红蛋白（HbA1c）变化轨迹有何影响？一项针对门诊治疗的糖尿病患者在2019冠状病毒病大流行之前、期间及之后的队列研究。
What is the impact of structural changes in society on diabetes self-management and trajectories of HbA1c? A cohort study before, during and after the COVID-19 pandemic in people with diabetes treated at outpatient clinics.
作者信息
Rasmussen Martin Gillies Banke, Just-Østergaard Emilie, Stidsen Jacob Volmer, Willaing Ingrid, Pedersen Grete Skøtt
机构信息
Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, Center of Research in Childhood Health, University of Southern Denmark, Odense, Denmark.
出版信息
PLoS One. 2025 Aug 12;20(8):e0329394. doi: 10.1371/journal.pone.0329394. eCollection 2025.
BACKGROUND
The impact of COVID-19-related changes in diabetes self-management and trajectories of HbA1c throughout COVID-19 is not fully understood. Here, we describe HbA1c trajectories, changes in diabetes self-management and their association before, during and after the COVID-19 pandemic (2019-2022).
METHODS
During the spring of 2021, we invited 13,641 outpatients from diabetes clinics in the Region of Southern Denmark to complete a questionnaire regarding changes in diabetes self-management during COVID-19. We linked the questionnaire and registry HbA1c data from before, during and after the COVID-19 pandemic and conducted multivariable adjusted linear mixed-effect regression to assess the association between changes in diabetes self-management and HbA1c.
RESULTS
5,581 (40.9%) people responded to the questionnaire (median age: 65 years, males: 59.7%). HbA1c decreased in people with type 2-diabetes and was unchanged for people with type 1-diabetes (interaction: p < 0.001). The majority of people reported unchanged diet (65-71%) and usual medication taking (89-90%). No changes in physical activity were reported by 43%, while 42% reported decreased physical activity. HbA1c trajectories did not differ according to change in physical activity and change in diet intake, while taking medication more regularly was associated with a decrease in HbA1c, from approximately 65/66 mmol/mol (8.1/8.2%) to 60/61 mmol/mol (7.6/7.7%) in both diabetes types.
CONCLUSIONS
During COVID-19, HbA1c trajectories differed between diabetes types. Most of the sample maintained usual diabetes self-management, although some decreased physical activity levels. Improved medication taking was associated with decreased HbA1c. This information is crucial for health professionals, in order to provide support aimed at reducing HbA1c.
背景
2019冠状病毒病（COVID-19）期间糖尿病自我管理的相关变化以及糖化血红蛋白（HbA1c）的变化轨迹尚未完全明确。在此，我们描述了COVID-19大流行期间（2019 - 2022年）及之前和之后的HbA1c变化轨迹、糖尿病自我管理的变化及其关联。
方法
2021年春季，我们邀请了丹麦南部地区糖尿病诊所的13641名门诊患者填写一份关于COVID-19期间糖尿病自我管理变化的问卷。我们将问卷与COVID-19大流行之前、期间和之后的登记HbA1c数据相联系，并进行多变量调整线性混合效应回归，以评估糖尿病自我管理变化与HbA1c之间的关联。
结果
5581人（40.9%）回复了问卷（中位年龄：65岁，男性：59.7%）。2型糖尿病患者的HbA1c下降，1型糖尿病患者的HbA1c无变化（交互作用：p < 0.001）。大多数人报告饮食（65 - 71%）和日常用药（89 - 90%）没有变化。43%的人报告身体活动没有变化，而42%的人报告身体活动减少。HbA1c变化轨迹在身体活动变化和饮食摄入量变化方面没有差异，而更规律地服药与HbA1c降低相关，在两种糖尿病类型中，HbA1c从约65/66 mmol/mol（8.1/8.2%）降至60/61 mmol/mol（7.6/7.7%）。
结论
在COVID-19期间，不同糖尿病类型的HbA1c变化轨迹有所不同。大多数样本维持了常规的糖尿病自我管理，尽管一些人的身体活动水平有所下降。改善服药与HbA1c降低相关。这些信息对卫生专业人员至关重要，以便提供旨在降低HbA1c的支持。
Zotero 插件