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Policarpo S, Machado MV, Cortez-Pinto H. Telemedicine as a tool for dietary intervention in NAFLD-HIV patients during the COVID-19 lockdown: A randomized controlled trial. Clin Nutr ESPEN 2021; 43:329-334. [PMID: 34024536 PMCID: PMC8056479 DOI: 10.1016/j.clnesp.2021.03.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Given reports of changes in dietary habits during covid-19 lockdown, our aim was to assess weight changes, over a 3-month Covid-19 national lockdown in a cohort of NAFLD-HIV patients on a dietary intervention trial. METHODS After NAFLD screening in an outpatient Infectious Diseases Clinic, NAFLD patients were randomly allocated to general dietary recommendations (SC group) or to a structured dietary intervention based on the Mediterranean diet (intervention group). During lockdown, follow-up consultations in the intervention group were done by video and/or phone. After 3 months of lockdown, all patients (intervention and SC group) consented to a telephone interview which aimed to characterize eating habits and lifestyle changes and evaluate stress and depression. Biochemical data when available, was compared between the peri-period of confinement. RESULTS One hundred and twelve patients were screened. From the 55 NAFDL identified, 27 were allocated to dietary intervention and 28 to SC and were followed before lockdown for a mean period of 5.0 ± 1.5 months in which SC group gained a median of 0.65 kg vs. a median loss of 1.5 kg in the intervention group (p < 0.001). During lockdown, 93.3% of patients in the SC group referred that "diet got worse" vs. 6.7% in the intervention group p < 0.01), and 35.3% vs. 15.7% (p = 0.014) reported increase in appetite, respectively. Both groups gained weight, SC group vs. 0.7 ± 1.7 kg in the intervention group, p < 0.001). Higher weight gain was associated with changes in the dietary pattern (3.8 ± 2.1 kg vs. 2.0 ± 1.3 kg in "no change in dietary pattern"; p = 0.002). Glucose blood levels increased after lockdown in the SC group, with a mean increase of 15 mg/dl (p = 0.023). The remaining metabolic parameters remained unchanged. CONCLUSION The maintenance of dietary intervention, using telemedicine, can mitigate the adverse change in dietary habits and physical activity pattern, preventing a substantial increase in body weight.
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Affiliation(s)
- Sara Policarpo
- Centro Hospitalar Lisboa Norte, Serviço de Dietética e Nutrição, Lisboa, Portugal; Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Portugal.
| | - Mariana V Machado
- Centro Hospitalar Lisboa Norte, Departamento de Gastrenterologia, Lisboa, Portugal; Clínica Universitária de Gastroenterlogia, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Helena Cortez-Pinto
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Portugal; Centro Hospitalar Lisboa Norte, Departamento de Gastrenterologia, Lisboa, Portugal; Clínica Universitária de Gastroenterlogia, Faculdade de Medicina, Universidade de Lisboa, Portugal
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Karatas S, Yesim T, Beysel S. Impact of lockdown COVID-19 on metabolic control in type 2 diabetes mellitus and healthy people. Prim Care Diabetes 2021; 15:424-427. [PMID: 33441263 PMCID: PMC7834877 DOI: 10.1016/j.pcd.2021.01.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 12/31/2022]
Abstract
AIMS The impact of prolonged COVID-19 lockdown on metabolic control in type 2 diabetes patients and healthy individuals has not exactly been known. We aimed to evaluate the change in body weight and metabolic control in type 2 diabetic and non-diabetic healthy subjects during the prolonged lockdown period. METHODS Diabetic (n = 85), and age-and sex-matched non-diabetic subjects (n = 55) were included in this prospective study. Body mass index and metabolic parameters were compared between before and 6th months of lockdown. Changes in values were evaluated using the difference before and after lockdown. RESULTS Age (54.81 ± 10.53 vs. 52.61 ± 4.88 years), gender (female, 68.2% vs. 56.4%) and, BMI (33.44 ± 6.48 vs. 31.63 ± 3.57 kg/m2) were similar between groups (p > 0.05). Before and after lockdown, BMI increased both in non-diabetic (0.54 ± 0.95 kg) and diabetic groups (1.91 ± 5.48 kg) (p > 0.05). Increase in HbA1c was more in diabetic than in non-diabetic groups (0.71 ± 1.35 vs. 0.02 ± 0.19%, p = 0.002). Glucose, LDL-C, and TG increased in diabetic (39.69 ± 74.69, 7.60 ± 34.33, and 58.21 ± 133.54 mg/dl, p < 0.05) whereas non significantly decreased in non-diabetic group (-0.51 ± 4.40, -3.52 ± 14.53, and -6.47 ± 41.77 mg/dl, respectively. After adjusting BMI, increase in blood glucose (p = 0.021), HbA1c (p = 0.018), and TG (p = 0.041) levels were more in diabetic than non-diabetic group. Duration of diabetes was an independent predictor of the change in HbA1c (OR: 1.2, 95% CI = 1.1-1.8, p = 0.032). CONCLUSIONS Body weight gain was observed in type 2 diabetic patients and healthy subjects. This is the first study to show that prolonged lockdown COVID-19 pandemic worsened glucose regulation and increased TG level in diabetes mellitus independent of weight gain.
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Affiliation(s)
- Savas Karatas
- Istanbul Research and Education Hospital, Endocrinology and Metabolism Department, Kasap İlyas Mah, Org. Abdurrahman Nafiz Gürman Cd., 34098 Fatih, Istanbul, Turkey.
| | - Tijen Yesim
- Istanbul Research and Education Hospital, Endocrinology and Metabolism Department, Kasap İlyas Mah, Org. Abdurrahman Nafiz Gürman Cd., 34098 Fatih, Istanbul, Turkey.
| | - Selvihan Beysel
- Afyon Kocatepe University Endocrinology and Metabolism Department, Erenler, Gazlıgöl Yolu Rektörlük E Blok, 03200 Afyon,Turkey.
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Social Distancing During A COVID-19 Lockdown Contributes to The Maintenance of Social Anxiety: A Natural Experiment. COGNITIVE THERAPY AND RESEARCH 2021; 45:708-714. [PMID: 34007091 PMCID: PMC8117800 DOI: 10.1007/s10608-021-10231-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 11/15/2022]
Abstract
Background The COVID-19 pandemic has led to extensive social distancing measures. For those suffering from social anxiety, social distancing coincides with a tendency to avoid social interactions. We used this natural experiment imposed by a COVID-19 lockdown to examine how mandated low social exposure influenced socially anxious university students, and compared their anxiety to that of socially anxious students in preceding academic years with no social distancing. Methods Ninety-nine socially anxious students were assessed for social anxiety symptoms at the beginning of the fall and spring semesters. Students from the 2019–2020 academic year (which included a lockdown followed by social distancing measures at the end of the fall semester) were compared to students from preceding years (2016–2019) on social anxiety levels. Results Whereas social anxiety decreased in socially anxious students from the fall to the spring semester in the years preceding the pandemic, during the 2019–2020 academic year social anxiety levels remained high and unchanged. These results held when controlling for depressive symptoms and when analyzing social anxiety items that cannot be confounded with COVID-19-related anxiety. Conclusions The current results suggest that reduced exposure to social situations may play a role in the maintenance of social anxiety. Alternative explanations are discussed.
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Abstract
Background: The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic has been controlling disease transmission. However, lockdown measures used to mitigate transmission have affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature has emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances. Methods: We comprehensively searched PubMed and the World Health Organization’s global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed. Results: Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes. Conclusions: The COVID-19 pandemic provides an opportunity to better understand the negative impact of strict lockdown measures on lifestyles. At the same time, it helps us identify and initiate positive behavioral changes, which, if consolidated, could improve chronic disease outcomes. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities.
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Srikanth N, Rana R, Singhal R, Jameela S, Singh R, Khanduri S, Tripathi A, Goel S, Chhatre L, Chandra A, Rao BCS, Dhiman KS. Mobile App-Reported Use of Traditional Medicine for Maintenance of Health in India During the COVID-19 Pandemic: Cross-sectional Questionnaire Study. ACTA ACUST UNITED AC 2021; 2:e25703. [PMID: 34032815 PMCID: PMC8110045 DOI: 10.2196/25703] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/26/2021] [Accepted: 04/09/2021] [Indexed: 02/06/2023]
Abstract
Background India follows a pluralistic system for strategic and focused health care delivery in which traditional systems of medicine such as Ayurveda, yoga and naturopathy, Unani, Siddha, Sowa Rigpa, and homoeopathy (AYUSH) coexist with contemporary medicine, and this system functions under the Ministry of AYUSH (MoA). The MoA developed a mobile app, called AYUSH Sanjivani, to document the trends of the use of AYUSH-based traditional and holistic measures by the public across India. Analysis of the data generated through this app can help monitor the extent of the use of AYUSH measures for maintenance of health during the COVID-19 pandemic and aid effective health promotion and communication efforts focused on targeted health care delivery during the pandemic. Objective The purpose of the study was to determine the extent of use of AYUSH measures by the public in India for maintenance of health during the COVID-19 pandemic as reported through the AYUSH Sanjivani mobile app. Methods Cross-sectional analysis of the data generated through the Ayush Sanjivani app from May 4 to July 31, 2020, was performed to study the pattern and extent of the use of AYUSH-based measures by the Indian population. The responses of the respondents in terms of demographic profile, use pattern, and benefits obtained; the association between the use of AYUSH-based measures and symptomatic status; and the association between the duration of use of AYUSH-based measures and the outcome of COVID-19 testing were evaluated based on bivariate and multivariate logistic regression analysis. Results Data from 723,459 respondents were used for the analysis, among whom 616,295 (85.2%) reported that they had been using AYUSH measures for maintenance of health during the COVID-19 pandemic. Among these 616,295 users, 553,801 (89.8%) either strongly or moderately agreed to have benefitted from AYUSH measures. Ayurveda and homeopathic measures and interventions were the most preferred by the respondents across India. Among the 359,785 AYUSH users who described their overall improvement in general health, 144,927 (40.3%) rated it as good, 30,848 (8.6%) as moderate, and 133,046 (40.3%) as slight. Respondents who had been using AYUSH measures for less than 30 days were more likely to be COVID-19–positive among those who were tested (odds ratio 1.52, 95% CI 1.44-1.60). The odds of nonusers of AYUSH measures being symptomatic if they tested positive were greater than those of AYUSH users (odds ratio 4.01, 95% CI 3.61-4.59). Conclusions The findings of this cross-sectional analysis assert that a large proportion of the representative population practiced AYUSH measures across different geographic locations of the country during the COVID-19 pandemic and benefitted considerably in terms of general well-being, with a possible impact on their quality of life and specific domains of health.
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Affiliation(s)
- N Srikanth
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
| | - Rakesh Rana
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
| | - Richa Singhal
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
| | - Sophia Jameela
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
| | - Rajeshwari Singh
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
| | - Shruti Khanduri
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
| | - Arunabh Tripathi
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
| | - Sumeet Goel
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
| | | | | | - B C S Rao
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
| | - K S Dhiman
- Central Council for Research in Ayurvedic Sciences Ministry of AYUSH Delhi India
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Rastogi A, Hiteshi P, Bhansali A. A, Jude EB. Virtual triage and outcomes of diabetic foot complications during Covid-19 pandemic: A retro-prospective, observational cohort study. PLoS One 2021; 16:e0251143. [PMID: 33956847 PMCID: PMC8101747 DOI: 10.1371/journal.pone.0251143] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/20/2021] [Indexed: 12/23/2022] Open
Abstract
AIMS Limb and patient outcomes in people with diabetic foot complications including diabetic foot ulcer (DFU) provided virtual triage and personalized video consultations during COVID-19 pandemic are not known. METHODS Patients with foot complications attending the diabetic foot clinic prior to lockdown who sought teleconsultations during COVID-19 lockdown underwent virtual triage to include clinical history, visual inspection of feet, domiciliary wound care (community nurse assisted dressings) and offloading instructions. The subsequent ulcer, limb and mortality outcomes during the following 24 weeks of COVID-19 lockdown (April-September 2020, group 1) were assessed and compared with those who attended foot clinic during the same period in 2019 (April-September, group 2). RESULTS Group 1 included 561 participants with foot complications provided with teleconsultations, median age 57 (51 to 63) years and diabetes duration of 10 (5 to 16) years. Twelve patients with severe DFU were excluded and 549 patients [357 (65%) neuropathic foot, 104 (18.9%) ischemic foot and 88 (16%) chronic Charcot foot with deformities] were evaluated. There were 227 (41.3%) participants with active DFU at start of lockdown, 32 (5.8%) with new onset ulcer during lockdown (47.1%) and 290 patients without ulcers. Group 2 included 650 participants; active foot ulcer was present in 366 patients. Wound closed or reduced in area in 78.4% of participants of group 1 compared to 76.0% (p = 0.318) in group 2. Fourteen (5.4%) patients required amputations [3 major and 11 minor] in group 1 during the study period compared to 6.8% in group 2 (p = 0.191). Twenty-one (3.8%) and 28 (4.3%) patients died (p = 0.532) during 24 weeks of follow up in group 1 and 2, respectively. CONCLUSIONS Targeted foot-care service through virtual triage and teleconsultations during COVID-19 pandemic for people with foot complications have similar ulcer and limb outcomes compared to face-to-face foot care delivery.
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Affiliation(s)
- Ashu Rastogi
- Department of Endocrinology, PGIMER, Chandigarh, India
- * E-mail: (EBJ); (AR)
| | - Priya Hiteshi
- Department of Endocrinology, PGIMER, Chandigarh, India
| | | | - Edward B. Jude
- Tameside and Glossop Integrated Care NHS Foundation Trust, Tameside on Lyne, United Kingdom and Manchester Metropolitan University, Manchester, United Kingdom
- * E-mail: (EBJ); (AR)
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Carranza Esteban RF, Turpo-Chaparro JE, Mamani-Benito O, Torres JH, Arenaza FS. Spirituality and religiousness as predictors of life satisfaction among Peruvian citizens during the COVID-19 pandemic. Heliyon 2021; 7:e06939. [PMID: 34027158 PMCID: PMC8121659 DOI: 10.1016/j.heliyon.2021.e06939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/23/2021] [Accepted: 04/23/2021] [Indexed: 01/07/2023] Open
Abstract
The objective of this study was to determine if religiousness and spirituality predict life satisfaction among Peruvian citizens during the COVID-19 pandemic. This is a non-experimental, predictive and cross-sectional study with a sample of 734 people of both sexes (39.5% males and 60.5% females) between 17-75 years of age (M = 32.05). To measure the variables, the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) and the Satisfaction with Life Scale (SWLS) were used. A multiple regression analysis was performed to determine the variables that best predict life satisfaction, finding that the spirituality variable explains 10.7 % of the total variance of the life satisfaction variable. In summary, a positive and significant correlation between spirituality and life satisfaction is identified (r = .328, p < .01).
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Affiliation(s)
| | - Josue Edison Turpo-Chaparro
- Escuela de Posgrado, Universidad Peruana Unión, Carretera Central Km 19.5 Ñaña, Chosica, Lima 15, Lima, Peru
| | - Oscar Mamani-Benito
- Universidad Nacional de San Agustín de Arequipa, Calle Santa Catalina 117, Arequipa, Peru
| | - Jesús Hanco Torres
- Escuela de Posgrado, Universidad Peruana Unión, Carretera Central Km 19.5 Ñaña, Chosica, Lima 15, Lima, Peru
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Al-Musharaf S, Aljuraiban G, Bogis R, Alnafisah R, Aldhwayan M, Tahrani A. Lifestyle changes associated with COVID-19 quarantine among young Saudi women: A prospective study. PLoS One 2021; 16:e0250625. [PMID: 33914800 PMCID: PMC8084143 DOI: 10.1371/journal.pone.0250625] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Negative lifestyle behaviors are associated with an increased risk of adverse outcomes from coronavirus disease (COVID-19). This study aimed to assess lifestyle changes affecting weight, sleep, mental health, physical activity, and dietary habits prospectively from before COVID-19 to during lockdown. METHODS A total of 297 Saudi women, aged 19-30 years (mean age, 20.7 ± 1.4 years), were interviewed at two time points, before and during the quarantine. The data collected included anthropometrics, sociodemographic data, clinical history, food frequency questionnaire responses, Pittsburgh Sleep Quality Index scores, Global Physical Activity Questionnaire (GPAQ) responses, and Perceived Stress Scale measures. In addition, during quarantine, COVID-19 and nutrition-related information and Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scores were collected. Multivariate multinomial logistic regression analysis was used to examine the indicators of weight gain and loss from before COVID-19 (baseline) until during lockdown. RESULTS Although approximately half of the participants did not report a weight change, 30% revealed weight loss and 18%, weight gain. The variables associated with increased weight gain were self-quarantine since COVID-19 started (OR: 5.17, 95% CI: 1.57-17.01, p = 0.007), age (OR: 1.53, 1.03-2.28, p = 0.04), and stress at baseline and during lockdown (OR: 1.15, 1.03-1.29, p = 0.01; OR: 1.10, 1.01-1.19, p = 0.03, respectively). The variables associated with a reduced risk of weight gain were the GPAQ score during lockdown (OR: 0.16, 0.04-0.66, p = 0.01), coffee consumption (OR: 0.36, 0.19-0.67, p = 0.01), and total sleep time (OR: 0.70, 0.51-0.97, p = 0.03). CONCLUSION While most young Saudi women experienced no weight change during the COVID-19 lockdown, one-third lost weight and a significant proportion gained weight. Factors associated with weight, such as stress, sleep hours, physical activity, and coffee consumption, highlight the need to carefully consider those at risk during future circumstances that may require lockdowns. These factors could also aid in implementing policies for future lockdowns and support those most at risk of gaining weight.
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Affiliation(s)
- Sara Al-Musharaf
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ghadeer Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Rania Bogis
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ruyuf Alnafisah
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Madhawi Aldhwayan
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abd Tahrani
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
- Department of Endocrinology and Diabetes, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Singh RK, Bajpai R, Kaswan P. COVID-19 pandemic and psychological wellbeing among health care workers and general population: A systematic-review and meta-analysis of the current evidence from India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 11:100737. [PMID: 33898866 PMCID: PMC8055546 DOI: 10.1016/j.cegh.2021.100737] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/09/2021] [Accepted: 04/04/2021] [Indexed: 01/18/2023] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) was declared as pandemic and measures adopted for its control included quarantine of at-risk, isolation of infected along with other measures such as lockdown, restrictions on movement, and social interactions. Both the pandemic and these measures have the potential to cause mental health problems among individuals. Objective The present study aimed to investigate and estimate the prevalence of psychological well-being, particularly from an Indian perspective using systematic review and meta-analysis of existing literature. Methods We searched in the PubMed database, starting from the onset of the current pandemic and until 10th October 2020 to synthesize evidence on mental health outcomes from India. DerSimonian and Laird method of the random-effects meta-analysis was employed and heterogeneity between studies was assessed using the Chi-square based Cochran's Q statistic and I-squared (I2) statistics. Results The pooled prevalence of stress in nine studies was 60.7% (95% CI: 42.3%–77.7%), depression in eight studies was 32.7% (95% CI: 24.6%–41.3%), anxiety in six studies was 34.1% (95% CI: 26.3%–42.3%) and sleep disturbances in six studies was 26.7% (95% CI: 13.9%–41.8%). As expected, high heterogeneity was observed in the above-mentioned outcomes. Sub-group analysis showed that Health Care Workers (HCWs) had a higher prevalence of stress, anxiety, depression & psychological distress in comparison to the general population. Conclusion A significant impact on psychological well-being during COVID-19 was observed in India as common adverse outcomes were stress (61%), psychological distress (43%), anxiety (34%), depression (33%), and sleep disturbances (27%). Thus the COVID-19 pandemic represents an unprecedented threat to mental health, which should become a priority for public health strategies.
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Affiliation(s)
| | - Ram Bajpai
- School of Medicine, Keele University, Staffordshire, UK
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Softa A, Bahl S, Bagha AK, Sehgal S, Haleem A, Javaid M. Tissue Engineering and its Significance in Healthcare During COVID-19 Pandemic: Potential Applications and Perspectives. JOURNAL OF INDUSTRIAL INTEGRATION AND MANAGEMENT 2021. [DOI: 10.1142/s242486222150007x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In the present times of the COVID-19 pandemic, there is a great need for new therapeutic and diagnostic strategies to prevent infectious diseases worldwide. Tissue engineering covers the phenomenon of the evolution of tissue, its behavior and growth factors that are better supported in the medical environment. This area of tissue engineering can support the treatment of infected patients of COVID-19 and can help fight the current crisis and viral outbreaks in general. This study aims to identify the significant advancement of tissue engineering for taking up the challenges posed by COVID-19. Major challenges faced during the COVID-19 pandemic situation in the current scenario are discussed. The significant advancements of tissue engineering in the medical field are listed in chronological order. The positive impacts of tissue engineering during the COVID 19 crisis are discussed and finally its useful applications during the ongoing COVID-19 pandemic situation are identified and briefed. This branch of science’s primary importance is to provide biological alternatives that can perform full or partial functions of the damaged, malfunctioned and failing organs or tissues in humans. It is helpful for the supply of convalescent plasma to patients especially during COVID-19. A donor is selected strictly based on a validated case of COVID-19 contagion. The donor must confirm a negative follow-up molecular examination, free from manifestations; usual good health and other pre-donation screening procedures are to be followed.
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Affiliation(s)
- Abhishek Softa
- Department of New Product Development, NTF India Private Limited, Gurugram 122050, India
| | - Shashi Bahl
- Department of Mechanical Engineering, I.K. Gujral Punjab Technical University, Hoshiarpur Campus Hoshiarpur 146001, India
| | - Ashok Kumar Bagha
- Department of Mechanical Engineering, Dr B.R. Ambedkar National Institute of Technology, Jalandhar 144011, India
| | - Shankar Sehgal
- University Institute of Engineering and Technology, Panjab University, Chandigarh 160014, India
| | - Abid Haleem
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi 110025, India
| | - Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi 110025, India
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Deschasaux-Tanguy M, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, Allès B, Andreeva VA, Baudry J, Charreire H, Deschamps V, Egnell M, Fezeu LK, Galan P, Julia C, Kesse-Guyot E, Latino-Martel P, Oppert JM, Péneau S, Verdot C, Hercberg S, Touvier M. Diet and physical activity during the coronavirus disease 2019 (COVID-19) lockdown (March-May 2020): results from the French NutriNet-Santé cohort study. Am J Clin Nutr 2021; 113:924-938. [PMID: 33675635 PMCID: PMC7989637 DOI: 10.1093/ajcn/nqaa336] [Citation(s) in RCA: 230] [Impact Index Per Article: 76.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/22/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Since December 2019, coronavirus disease 2019 (COVID-19) has been spreading steadily, resulting in overwhelmed health-care systems and numerous deaths worldwide. To counter these outcomes, many countries, including France, put in place strict lockdown measures, requiring the temporary closure of all but essential places and causing an unprecedented disruption of daily life. OBJECTIVES Our objective was to explore potential changes in dietary intake, physical activity, body weight, and food supply during the COVID-19 lockdown and how these differed according to individual characteristics. METHODS The analyses included 37,252 adults from the French web-based NutriNet-Santé cohort who completed lockdown-specific questionnaires in April-May 2020. Nutrition-related changes and their sociodemographic, lifestyle, and health-status correlates were investigated using multivariable logistic regression models. Clusters of participants were defined using an ascending hierarchical classification of change profiles derived from multiple correspondence analyses. RESULTS During the lockdown, trends of unfavorable changes were observed: decreased physical activity (reported by 53% of the participants), increased sedentary time (reported by 63%), increased snacking, decreased consumption of fresh food (especially fruit and fish), and increased consumption of sweets, cookies, and cakes. Yet, the opposite trends were also observed: increased home cooking (reported by 40%) and increased physical activity (reported by 19%). Additionally, 35% of the participants gained weight (mean weight gain in these individuals, 1.8 kg ± SD 1.3 kg) and 23% lost weight (2 kg ± SD 1.4 kg weight loss). All of these trends displayed associations with various individual characteristics. CONCLUSIONS These results suggest that nutrition-related changes occurred during the lockdown in both unfavorable and favorable directions. The observed unfavorable changes should be considered in the event of a future lockdown, and should also be monitored to prevent an increase in the nutrition-related burden of disease, should these diet/physical activity changes be maintained in the long run. Understanding the favorable changes may help extend them on a broader scale. This trial was registered at clinicaltrials.gov as NCT03335644.
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Affiliation(s)
- Mélanie Deschasaux-Tanguy
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Younes Esseddik
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Benjamin Allès
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Julia Baudry
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Hélène Charreire
- Paris-Est University, Lab'Urba, Université Paris-Est Créteil (UPEC), Créteil, France
| | - Valérie Deschamps
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Sorbonne Paris Nord University, Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Manon Egnell
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Leopold K Fezeu
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Department of Public Health, Paris Seine-Saint-Denis University Hospital System, Assistance Publique - Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Paule Latino-Martel
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Jean-Michel Oppert
- Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Charlotte Verdot
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Sorbonne Paris Nord University, Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France.,Department of Public Health, Paris Seine-Saint-Denis University Hospital System, Assistance Publique - Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Conservatoire National des Arts et Métiers (CNAM), Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Bobigny, France
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112
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Biancalana E, Parolini F, Mengozzi A, Solini A. Short-term impact of COVID-19 lockdown on metabolic control of patients with well-controlled type 2 diabetes: a single-centre observational study. Acta Diabetol 2021; 58:431-436. [PMID: 33219884 PMCID: PMC7680070 DOI: 10.1007/s00592-020-01637-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/07/2020] [Indexed: 01/05/2023]
Abstract
AIMS/HYPOTHESIS The strict rules applied in Italy during the recent COVID-19 pandemic, with the prohibition to attend any regular outdoor activity, are likely to influence the degree of metabolic control in patients with type 2 diabetes. We explored such putative effect immediately after the resolution of lockdown rules, in the absence of any variation of pharmacologic treatment. METHODS One-hundred and fourteen patients with adequate metabolic control took part in this single-centre, prospective, observational study. The metabolic profile tested 1 week after the end of the lockdown was compared with the last value and the mean of the last three determinations performed before the pandemic emergency (from 6 months to 2 years before). RESULTS After 8 weeks of lockdown, an increase of HbA1c > 0.3% (mean +0.7%) was observed in 26% of the participants; these were also characterized by a persistent elevation in serum triglycerides able to predict the worsening of glucose control. CONCLUSIONS Lockdown determined a relevant short-term metabolic worsening in approximately one-fourth of previously well-controlled type 2 diabetic individuals; pre-lockdown triglycerides were the only parameter able to predict such derangement of glucose control.
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Affiliation(s)
- Edoardo Biancalana
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Federico Parolini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Alessandro Mengozzi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
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113
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Antoun J, Brown DJ, Jones DJW, Sangala NC, Lewis RJ, Shepherd AI, McNarry MA, Mackintosh KA, Mason L, Corbett J, Saynor ZL. Understanding the Impact of Initial COVID-19 Restrictions on Physical Activity, Wellbeing and Quality of Life in Shielding Adults with End-Stage Renal Disease in the United Kingdom Dialysing at Home versus In-Centre and Their Experiences with Telemedicine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3144. [PMID: 33803708 PMCID: PMC8002886 DOI: 10.3390/ijerph18063144] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/15/2022]
Abstract
Early in the coronavirus-2019 (COVID-19) containment strategy, people with end-stage renal disease (ESRD) were identified as extremely clinically vulnerable and subsequently asked to 'shield' at home where possible. The aim of this study was to investigate how these restrictions and the transition to an increased reliance on telemedicine within clinical care of people living with kidney disease impacted the physical activity (PA), wellbeing and quality of life (QoL) of adults dialysing at home (HHD) or receiving in-centre haemodialysis (ICHD) in the UK. Individual semistructured telephone interviews were conducted with adults receiving HHD (n = 10) or ICHD (n = 10), were transcribed verbatim and, subsequently, thematically analysed. As result of the COVID-19 restrictions, PA, wellbeing and QoL of people with ESRD were found to have been hindered. However, widespread support for the continued use of telemedicine was strongly advocated and promoted independence and satisfaction in patient care. These findings highlight the need for more proactive care of people with ESRD if asked to shield again, as well as increased awareness of safe and appropriate PA resources to help with home-based PA and emotional wellbeing.
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Affiliation(s)
- Joe Antoun
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth PO1 2UP, UK; (J.A.); (D.J.B.); (A.I.S.); (J.C.)
- Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth PO6 3LY, UK; (N.C.S.); (R.J.L.)
| | - Daniel J. Brown
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth PO1 2UP, UK; (J.A.); (D.J.B.); (A.I.S.); (J.C.)
| | - Daniel J. W. Jones
- School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6AH, UK;
| | - Nicholas C. Sangala
- Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth PO6 3LY, UK; (N.C.S.); (R.J.L.)
| | - Robert J. Lewis
- Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth PO6 3LY, UK; (N.C.S.); (R.J.L.)
| | - Anthony I. Shepherd
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth PO1 2UP, UK; (J.A.); (D.J.B.); (A.I.S.); (J.C.)
- Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth PO6 3LY, UK; (N.C.S.); (R.J.L.)
| | - Melitta A. McNarry
- Applied Sports, Technology, Exercise and Medicine Research Centre (A-STEM), School of Sport and Exercise Sciences, Swansea University, Swansea SA2 8PP, UK; (M.A.M.); (K.A.M.); (L.M.)
| | - Kelly A. Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Centre (A-STEM), School of Sport and Exercise Sciences, Swansea University, Swansea SA2 8PP, UK; (M.A.M.); (K.A.M.); (L.M.)
| | - Laura Mason
- Applied Sports, Technology, Exercise and Medicine Research Centre (A-STEM), School of Sport and Exercise Sciences, Swansea University, Swansea SA2 8PP, UK; (M.A.M.); (K.A.M.); (L.M.)
| | - Jo Corbett
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth PO1 2UP, UK; (J.A.); (D.J.B.); (A.I.S.); (J.C.)
| | - Zoe L. Saynor
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth PO1 2UP, UK; (J.A.); (D.J.B.); (A.I.S.); (J.C.)
- Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth PO6 3LY, UK; (N.C.S.); (R.J.L.)
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114
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Akirov A, Cahn A, Del Prato S, Home P, Van Gaal L, Chan J, Ning G, Raz I. Tackling obesity during the COVID-19 pandemic. Diabetes Metab Res Rev 2021; 37:e3393. [PMID: 32797666 PMCID: PMC7435354 DOI: 10.1002/dmrr.3393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/02/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Amit Akirov
- Institute of EndocrinologyBeilinson HospitalPetach TikvaIsrael
- Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
| | - Avivit Cahn
- Diabetes UnitDepartment of Endocrinology and MetabolismFaculty of MedicineHadassah Hebrew University Medical CenterJerusalemIsrael
| | - Stefano Del Prato
- Department of Clinical & Experimental MedicineSection of Metabolic Diseases and DiabetesUniversity of PisaPisaItaly
| | - Philip Home
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Luc Van Gaal
- Department of Endocrinology & MetabolismAntwerp University HospitalEdegem‐AntwerpBelgium
| | - Juliana Chan
- Department of Medicine and TherapeuticsPrince of Wales HospitalChinese University of Hong KongHong KongChina
- Hong Kong Institute of Diabetes and ObesityPrince of Wales HospitalChinese University of Hong KongHong KongChina
- Li Ka Shing Institute of Health SciencePrince of Wales HospitalChinese University of Hong KongHong KongChina
| | - Guang Ning
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of HealthDepartment of Endocrine and Metabolic DiseasesRui‐Jin HospitalShanghai Jiao‐Tong University School of MedicineShanghaiChina
| | - Itamar Raz
- Diabetes UnitDepartment of Endocrinology and MetabolismFaculty of MedicineHadassah Hebrew University Medical CenterJerusalemIsrael
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115
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Alharthi SK, Alyusuf EY, Alguwaihes AM, Alfadda A, Al-Sofiani ME. The impact of a prolonged lockdown and use of telemedicine on glycemic control in people with type 1 diabetes during the COVID-19 outbreak in Saudi Arabia. Diabetes Res Clin Pract 2021; 173:108682. [PMID: 33539868 PMCID: PMC9754156 DOI: 10.1016/j.diabres.2021.108682] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/03/2021] [Accepted: 01/19/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND To minimize the spread of Coronavirus Disease-2019, Saudi Arabia imposed a nationwide lockdown for over 6 weeks. We examined the impact of lockdown on glycemic control in individuals with type 1 diabetes (T1D) using continuous glucose monitoring (CGM); and assessed whether changes in glycemic control differ between those who attended a telemedicine visit during lockdown versus those who did not. MATERIALS AND METHODS Flash CGM data from 101 individuals with T1D were retrospectively evaluated. Participants were categorized into two groups: Attended a telemedicine visit during lockdown (n = 61) or did not attend (n = 40). Changes in CGM metrics from the last 2 weeks pre-lockdown period (Feb 25 - March 9, 2020) to the last 2 weeks of complete lockdown period (April 7-20, 2020) were examined in the two groups. RESULTS Those who attended a telemedicine visit during the lockdown period had a significant improvement in the following CGM metrics by the end of lockdown: Average glucose (from 180 to 159 mg/dl, p < 0.01), glycemic management indicator (from 7.7 to 7.2%, p = 0.03), time in range (from 46 to 55%, p < 0.01), and time above range (from 48 to 35%, p < 0.01) without significant changes in time below range, number of daily scans or hypoglycemic events, and other indices. In contrast, there were no significant changes in any of the CGM metrics during lockdown in those who did not attend telemedicine. CONCLUSIONS A six-week lockdown did not worsen, nor improve, glycemic control in individuals with T1D who did not attend a telemedicine visit. Whereas those who attended a telemedicine visit had a significant improvement in glycemic metrics; supporting the clinical effectiveness of telemedicine in diabetes care.
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Affiliation(s)
- Sahar K Alharthi
- Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ebtihal Y Alyusuf
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M Alguwaihes
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Assim Alfadda
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed E Al-Sofiani
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, Baltimore, MD, United States; Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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116
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Kusuma D, Pradeepa R, Khawaja KI, Hasan M, Siddiqui S, Mahmood S, Ali Shah SM, De Silva CK, de Silva L, Gamage M, Loomba M, Rajakaruna VP, Hanif AAM, Kamalesh RB, Kumarendran B, Loh M, Misra A, Tassawar A, Tyagi A, Waghdhare S, Burney S, Ahmad S, Mohan V, Sarker M, Goon IY, Kasturiratne A, Kooner JS, Katulanda P, Jha S, Anjana RM, Mridha MK, Sassi F, Chambers JC. Low uptake of COVID-19 prevention behaviours and high socioeconomic impact of lockdown measures in South Asia: Evidence from a large-scale multi-country surveillance programme. SSM Popul Health 2021; 13:100751. [PMID: 33665333 PMCID: PMC7902538 DOI: 10.1016/j.ssmph.2021.100751] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND South Asia has become a major epicentre of the COVID-19 pandemic. Understanding South Asians' awareness, attitudes and experiences of early measures for the prevention of COVID-19 is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region. METHODS We assessed the knowledge, behaviours, health and socio-economic circumstances of 29,809 adult men and women, at 93 locations across four South Asian countries. Data were collected during the national lockdowns implemented from March to July 2020, and compared with data collected prior to the pandemic as part of an ongoing prospective surveillance initiative. RESULTS Participants were 61% female, mean age 45.1 years. Almost half had one or more chronic disease, including diabetes (16%), hypertension (23%) or obesity (16%). Knowledge of the primary COVID-19 symptoms and transmission routes was high, but access to hygiene and personal protection resources was low (running water 63%, hand sanitisers 53%, paper tissues 48%). Key preventive measures were not widely adopted. Knowledge, access to, and uptake of COVID-19 prevention measures were low amongst people from disadvantaged socio-economic groups. Fifteen percent of people receiving treatment for chronic diseases reported loss of access to long-term medications; 40% reported symptoms suggestive of anxiety or depression. The prevalence of unemployment rose from 9.3% to 39.4% (P < 0.001), and household income fell by 52% (P < 0.001) during the lockdown. Younger people and those from less affluent socio-economic groups were most severely impacted. Sedentary time increased by 32% and inadequate fruit and vegetable intake increased by 10% (P < 0.001 for both), while tobacco and alcohol consumption dropped by 41% and 80%, respectively (P < 0.001), during the lockdown. CONCLUSIONS Our results identified important knowledge, access and uptake barriers to the prevention of COVID-19 in South Asia, and demonstrated major adverse impacts of the pandemic on chronic disease treatment, mental health, health-related behaviours, employment and household finances. We found important sociodemographic differences for impact, suggesting a widening of existing inequalities. Our findings underscore the need for immediate large-scale action to close gaps in knowledge and access to essential resources for prevention, along with measures to safeguard economic production and mitigate socio-economic impacts on the young and the poor.
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Affiliation(s)
- Dian Kusuma
- Centre for Health Economics & Policy Innovation, Imperial College Business School, UK
| | | | | | - Mehedi Hasan
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Sara Mahmood
- Services Institute of Medical Sciences, Lahore, Pakistan
| | | | | | | | - Manoja Gamage
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | - Abu AM Hanif
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | | | - Marie Loh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- School of Public Health, Imperial College London, London, UK
| | | | | | | | | | - Saira Burney
- Services Institute of Medical Sciences, Lahore, Pakistan
| | - Sajjad Ahmad
- Punjab Institute of Cardiology, Lahore, Pakistan
| | | | - Malabika Sarker
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Ian Y. Goon
- School of Public Health, Imperial College London, London, UK
| | | | - Jaspal S. Kooner
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | | | - Malay K. Mridha
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Franco Sassi
- Centre for Health Economics & Policy Innovation, Imperial College Business School, UK
| | - John C. Chambers
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- School of Public Health, Imperial College London, London, UK
| | - NIHR Global Health Research Unit for Diabetes and Cardiovascular Disease in South Asia
- Centre for Health Economics & Policy Innovation, Imperial College Business School, UK
- Madras Diabetes Research Foundation, Chennai, India
- Services Institute of Medical Sciences, Lahore, Pakistan
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Max Healthcare, New Delhi, India
- Punjab Institute of Cardiology, Lahore, Pakistan
- Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- School of Public Health, Imperial College London, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
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117
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Prabhu Navis J, Leelarathna L, Mubita W, Urwin A, Rutter MK, Schofield J, Thabit H. Impact of COVID-19 lockdown on flash and real-time glucose sensor users with type 1 diabetes in England. Acta Diabetol 2021; 58:231-237. [PMID: 33067723 PMCID: PMC7567414 DOI: 10.1007/s00592-020-01614-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/01/2020] [Indexed: 01/11/2023]
Abstract
AIMS People with type 1 diabetes (T1D) face the daily task of implementing self-management strategies to achieve their glycaemic goals. The UK COVID-19 lockdown has had an impact on day-to-day behaviour, which may affect diabetes self-management and outcomes. We assessed whether sensor-based outcomes pre- and during lockdown periods were different in a cohort of glucose sensor users with T1D. METHODS Data were collected from Freestyle Libre (FSL) or Dexcom G6 sensor users who remotely shared their data with the diabetes clinic web platform. Sensor metrics according to international consensus were analysed and compared between pre-lockdown period and 2 and 3 weeks into lockdown (periods 1 and 2). RESULTS Two hundred and sixty-nine T1D patients (baseline HbA1c 57 ± 14 mmol/mol) were identified as FSL (n = 190) or Dexcom G6 (n = 79) users. In patients with sensor use > 70% (N = 223), compared to pre-lockdown period percentage TIR 3.9-10 mM (TIR) significantly increased during period 1 (59.6 ± 18.2 vs. 57.5 ± 17.2%, p = 0.002) and period 2 (59.3 ± 18.3 vs. 57.5 ± 17.2%, p = 0.035). The proportion of patients achieving TIR ≥ 70% increased from 23.3% pre-lockdown to 27.8% in period 1 and 30.5% in period 2. A higher proportion also achieved the recommended time below and above range, and coefficient of variation in periods 1 and 2. Dexcom G6 users had significantly lower % time below range (< 3.9 mM) compared to FSL users during both lockdown periods (period 1: Dexcom G6 vs. FSL: 1.8% vs. 4%; period 2: 1.4% vs. 4%, p < 0.005 for both periods). CONCLUSION Sensor-based glycaemic outcomes in people with T1D in the current cohort improved during COVID-19 lockdown, which may be associated with positive changes in self-management strategies. Further work is required to evaluate long-term sustainability and support.
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Affiliation(s)
- Joshi Prabhu Navis
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Lalantha Leelarathna
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester,, M13 9WL, UK
| | - Womba Mubita
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Andrea Urwin
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Martin K Rutter
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester,, M13 9WL, UK
| | - Jonathan Schofield
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Hood Thabit
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK.
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester,, M13 9WL, UK.
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Rani R, Kumar R, Mishra R, Sharma SK. Digital health: A panacea in COVID-19 crisis. J Family Med Prim Care 2021; 10:62-65. [PMID: 34017704 PMCID: PMC8132818 DOI: 10.4103/jfmpc.jfmpc_1494_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/29/2020] [Accepted: 10/20/2020] [Indexed: 12/15/2022] Open
Abstract
The whole world is in the grip of the coronavirus disease (COVID-19) outbreak. This pandemic brought visible changes in the life of humans around the globe. Likewise, the medical health sector is forced to use digital technology to continue to provide medical health services by preventing themselves. COVID-19 pandemic highlighted the significance of digitalization in every sphere of life. By focusing on virtual care at a large scale, health care delivery becomes possible and convenient even for remote places. The use of artificial intelligence concepts in this pandemic, like robots replaced human movements and function automatically to guide the patients in the reception area and found helpful to prevent and manage the crowd in a few countries. Similarly, the use of e-earning platform has emerged as a digital solution to impart medical education to medical students in this corona outbreak.
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Affiliation(s)
- Ruchika Rani
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Rajesh Kumar
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Rakhi Mishra
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Suresh K Sharma
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
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Fedullo AL, Schiattarella A, Morlando M, Raguzzini A, Toti E, De Franciscis P, Peluso I. Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity. Int J Mol Sci 2021; 22:1213. [PMID: 33530554 PMCID: PMC7866163 DOI: 10.3390/ijms22031213] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.
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Affiliation(s)
- Anna Lucia Fedullo
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.S.); (M.M.); (P.D.F.)
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.S.); (M.M.); (P.D.F.)
| | - Anna Raguzzini
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
| | - Elisabetta Toti
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.S.); (M.M.); (P.D.F.)
| | - Ilaria Peluso
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
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Raman R, Rajalakshmi R, Surya J, Ramakrishnan R, Sivaprasad S, Conroy D, Thethi JP, Mohan V, Netuveli G. Impact on health and provision of healthcare services during the COVID-19 lockdown in India: a multicentre cross-sectional study. BMJ Open 2021; 11:e043590. [PMID: 33468529 PMCID: PMC7817386 DOI: 10.1136/bmjopen-2020-043590] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/28/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic resulted in a national lockdown in India from midnight on 25 March 2020, with conditional relaxation by phases and zones from 20 April. We evaluated the impact of the lockdown in terms of healthcare provisions, physical health, mental health and social well-being within a multicentre cross-sectional study in India. METHODS The SMART India study is an ongoing house-to-house survey conducted across 20 regions including 11 states and 1 union territory in India to study diabetes and its complications in the community. During the lockdown, we developed an online questionnaire and delivered it in English and seven popular Indian languages (Hindi, Tamil, Marathi, Telegu, Kannada, Bengali, Malayalam) to random samples of SMART-India participants in two rounds from 5 May 2020 to 24 May 2020. We used multivariable logistic regression to evaluate the overall impact on health and healthcare provision in phases 3 and 4 of lockdown in red and non-red zones and their interactions. RESULTS A total of 2003 participants completed this multicentre survey. The bivariate relationships between the outcomes and lockdown showed significant negative associations. In the multivariable analyses, the interactions between the red zones and lockdown showed that all five dimensions of healthcare provision were negatively affected (non-affordability: OR 1.917 (95% CI 1.126 to 3.264), non-accessibility: OR 2.458 (95% CI 1.549 to 3.902), inadequacy: OR 3.015 (95% CI 1.616 to 5.625), inappropriateness: OR 2.225 (95% CI 1.200 to 4.126) and discontinuity of care: OR 6.756 (95% CI 3.79 to 12.042)) and associated depression and social loneliness. CONCLUSION The impact of COVID-19 pandemic and lockdown on health and healthcare was negative. The exaggeration of income inequality during lockdown can be expected to extend the negative impacts beyond the lockdown.
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Affiliation(s)
- Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | | | - Janani Surya
- Diabetic Retinopathy Project, Sankara Nethralaya, Chennai, India
| | | | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hosp NHS Foundation Trust, London, UK
| | | | | | - V Mohan
- Madras Diabetes Research Foundation, Chennai, India
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Rawat D, Dixit V, Gulati S, Gulati S, Gulati A. Impact of COVID-19 outbreak on lifestyle behaviour: A review of studies published in India. Diabetes Metab Syndr 2021; 15:331-336. [PMID: 33493852 PMCID: PMC7837201 DOI: 10.1016/j.dsx.2020.12.038] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS The entire globe is undergoing an unprecedented challenge of COVID-19 which has affected the lifestyle behaviour of individuals. The present review is an attempt to summarize the effect of pandemic COVID-19 on lifestyle behaviour among the Indian population. METHODS A review was carried out to summarize the effect of pandemic COVID-19 on lifestyle behaviour focusing on changes in dietary or eating behaviour, stress, sleep pattern, and level of physical activity among the Indian population. Literature searches were conducted in PubMed and Google Scholar from inception till October 2020 to identify all relevant studies. RESULTS A total of 11 studies (n = 5957, age group 18-70 years, comprising both genders) consisting of 1 hospital and 10 community based, were included in the present review. A change in lifestyle behaviour was observed due to COVID-19. Psychosocial or any kind of mental stress among the participants was found to be prevalent. Weight gain and decline in physical activity were also observed. Not only sleep quantity but sleep quality was also found to be affected due to COVID-19. CONCLUSION The present review indicates the need for lifestyle behaviour programmes via using the platform of E-media and also for the dissemination of health education.
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Affiliation(s)
- Dimple Rawat
- Clinical Epidemiology Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Dixit
- Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India.
| | - Sarthak Gulati
- Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka, India
| | | | - Arti Gulati
- Clinical Epidemiology Unit, All India Institute of Medical Sciences, New Delhi, India
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Ullas S, Pradeep M, Surendran S, Ravikumar A, Bastine AM, Prasad A, Mohan A. Telemedicine During the COVID-19 Pandemic: A Paradigm Shift in Non-Communicable Disease Management? - A Cross-Sectional Survey from a Quaternary-Care Center in South India. Patient Prefer Adherence 2021; 15:2715-2723. [PMID: 34916781 PMCID: PMC8667749 DOI: 10.2147/ppa.s332636] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/09/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE This study aims to gauge the perception and adoption rates of telemedicine amongst patients with non-communicable diseases (NCD) as opposed to in-person consultations in a quaternary care center in South India. PATIENTS AND METHODS A web-hosted 21-item cross-sectional survey was distributed to 220 randomly selected patients with a routine appointment in one of the seven departments caring for NCDs in the study center. Descriptive analysis and inferential analyses were done. Paired samples T-test and Pearson's Chi-square test were used study associations. RESULTS In-person consultations decreased by 1.9±4.47 visits per year, in 2020 vs 2019. Most participants reported "fear of COVID-19" as the primary reason for this decline. Participants also reported that their consultation times had significantly decreased (OR=6.43, 95% CI=1.7-24.08, p=0.006). The decreased consultations time, difficulty in obtaining in-person appointments, along with the reduced physical examination during consultations have made participants more open to the idea of teleconsultations (OR=3.88, 95% CI=1.21-12.47, p=0.022). Eighty-five (38.63%) participants had already adopted telemedicine for their routine consultations during the pandemic. Whilst participants felt that telemedicine was an adequate surrogate for in-person consultations, a significant difficulty in obtaining medications was noted (OR=6, 95% CI=1.34-26.81, p=0.019). CONCLUSION In-person consultations were decreased primarily due to the perception of significant risk of COVID-19 exposure in the present scenario. Telemedicine adoption in the private sector may be sustainable throughout the pandemic and beyond, if patients are offered to continue their routine consultations with their regular doctors and ensured medicine availability. Integration of telemedicine by the public and private health sector of India into routine NCD care delivery is the need of the hour, but further studies are required to estimate the effectiveness of the systems.
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Affiliation(s)
- Sisira Ullas
- Amrita School of Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Manu Pradeep
- Department of Pharmacology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
- Correspondence: Manu Pradeep Department of Pharmacology, Amrita Institute of Medical Sciences, Ponekkara, P.O Kochi, Kerala, 682041, IndiaTel +91 9947568919 Email
| | - Sandeep Surendran
- Department of Rheumatology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Anjali Ravikumar
- Department of General Surgery, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Anna Maria Bastine
- Amrita School of Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Ayush Prasad
- Amrita School of Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Aravind Mohan
- Amrita School of Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Bala R, Srivastava A, Potsangbam T, Anal L, Ningthoujam GD. Self care practices and psychological distress among diabetic patients in Manipur during COVID-19: A scenario from the North East. Diabetes Metab Syndr 2021; 15:93-98. [PMID: 33316765 PMCID: PMC7720010 DOI: 10.1016/j.dsx.2020.12.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM Uncontrolled diabetes has emerged as one of the major risk factors for mortality in patients with coronavirus disease (COVID-19). Physical inactivity, alterations in dietary habits, and inability to seek guidance from the physician are some of the contributing factors. This study aims to assess the self-care practices and psychological distress during the pandemic among diabetic patients visiting the institute's out patient department. METHOD A convenient sampling method was used to recruit subjects from a representative clinical sample using validated scales like the Summary of Diabetes Self-Care Activities (SDSCA) and Kessler Psychological Distress Scale (K10). RESULT The study enrolled a total of 108 subjects with the mean age being 56.3 years. The everyday healthy eating plan was followed by 76.85% (N = 83) subjects and daily physical activity for at least 30 min performed by 50% (54) subjects. Only 12.04% (13) subjects tested their blood sugar and 6.48% (7) respondents checked their feet daily. There was no significant difference found between the SDSCA and psychological distress based on socio-demographic variables. CONCLUSION Participants in this study typically reported a good level of self-care behavior particularly for diet followed by exercise whereas the self-care behavior was not adequate for foot care and blood-glucose testing. People were not too anxious about COVID-19. This study highlighted the fact that people with diabetes should monitor their blood sugar levels more often along with their foot care.
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Affiliation(s)
- Renu Bala
- Regional Research Institute for Homoeopathy, (Under Central Council for Research in Homoeopathy, New Delhi), New Checkon, Opposite Tribal Colony, Imphal East, Manipur, 795001, India
| | - Amit Srivastava
- Regional Research Institute for Homoeopathy, (Under Central Council for Research in Homoeopathy, New Delhi), New Checkon, Opposite Tribal Colony, Imphal East, Manipur, 795001, India.
| | - Thadoi Potsangbam
- Regional Research Institute for Homoeopathy, (Under Central Council for Research in Homoeopathy, New Delhi), New Checkon, Opposite Tribal Colony, Imphal East, Manipur, 795001, India
| | - Lily Anal
- Regional Research Institute for Homoeopathy, (Under Central Council for Research in Homoeopathy, New Delhi), New Checkon, Opposite Tribal Colony, Imphal East, Manipur, 795001, India
| | - Gouri D Ningthoujam
- Regional Research Institute for Homoeopathy, (Under Central Council for Research in Homoeopathy, New Delhi), New Checkon, Opposite Tribal Colony, Imphal East, Manipur, 795001, India
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Misra A, Ghosh A, Gupta R. Heterogeneity in presentation of hyperglycaemia during COVID-19 pandemic: A proposed classification. Diabetes Metab Syndr 2021; 15:403-406. [PMID: 33588198 PMCID: PMC7847699 DOI: 10.1016/j.dsx.2021.01.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Diabetes and hyperglycemia occurring during COVID-19 era have implications for COVID-19 related morbidity/mortality. In this brief review, we have attempted to categorise and classify such heterogenous hyperglycemic states. During COVID-19 pandemic broadly two types of hyperglycemia were seen: one in patients without COVID-19 infection and second in patients with COVID-19 infection. Patients not inflicted with COVID-19 infection and diagnosed with either type 2 diabetes mellitus (T2DM) or type 1 diabetes mellitus (T1DM) show more severe hyperglycemia and more ketoacidosis, respectively. In former, it could be attributed to weight gain, decreased exercise, stress and in both type of diabetes, due to delayed diagnosis during lockdown and pandemic. In patients with COVID-19 and associated pneumonia, altered glucose metabolism leading to hyperglycemia could be due to corticosteroids, cytokine storm, damage to pancreatic beta cells, or combination of these factors. Some of these patients present with diabetic ketoacidosis, hyperglycemic hyperosmolar state or both. We have provided a framework for categorisation of hyperglycemic states, which could be consolidated/revised in future based on new research data.
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Affiliation(s)
- Anoop Misra
- Centre of Nutrition & Metabolic Research (C-NET), National Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, India; Diabetes Foundation (India), SDA, New Delhi, India; Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, Nehru Place, New Delhi, India.
| | - Amerta Ghosh
- Centre of Nutrition & Metabolic Research (C-NET), National Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, India; Diabetes Foundation (India), SDA, New Delhi, India; Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, Nehru Place, New Delhi, India
| | - Ritesh Gupta
- Centre of Nutrition & Metabolic Research (C-NET), National Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, India; Diabetes Foundation (India), SDA, New Delhi, India; Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, Nehru Place, New Delhi, India
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Bandyopadhyay K, Yasmin M, Bhattacharyya G, Ghosh S, Mukhopadhyay D, Biswas A. Perceived stress, hardship, and self-reported health status of persons living with diabetes mellitus during Coronavirus Disease-19 pandemic and lockdown: A descriptive study. ACTA MEDICA INTERNATIONAL 2021. [DOI: 10.4103/amit.amit_111_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gautam V, S D, Rustagi N, Mittal A, Patel M, Shafi S, Thirunavukkarasu P, Raghav P. Health literacy, preventive COVID 19 behaviour and adherence to chronic disease treatment during lockdown among patients registered at primary health facility in urban Jodhpur, Rajasthan. Diabetes Metab Syndr 2021; 15:205-211. [PMID: 33387854 PMCID: PMC7833282 DOI: 10.1016/j.dsx.2020.12.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/06/2020] [Accepted: 12/11/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Potential role of health literacy in determining adherence to COVID-19 preventive behavior, pharmacological, and lifestyle management among diagnosed patients of chronic diseases during nationwide lockdown is inadequately investigated. METHODS A cross-sectional study was conducted from May-August 2020 among diagnosed patients of chronic diseases residing in a COVID-19 hotspot of urban Jodhpur, Rajasthan, and availing health services from primary care facility. Telephonic interviews of participants were conducted to determine their health literacy using HLS-EU-Q47 questionnaire, adherence to COVID-19 preventive behaviour as per World Health Organization recommendations, and compliance to prescribed pharmacological and physical activity recommendations for chronic disease. RESULTS All the 605 diagnosed patients of chronic diseases availing services from primary care facility were contacted for the study, yielding response rate of 68% with 412 agreeing to participate. Insufficient health literacy was observed for 65.8% participants. Only about half of participants had scored above median for COVID-19 awareness (55.1%) and preventive behavior (45.1%). Health literacy was observed to be significant predictor of COVID-19 awareness [aOR: 3.53 (95% CI: 1.81-6.88)]; COVID-19 preventive behavior [aOR: 2.06, 95%CI; 1.14-3.69] and compliance to pharmacological management [aOR: 3.05; 95% CI: 1.47-6.35] but not for physical activity. CONCLUSION COVID-19 awareness, preventive behavior, and compliance to pharmacological management is associated with health literacy among patients of chronic disease availing services from primary health facility. Focusing on health literacy could thus be an essential strategic intervention yielding long term benefits.
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Affiliation(s)
- Vaishali Gautam
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Dileepan S
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Neeti Rustagi
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India.
| | - Ankit Mittal
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Mehul Patel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Shazia Shafi
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Prasanna Thirunavukkarasu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Pankaja Raghav
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
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CARVALHAL MMDL, DIAS JLL, REIS AL, BERINO TN, ULIANA GC, GOMES DL. Cooking habits and food choices of individuals with Type 1 Diabetes Mellitus during the pandemic of COVID-19. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e210043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ABSTRACT Objective To verify the association between cooking habits, socioeconomic data, and food choices of individuals with Type 1 Diabetes Mellitus during the pandemic of COVID-19. Methods Transversal study with individuals with Type 1 Diabetes Mellitus carried out in July 2020. Socioeconomic data and information about social distancing and food practices were collected with an online form. The research was approved by the university’s Ethics and Research Committee (Process number 4.147.663). Results Out of the 472 participants, 50.9% reported that they have been cooking more during the pandemic. An association between cooking more and having a university degree (p<0.000) was observed. Not being able to comply with social distancing rules because of work necessities was associated with not cooking (p=0.006). Cooking more during the quarantine was associated with eating less than five meals per day (p=0.04), having an appropriate consumption of fruits (p=0.02) and vegetables (p=0.04), and increased water intake (p=0.01). Conclusion In Brazil, the habit of cooking during the pandemic may represent an increase in domestic work, reinforced by social inequalities. Therefore, comprehending the cooking habits and food choices of people with diabetes may widen the perspectives of health professionals involved in the treatment of the disease and contribute to the elaboration of public policies that take the country's inequalities into account. We emphasize the importance of investing in policies that encourage the development of culinary skills, as well as the habit of cooking as part of the actions of Food and Nutrition Education.
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Ghosh A, Anjana RM, Shanthi Rani CS, Jeba Rani S, Gupta R, Jha A, Gupta V, Kuchay MS, Luthra A, Durrani S, Dutta K, Tyagi K, Unnikrishnan R, Srivastava BK, Ramu M, Sastry NG, Gupta PK, Umasankari G, Jayashri R, Mohan V, Misra A. Glycemic parameters in patients with new-onset diabetes during COVID-19 pandemic are more severe than in patients with new-onset diabetes before the pandemic: NOD COVID India Study. Diabetes Metab Syndr 2021; 15:215-220. [PMID: 33450530 PMCID: PMC7771314 DOI: 10.1016/j.dsx.2020.12.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS It is not known if new onset diabetes during Coronavirus-19 disease (COVID-19; NOD COVID) is phenotypically or biochemically different than new onset diabetes before COVID-19 (NOD). METHODS All adults diagnosed with new onset diabetes from during the time of COVID-19 were compared with new onset diabetes prior to COVID-19 from two tertiary care hospitals in Chennai and Delhi. RTPCR test for SARS-CoV-2 virus was done as appropriate, and COVID-19 antibody test was done in all other NOD COVID patients. RESULT A total of 555 patients with new onset diabetes were included in the study (282 NOD and 273 NOD COVID patients). Patients with NOD COVID had higher fasting and post prandial blood glucose and glycated hemoglobin levels vs. NOD patients. Both the groups had high average body mass index; ∼28 kg/m2. Interestingly, fasting C-peptide levels were significantly higher in the NOD COVID group vs. NOD group. There was no difference in C-peptide levels or glycemic parameters between the COVID-19 antibody positive and negative NOD COVID cases. CONCLUSION Individuals who were diagnosed with diabetes during COVID-19 epidemic (NOD COVID) do not significantly differ from those diagnosed before COVID-19 in symptomatology, phenotype, and C-peptide levels but they had more severe glycemia.
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Affiliation(s)
- Amerta Ghosh
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | | | - Saravanan Jeba Rani
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ritesh Gupta
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Alka Jha
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Vimal Gupta
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | | | - Atul Luthra
- Fortis CDOC Center for Diabetes, Fortis Memorial Institute, Gurgaon, India
| | - Suhail Durrani
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Koel Dutta
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Kanika Tyagi
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | | | - Muthu Ramu
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | | | - Prasanna Kumar Gupta
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ganesan Umasankari
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ramamoorthy Jayashri
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India.
| | - Anoop Misra
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India.
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Knowledge, attitude and practice of physical activity promotion among physiotherapists in India during COVID 19. J Bodyw Mov Ther 2020; 26:463-470. [PMID: 33992283 DOI: 10.1016/j.jbmt.2020.12.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/28/2020] [Accepted: 12/28/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Coronavirus disease (COVID-19) pandemic and the nationwide lockdown has increased sedentary time and physical inactivity. Physiotherapists are one of the essential health professionals who are actively involved in promoting physical activities. The study objectives included assessing knowledge of physical activity guidelines, physiotherapist attitude towards involvement in physical activities and practice of routine physical activity assessment, and its promotion among physiotherapists in India during COVID-19. METHOD In this cross-sectional survey study, the study tool was prepared using Google Forms. It consisted of sixteen questions on knowledge, attitude, and practice of physical activities among physiotherapists. Study participants were physiotherapists with a minimum of a bachelor's degree qualification and practicing in India. RESULTS One hundred and eighty responses were received from sixteen states of India. The average age of respondents was 28 years, and the average work experience of five years. This study found that only 19% of physiotherapists could give the correct answer in all three domains of WHO PA guidelines. 70% of physiotherapists found with an appropriate attitude as they met the 150 min of moderate PA per week. 68% reported that they promote physical activities in routine practice. CONCLUSION This study suggested the majority of physiotherapists perform physical activity assessment and promotion in routine practice in India. Most of them have an appropriate attitude towards physical activity, but very few physiotherapists have adequate knowledge of WHO physical activity guidelines. Physiotherapists should actively promote physical activities in routine practice to reduce the impairment due to physical inactivity especially during the Corona virus disease pandemic in India. Efforts should be made to increase the physical activity awareness in terms of knowledge of WHO physical activity guidelines, different assessment, and promotion strategies.
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130
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Sciberras J, Camilleri LM, Cuschieri S. The burden of type 2 diabetes pre-and during the COVID-19 pandemic - a review. J Diabetes Metab Disord 2020; 19:1357-1365. [PMID: 33102262 PMCID: PMC7570404 DOI: 10.1007/s40200-020-00656-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/06/2020] [Indexed: 12/18/2022]
Abstract
Introduction Diabetes Mellitus is a chronic disease and a global epidemic. It is a known fact that co-morbidities, including Diabetes Mellitus, pose a higher risk of infection by COVID-19. Additionally, the outcomes following infection are far worse than in people without such co-morbities.Factors contributing to the development of type 2 diabetes mellitus (T2DM) have long been established, yet this disease still bestows a substantial global burden. The aim was to provide a comprehensive review of the burden of diabetes pre-COVID-19 and the additional impact sustained by the diabetes population and healthcare systems during the COVID-19 pandemic, while providing recommendations of how this burden can be subsided. Methodology Literature searches were carried out on 'Google Scholar' and 'PubMed' to identify relevant articles for the scope of this review. Information was also collected from reliable sources such as the World Health Organisation and the International Diabetes Federation. Results T2DM presented with economic, social and health burdens prior to COVID-19 with an significant 'Disability Adjusted Life Years' impact. Whilst people with diabetes are more susceptible to COVID-19, enforcing lockdown regulations set by the Public Health department to reduce risk of infection brought about its own challenges to T2DM management. Through recommendations and adapting to new methods of management such as telehealth, these challenges and potential consequences of mismanagement are kept to a minimum whilst safeguarding the healthcare system. Conclusion By understanding the challenges and burdens faced by this population both evident pre-covid and during, targeted healthcare can be provided during the COVID-19 pandemic. Furthermore, implementation of targeted action plans and recommendations ensures the care provided is done in a safe and effective environment.
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Affiliation(s)
| | | | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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131
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N Ahmed W. Lockdown and diabetes–what actually happened? JOURNAL OF DIABETES, METABOLIC DISORDERS & CONTROL 2020. [DOI: 10.15406/jdmdc.2020.07.00211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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132
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Melesie Taye G, Bose L, Beressa TB, Tefera GM, Mosisa B, Dinsa H, Birhanu A, Umeta G. COVID-19 Knowledge, Attitudes, and Prevention Practices Among People with Hypertension and Diabetes Mellitus Attending Public Health Facilities in Ambo, Ethiopia. Infect Drug Resist 2020; 13:4203-4214. [PMID: 33262615 PMCID: PMC7695607 DOI: 10.2147/idr.s283999] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/11/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To confirm effective preventive practice and reduce the risk of COVID-19 data on knowledge, attitude, and preventive practices (KAP) are essential. Therefore, the current study was designed to evaluate the KAP of COVID-19 among people with hypertension (HTN) and/or diabetes mellitus (DM) attending public health facilities in Ambo town. PATIENTS AND METHODS Institutional-based cross-sectional study design was done among patients with HTN and/or DM from June 2020 to September 2020 at Ambo University Referral Hospital (AURH) and Ambo General Hospital (AGH). To identify the associated factors with poor practice and knowledge, logistic regression analyses were used. RESULTS The mean age of the study respondents was 44.6 years (± 9.84) of which the majority were male 235 (55.6%) and 159 (37.59%) of the participants had good knowledge. Concerning attitude, 335 (79.2%) have strongly believed that DM and HTN patients were more at risk of death because of COVID-19. Only 44 (10.4%) of them had a good level of COVID-19 prevention practice measures. Patients who use the source of information daily were 54.4% less likely to have poor knowledge about COVID-19 than those who use it weekly. Participants with no formal education were 3 times more likely to have poor COVID-19 prevention practice than those who were with formal education, and participants who have poor knowledge about COVID-19 were 2 times more likely to have poor COVID-19 prevention practice than those who have knowledge. CONCLUSION The prevalence of poor knowledge about COVID-19 was low, and only less than ¾ of the participants strongly believed COVID-19 as a serious disease. A small percentage of participants had a good level of COVID-19 prevention practice. Good knowledge had an association with a good level of prevention practice. So, health sectors should work to increase accessibility of COVID-19 information.
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Affiliation(s)
- Getu Melesie Taye
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Lemma Bose
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Tamirat Bekele Beressa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Gosaye Mekonnen Tefera
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Biruk Mosisa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Hunduma Dinsa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Adamu Birhanu
- Department of Psychiatry, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Gurmu Umeta
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Alhadramy OM. The Structure and the Outcome of Telephone-Based Cardiac Consultations During Lockdown: A Lesson From COVID-19. Cureus 2020; 12:e11585. [PMID: 33364109 PMCID: PMC7749865 DOI: 10.7759/cureus.11585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 11/05/2022] Open
Abstract
Background In response to COVID-19, Saudi Arabia as many countries, implemented "lockdown" to contain the epidemic. This resulted in suspension of all outpatient services. The reliability of the alternative telecommunication cardiac services during that time is not well studied. Accordingly, the objective of this study is to describe the structure of the telephone-based cardiac consultation (TBCC) and to explore its outcome. Methods This is a cross-sectional study that has a prospective follow up on patients who underwent medical intervention. During the period of lockdown, Alre'aiah health care society in Almadinah Almunawwarah, Saudi Arabia, provided a community health service. This was achieved by announcing telephone numbers for consultations in most specialties. This study includes all TBCC of a single cardiologist. Detailed demographic data, medical, social and drug histories of the patients were collected in charts. Individuals were requested to measure blood pressure (BP) and heart rate (HR) at the time of TBCC. Accordingly, cardiovascular assessment and appropriate intervention were executed. Patients who needed medical intervention were followed up in one week. The data were analyzed using appropriate statistical methods. Results From 01 April till 15 June 2020, a total of 168 individuals sought TBCC. Their median age was 51.5 ± 12.7 years, and (57.1%) were females. Healthy individuals constituted (33.9%), and (59.9%) were non-smokers. The most common reported medical illnesses were hypertension (27.3%), diabetes (23.8%), heart failure (16.1%), and coronary artery disease (14.9%). Palpitations were encountered by 58 patients. None of them had high-risk features or cardiac disease. Stress, excessive smoking, and caffeine intake were thought to be responsible for palpitations in 52 individuals who were reassured and educated, and newly diagnosed hypertension was established prospectively in eight patients and they were started on medications. Chest pain was reported by 51 individuals. The diagnosis of typical angina was made in nine patients and they were instructed to seek emergency care. Atypical angina pain was established in 10 cases who were advised to seek formal consultation once lockdown ends. Reassurance was achieved in 32 individuals who had features of non-angina pain. Uncontrolled hypertension was reported by 32 patients. Blood pressure control was achieved prospectively in 70% of these patients who followed up by adjusting their antihypertensive drugs. Twenty-seven patients with heart failure complained of worsening shortness of breath. New York Heart Association (NYHA) class 1-2 was reported by 21 patients, and they were managed by doubling diuretic dose, 19 of them followed back and reported significant improvement. NYHA class 3-4 was established in 6 patients and they were instructed to seek emergency care. Conclusions When standard face-to-face cardiac consultations are compromised, a structured TBCC is considered feasible, seems effective, and promising alternative method of delivering the utmost cardiac care to the community. When conducted properly, it is useful to triage patients.
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Affiliation(s)
- Osama M Alhadramy
- Internal Medicine, College of Medicine, Taibah University, Medina, SAU
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134
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Singh AK, Misra A. Impact of COVID-19 and comorbidities on health and economics: Focus on developing countries and India. Diabetes Metab Syndr 2020; 14:1625-1630. [PMID: 32891011 PMCID: PMC7451213 DOI: 10.1016/j.dsx.2020.08.032] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Presence of comorbidities in patients with Coronavirus disease 2019 (COVID-19) have often been associated with increased in-hospital complications and mortality. Intriguingly, several developed countries with a higher quality of life have relatively higher mortality with COVID-19, compared to the middle- or low-income countries. Moreover, certain ethnic groups have shown a higher predilection to contract COVID-19, with heightened mortality. We sought to review the available literature with regards to impact of COVID-19 and comorbidities on the health and economics, especially in context to the developing countries including India. METHODS A Boolean search was carried out in PubMed, MedRxiv and Google Scholar databases up till August 23, 2020 using the specific keywords, to find the prevalence of comorbidities and its outcome in patients with COVID-19. RESULTS All available evidence consistently suggests that presence of comorbidities is associated with a poor outcome in patients with COVID-19. Diabetes prevalence is highest in Indian COVID-19 patients, compared to other countries. Majority of the patients with COVID-19 are asymptomatic ranging from 26 to 76%. CONCLUSIONS Universal masking is the need of hour during unlock period. Low-income countries such as India, Brazil and Africa with less resources and an average socio-economic background, must adopt a strict policy for an affordable testing programs to trace, test, identify and home quarantine of asymptomatic cases. Despite the huge number of COVID-19 patients, India still has low volume research at the moment.
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Affiliation(s)
- Awadhesh Kumar Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata, India.
| | - Anoop Misra
- Fortis-C-DOC Center of Excellence for Diabetes, Metabolic Disease and Endocrinology, National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India
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135
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Khader MA, Jabeen T, Namoju R. A cross sectional study reveals severe disruption in glycemic control in people with diabetes during and after lockdown in India. Diabetes Metab Syndr 2020; 14:1579-1584. [PMID: 32858476 PMCID: PMC7434486 DOI: 10.1016/j.dsx.2020.08.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Uncontrolled diabetes has been associated with poorer clinical outcomes in COVID-19. We aimed to evaluate and assess the impact of COVID-19 pandemic on management of diabetes and challenges faced by people with diabetes in India during and after the lockdown phase. METHODS A cross-sectional study based on an online questionnaire survey was designed. The questions collected socio-demographic details, medical and social history, and impact of the pandemic on medical and social life from 1582 participants. Linear regression was employed to evaluate association of different parameters with the change in glycemic levels. RESULTS The frequency of clinical visits during the COVID-19 pandemic were reduced in 87.28% of participants. 92.45% of participants were able to monitor their blood glucose levels (BGLs) in which 78.42% (49.35%, 20.91%, and 8.16%) participants experienced an increase in BGL (mild, moderate, and severe respectively). Only 47.41% of participants possessed the digital glucometer at home. 69.07% of participants reported a decrease in physical activity while 46.88% reported an increase in food intake. 80.06% of participants were able to buy all medicines and 29.80% were gone for virtual consultations while 87.81% reported that they didn't have access to healthcare services. Overall, 89.47% participants experienced disruption in therapy. A highly significant correlation (r = 0.89, p = 0.0145) was found between increasing age and reporting of higher BGLs. CONCLUSION This study provides a firsthand evidence of major disruption in diabetes care activities during and after the lockdown phase in India and increased risk of poorer clinical outcomes, if infected by SARS-CoV-2.
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Affiliation(s)
- Mohammed Abdul Khader
- Department of Pharmacology & Pharmacy Practice, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad, Telangana, 500075, India.
| | - Talha Jabeen
- Department of Pharmacology & Pharmacy Practice, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad, Telangana, 500075, India.
| | - Ramanachary Namoju
- Department of Pharmacology & Pharmacy Practice, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad, Telangana, 500075, India; Department of Pharmacology, GITAM University, Gandhi Nagar, Vishakhapatnam, Andhra Pradesh, 530045, India.
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136
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Gupta R, Misra A. Clinical considerations in patients with diabetes during times of COVID19: An update on lifestyle factors and antihyperglycemic drugs with focus on India. Diabetes Metab Syndr 2020; 14:1777-1781. [PMID: 32942253 PMCID: PMC7477599 DOI: 10.1016/j.dsx.2020.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diabetes is recognized as an important comorbidity in patients with COVID-19 and a large amount of literature has become available regarding this. The aim of this article is to review the literature regarding various aspects of association between diabetes and COVID-19 and to highlight clinically relevant points with focus on India. METHODS We searched Pubmed and Google Scholar databases for articles regarding diabetes and COVID-19 published between March 19, 2020 and August 30, 2020. RESULTS Diabetes and poor glycemic control are associated with increased severity and mortality in patients with COVID-19. Several clinical scenarios about hyperglycemia and COVID-19 are identified and each of these needs specific management strategies. CONCLUSION It is prudent to maintain good glycemic control in patients with diabetes in order to minimize the complications of COVID-19. There is a need for well conducted studies to asses the role of individual antihyperglycemic therapies in COVID-19 and also the behavior of new onset diabetes diagnosed either after COVID-19 infection or during this time.
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Affiliation(s)
- Ritesh Gupta
- Fortis CDOC Hospital, Chirag Enclave, New Delhi, India.
| | - Anoop Misra
- Fortis CDOC Hospital, Chirag Enclave, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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137
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Misra A. Balanced nutrition is needed in times of COVID19 epidemic in India: A call for action for all nutritionists and physicians. Diabetes Metab Syndr 2020; 14:1747-1750. [PMID: 32927405 PMCID: PMC7451051 DOI: 10.1016/j.dsx.2020.08.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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138
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Olickal JJ, Chinnakali P, Suryanarayana BS, Ulaganeethi R, Kumar SS, Saya GK. Effect of COVID19 pandemic and national lockdown on persons with diabetes from rural areas availing care in a tertiary care center, southern India. Diabetes Metab Syndr 2020; 14:1967-1972. [PMID: 33059300 PMCID: PMC7548067 DOI: 10.1016/j.dsx.2020.10.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/04/2020] [Accepted: 10/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS COVID-19 pandemic and lockdown measures to contain it have affected health care services globally. This study aims to assess the effect and urban-rural differences of COVID19 pandemic on diabetes care. METHODS This cross-sectional study was conducted among persons with diabetes (PWDs) registered for care at a diabetes clinic of a tertiary care center in Southern India. We collected following information by telephonic interviews: physician consultations, access to diabetes medications and blood sugar tests, use of telemedicine services, out of pocket expenditure and psychological morbidity. RESULTS A total of 350 PWDs were interviewed. Majority were male (78%) and from rural areas (79%). One fourth (24%) met any physician for diabetes care at least once during lockdown. PWDs from rural areas mainly consulted a physician in a private clinic (55%) compared to urban areas (26%). Two third (65%) availed medications from private medical shops. Almost half (46%) got their blood sugar tested during and majority of them (81%) reported unsatisfactory glycemic control. Only few (5%) was aware and three utilized telemedicine services. Almost all (99%) spent money (US $ 8.3) for diabetes care. One third (33%) had moderate or high psychological distress. CONCLUSIONS Majority of PWDs did not consult a physician during lockdown. Cost of care was high. Measures to improve utilisation of telemedicine services and peripheral health facilities are needed.
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Affiliation(s)
- Jeby Jose Olickal
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Palanivel Chinnakali
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
| | - B S Suryanarayana
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Revathi Ulaganeethi
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Swetha S Kumar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Ganesh Kumar Saya
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Khader MA, Jabeen T, Namoju R. A cross sectional study reveals severe disruption in glycemic control in people with diabetes during and after lockdown in India. Diabetes Metab Syndr 2020; 14:1579-1584. [DOI: https:/doi.org/10.1016/j.dsx.2020.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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140
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Sankar P, Ahmed WN, Mariam Koshy V, Jacob R, Sasidharan S. Effects of COVID-19 lockdown on type 2 diabetes, lifestyle and psychosocial health: A hospital-based cross-sectional survey from South India. Diabetes Metab Syndr 2020; 14:1815-1819. [PMID: 32956926 PMCID: PMC7485570 DOI: 10.1016/j.dsx.2020.09.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Lockdown during the COVID-19 pandemic imposed many restrictions on the public. Loss of continuum of care along with improper lifestyle was expected to worsen glycemic control in people with type 2 diabetes (T2D). We aimed to identify the effects of lockdown on their glycemic status, lifestyle changes and psychosocial health. METHODS The pre- and post-lockdown data of 110 adults with T2D who were under regular follow up was collected by direct interview during their visit to the diabetes clinic. The variables analyzed included demographic data, HbA1c, body weight, lifestyle changes, psychosocial factors and use of technology. RESULT The overall physical activity and dietary adherence remained unchanged in more than 80% of the participants. There was increased consumption of vegetables (80.9%), fruits (42.7%), and decreased unhealthy snacking (63%). 90% of them had access to medications. No significant change was noted in the mean HbA1c and body weight before and after lockdown. Most of them (99%) watched television and 73.6% of them spent time with their family members. Those with mental stress and poor sleep had unhealthy dietary habits. Poor glycemic control was seen in those with less physical activity and an unhealthy diet. CONCLUSION Lockdown did not cause a major change in the overall glycemic control. Measures to promote healthy lifestyle practices along with ways to reduce psychosocial stress must be implemented for better T2D management during such restricted times.
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Affiliation(s)
| | - Waseem N Ahmed
- Department of Family and Internal Medicine, CRAFT Hospital and Research Centre, Kodungallur, Thrissur, Kerala, India.
| | | | - Rittin Jacob
- MGM Muthoot Hospitals, Pathanamthitta, Kerala, India.
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Khare J, Jindal S. Observational study on Effect of Lock Down due to COVID 19 on glycemic control in patients with Diabetes: Experience from Central India. Diabetes Metab Syndr 2020; 14:1571-1574. [PMID: 32858474 PMCID: PMC7438221 DOI: 10.1016/j.dsx.2020.08.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Diabetes is a chronic metabolic condition characterized with hyperglycemia and associated with several complications. Glycemic control is important factor in preventing the complications associated with diabetes. Pillars for good glycemic control are good life style modification with proper medication under medical guidance. The aim of this study was to study the effect of lock down on glycemic control in diabetic patients and possible factor responsible for this. MATERIAL AND METHODS - Out of 407 only 143 diabetic patients who attended the our endocrine OPD in last 3 months who had good glycemic control in past without any chronic complication and willing to participate were included in study. They were advised for the self-monitoring of blood glucose for identifying the glycemic control and with questionnaire designed possible factor was identified during the lockdown period. RESULTS - The patients were aged between 18 and 65 years with mean age of 54.68 years and male to female ratio was 91:52.56 (39.16%) patients reported worsening of hyperglycemia and requiring addition of medications for control of blood glucose and 3 (2.09%) patients reported hypoglycemic events and medications were stepped down. Psychological stress was most common factor worsening of hyperglycemia followed by change in diet and exercise.
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Affiliation(s)
- Jaideep Khare
- People's Medical College and Research Centre, Director Hormone and Skin Center, Bhopal, India.
| | - Sushil Jindal
- People's Medical College and Research Centre, Bhopal, India.
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Misra A. Sagging original research in diabetes could be boosted if Indian pharmaceutical companies contribute to investigator-initiated hypothesis-driven research. Diabetes Metab Syndr 2020; 14:2231-2232. [PMID: 33395784 DOI: 10.1016/j.dsx.2020.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Anoop Misra
- National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India; Diabetes Foundation (India), New Delhi, India; Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, B-16, Chirag Enclave, New Delhi, 110048, India.
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Singhai K, Swami MK, Nebhinani N, Rastogi A, Jude E. Psychological adaptive difficulties and their management during COVID-19 pandemic in people with diabetes mellitus. Diabetes Metab Syndr 2020; 14:1603-1605. [PMID: 32862099 PMCID: PMC7443210 DOI: 10.1016/j.dsx.2020.08.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS People with diabetes have multiple psychosocial issues related to diabetes and its complications and this may be exacerbated during the COVID-19 pandemic. METHODS We reviewed the psychological adaptative difficulties in people with diabetes especially during natural disasters including the prevailing COVID-19 pandemic. RESULTS There are significant concerns regarding worsening of glycemic control, unavailability of appropriate medicines, inaccessibility to health care or acquiring SARS- CoV-2 infection and subsequent poorer outcomes during the COVID-19 pandemic. Although there are some guidance documents for managing diabetes and associated complications during COVID-19 pandemic but very few address the psychological issues in people with diabetes. We discuss the psychological adaptive difficulties and an approach to address the psychosocial concerns in people with diabetes during the COVID-19 pandemic. CONCLUSIONS People with diabetes have significant diabetes distress and psychological adaptive difficulties that is aggravated by the COVID-19 pandemic. An integrated multidisciplinary approach is needed to manage the prevailing psychological issues amongst people with diabetes during the COVID-19 pandemic.
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Affiliation(s)
- Kartik Singhai
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Mukesh Kumar Swami
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Naresh Nebhinani
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Ashu Rastogi
- Department of Endocrinology and Metabolism, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Edward Jude
- Consultant Diabetologist, Diabetes and Endocrinology Department, Tameside and Glossop Integrated Care NHS FT, Ashton under Lyne, Lancs, OL69RW, UK.
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144
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Rastogi A, Hiteshi P, Bhansali A. Improved glycemic control amongst people with long-standing diabetes during COVID-19 lockdown: a prospective, observational, nested cohort study. Int J Diabetes Dev Ctries 2020; 40:476-481. [PMID: 33106739 PMCID: PMC7576977 DOI: 10.1007/s13410-020-00880-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023] Open
Abstract
Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. However, the effect of COVID-19 lockdown on physical activity and glycemic control in such individuals is not known. We studied the physical activity and glycemic control during lockdown in comparison to pre-lockdown parameters in individuals with long-standing type 2 diabetes. Methods This prospective, observational study includes 2240 people with T2DM regularly attending diabetes clinic prior to lockdown. Glycemic record, HbA1c, and physical activity assessed with Global Physical Activity Questionnaire (GPAQ) as metabolic equivalents (MetS min/week) were obtained during lockdown (minimum duration of 3 months). Results A total of 422 out of 750 participants (nest) responded. The median (IQR) for age was 58 (52 to 64) years, duration of diabetes 11 (6 to 16) years, prevalent foot complications in 59.7%, and atherosclerotic cardiovascular disease in 21.3% of participants. There was a decrease in HbA1c from 7.8% (6.9 to 9.4) prior lockdown to 7.4% (6.6 to8.7) during lockdown [ΔHbA1c − 0.41 ± 0.27% (p = 0.005)] and postprandial blood glucose 200.0 mg/dl (152.0 to 252.0) to 158.0 (140.0 to 200.0) mg/dl (p < 0.001). The physical activity increased during lockdown from a GPAQ score 140 (0.0 to 1260) MetS to 840 (0.0 to 1680) MetS (p = 0.014). The improvement of glycemic control was observed in either gender and independent of the presence of foot complications or increase in physical activity. Conclusions There is an overall improvement of glycemic control during COVID-19 lockdown independent of increase in physical activity in people with long duration of diabetes.
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Affiliation(s)
- Ashu Rastogi
- Department of Endocrinology, Nehru Hospital, PGIMER, Chandigarh, 160012 India
| | - Priya Hiteshi
- Department of Endocrinology, PGIMER, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, PGIMER, Chandigarh, India
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145
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Błaszczyk-Bębenek E, Jagielski P, Bolesławska I, Jagielska A, Nitsch-Osuch A, Kawalec P. Nutrition Behaviors in Polish Adults before and during COVID-19 Lockdown. Nutrients 2020; 12:E3084. [PMID: 33050404 PMCID: PMC7601522 DOI: 10.3390/nu12103084] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/23/2020] [Accepted: 10/05/2020] [Indexed: 01/02/2023] Open
Abstract
Unexpected isolation, which has not yet been seen on a global scale, has created the conditions for evaluating nutrition in a situation of reduced spatial activity. The study aimed to assess the influence of lockdown on selected eating habits of Polish adults. An anonymous questionnaire was conducted, including questions about eating habits and self-reported anthropometric measurements, referring to "before" and "during" lockdown. We reported the findings of 312 adults (aged 41.12 ± 13.05 years). Overall, 64.1% of the participants were women, 77.7% urban inhabitants and 78.6% employed. The average length of social isolation was 50.79 ± 10.53 days. The majority (51.6%) of the respondents did not eat outside the house during lockdown (p < 0.0001). The number of meals eaten during the day during lockdown increased significantly, 11.2% of the respondents ate 5 and more meals (p < 0.0001). The percentage of people snacking between meals increased by 5.1% during lockdown (p = 0.0001). Eggs, potatoes, sweets, canned meat and alcohol were consumed considerably more commonly during lockdown, while fast-food products, instant soups and energy drinks were eaten or drunk significantly less frequently. A marked decrease in the number of daily servings of the following products was observed: bakery products, red meat, fast food, instant soups, sweet beverages and energy drinks. Conversely, the number of daily servings of sweets and canned meat significantly increased. Two thirds of the respondents reported body weight changes, with 45.86% of the participants being overweight during lockdown. Significant changes in the diet of Polish adults were found during lockdown due to COVID-19.
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Affiliation(s)
- Ewa Błaszczyk-Bębenek
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 20 Grzegórzecka Str., 31-531 Krakow, Poland; (P.J.); (P.K.)
| | - Paweł Jagielski
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 20 Grzegórzecka Str., 31-531 Krakow, Poland; (P.J.); (P.K.)
| | - Izabela Bolesławska
- Department of Bromatology, Poznan University of Medical Sciences, 42 Marcelińska Str., 60-354 Poznań, Poland;
| | - Anna Jagielska
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007 Warsaw, Poland; (A.J.); (A.N.-O.)
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007 Warsaw, Poland; (A.J.); (A.N.-O.)
| | - Paweł Kawalec
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 20 Grzegórzecka Str., 31-531 Krakow, Poland; (P.J.); (P.K.)
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146
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Chopra S, Ranjan P, Singh V, Kumar S, Arora M, Hasan MS, Kasiraj R, Suryansh, Kaur D, Vikram NK, Malhotra A, Kumari A, Klanidhi KB, Baitha U. Impact of COVID-19 on lifestyle-related behaviours- a cross-sectional audit of responses from nine hundred and ninety-five participants from India. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2020; 14:2021-2030. [PMID: 33099144 PMCID: PMC7537601 DOI: 10.1016/j.dsx.2020.09.034] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 09/27/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The impact of measures taken to contain COVID-19 on lifestyle-related behaviour is undefined in Indian population. The current study was undertaken to assess the impact of COVID-19 on lifestyle-related behaviours: eating, physical activity and sleep behaviour. METHODS The study is a cross-sectional web-based survey. A validated questionnaire to assess the changes in lifestyle-related behaviour was administered on adults across India using a Google online survey platform. RESULTS A total of 995 responses (58.5% male, mean age 33.3 years) were collected. An improvement in healthy meal consumption pattern and a restriction of unhealthy food items was observed, especially in the younger population (age <30 years). A reduction in physical activity coupled with an increase in daily screen time was found especially among men and in upper-socio-economic strata. Quarantine induced stress and anxiety showed an increase by a unit in nearly one-fourth of the participants. CONCLUSIONS COVID-19 marginally improved the eating behaviour, yet one-third of participants gained weight as physical activity declined significantly coupled with an increase in screen and sitting time. Mental health was also adversely affected. A detailed understanding of these factors can help to develop interventions to mitigate the negative lifestyle behaviours that have manifested during COVID-19.
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Affiliation(s)
- Sakshi Chopra
- Department of Home Science, University of Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Science, New Delhi, India.
| | - Vishwajeet Singh
- Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi, India
| | - Suraj Kumar
- All India Institute of Medical Science, New Delhi, India
| | - Mehak Arora
- All India Institute of Medical Science, New Delhi, India
| | | | - Rhytha Kasiraj
- All India Institute of Medical Science, New Delhi, India
| | - Suryansh
- All India Institute of Medical Science, New Delhi, India
| | - Divjyot Kaur
- Department of Home Science, University of Delhi, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Science, New Delhi, India
| | - Anita Malhotra
- Department of Home Science, Lakshmibai College University of Delhi, India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Science, New Delhi, India
| | - Kamal Bandhu Klanidhi
- Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Science, New Delhi, India
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147
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Zupo R, Castellana F, Sardone R, Sila A, Giagulli VA, Triggiani V, Cincione RI, Giannelli G, De Pergola G. Preliminary Trajectories in Dietary Behaviors during the COVID-19 Pandemic: A Public Health Call to Action to Face Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7073. [PMID: 32992623 PMCID: PMC7579065 DOI: 10.3390/ijerph17197073] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/21/2022]
Abstract
The world is currently struggling to face the coronavirus pandemic (COVID-19), and many countries have imposed lockdowns and recommended quarantine to limit both the spread of the virus and overwhelming demands for medical care. Direct implications include the disruption of work routines, boredom, depression, increased calorie consumption, and other similar harmful effects. The present narrative review article briefly analyzes the preliminary effects of the quarantine lifestyle from the standpoint of dietary habits. In six different databases, we searched for original articles up to 10 August 2020, assessing eating habits among populations during the COVID-19 pandemic, and recorded any change in the intake of major food categories, as well as changes in body weight. The research strategy yielded 364 articles, from which we selected 12 articles that fitted our goal. Our preliminary findings revealed a sharp rise of carbohydrates sources consumption, especially those with a high glycemic index (i.e., homemade pizza, bread, cake, and pastries), as well as more frequent snacks. A high consumption of fruits and vegetables, and protein sources, particularly pulses, was also recorded, although there was no clear peak of increase in the latter. Data concerning the consumption of junk foods lacked consistency, while there was a decreased alcohol intake and fresh fish/seafood consumption. As a possible connection, people gained body weight. Therefore, in the realistic perspective of a continuing global health emergency situation, timely preventive measures are needed to counteract obesity-related behaviors in the long-term, so as to prevent further health complications.
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Affiliation(s)
- Roberta Zupo
- Population Health Unit “Salus in Apulia Study”—National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (F.C.); (R.S.); (A.S.); (G.D.P.)
| | - Fabio Castellana
- Population Health Unit “Salus in Apulia Study”—National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (F.C.); (R.S.); (A.S.); (G.D.P.)
| | - Rodolfo Sardone
- Population Health Unit “Salus in Apulia Study”—National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (F.C.); (R.S.); (A.S.); (G.D.P.)
| | - Annamaria Sila
- Population Health Unit “Salus in Apulia Study”—National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (F.C.); (R.S.); (A.S.); (G.D.P.)
| | - Vito Angelo Giagulli
- Interdisciplinary Department of Medicine—Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, School of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy;
| | - Vincenzo Triggiani
- Section of Internal Medicine, Geriatrics, Endocrinology and Rare Disease, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, 70121 Bari, Italy;
| | - Raffaele Ivan Cincione
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy;
| | - Giovanni De Pergola
- Population Health Unit “Salus in Apulia Study”—National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (F.C.); (R.S.); (A.S.); (G.D.P.)
- Clinical Nutrition Unit, Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, 70121 Bari, Italy
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148
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Gopalan HS, Misra A. COVID-19 pandemic and challenges for socio-economic issues, healthcare and National Health Programs in India. Diabetes Metab Syndr 2020; 14:757-759. [PMID: 32504992 PMCID: PMC7261093 DOI: 10.1016/j.dsx.2020.05.041] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS The nationwide lockdown was imposed in India following novel coronavirus pandemic. In this paper, we discuss socio-economic, health and National healthcare challenges following lockdown, with focus on population belonging to low socio-economic stratum (SES). METHODS A literature search was conducted using PubMed and Google Scholar. In addition, existing guidelines including those by Ministry of Health and Family Welfare, Government of India, and articles from several non-academic sources (e.g. news websites etc.) were accessed. RESULTS While the nationwide lockdown has resulted in financial losses and has affected all segments of society, the domino effect on health, healthcare and nutrition could possibly pose major setbacks to previously gained successes of National health programs. CONCLUSION Apart from firm economic measures, all National Health Programs should be re-strengthened to avert possible surge of communicable (apart from COVID19) and non-communicable diseases. These efforts should be focussed on population belonging to low SES.
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Affiliation(s)
- Hema S Gopalan
- National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India
| | - Anoop Misra
- National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India; Diabetes Foundation (India), New Delhi, India; Fortis C-DOC Center for Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, India.
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149
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Ghosal S, Arora B, Dutta K, Ghosh A, Sinha B, Misra A. Increase in the risk of type 2 diabetes during lockdown for the COVID19 pandemic in India: A cohort analysis. Diabetes Metab Syndr 2020; 14:949-952. [PMID: 32604013 PMCID: PMC7303633 DOI: 10.1016/j.dsx.2020.06.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/10/2020] [Accepted: 06/10/2020] [Indexed: 01/19/2023]
Abstract
UNLABELLED Lockdown due to the Coronavirus disease 2019 (COVID 19) pandemic may cause weight gain and enhance the risk of type 2 diabetes mellitus (T2DM). We aimed to determine this risk in apparently non-diabetic individuals. MATERIAL METHODS Baseline demographic and clinical data from 100 apparently non-diabetic household members (related or unrelated) of patients with type 2 diabetes mellitus were collected until 49 days of lockdown and analyzed using the XL-STAT statistical software. A two-pronged analytical strategy was employed. First, the metabolic risk profile related to age, sex, weight, family history, and exercise pattern was analyzed. This was followed by an assessment of the risk of developing type 2 diabetes using an established risk assessment engine. RESULTS There was a trend towards weight gain seen in 40% of the cohort, with 16% of the population experiencing a 2.1-5 kg weight increment. When all the risk parameters were analyzed together using the ADA risk engine, there was an increase in the ADA diabetes risk score in 7% of the population, with 6.66% in the high-risk group. There was a further increase in weight among 3% of the population who were already obese at baseline. CONCLUSION We show an increased risk of T2MD consequent to weight gain during 49 days of lockdown in India.
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Affiliation(s)
| | - Bhavya Arora
- Fortis CDOC Hospital for Diabetes and Allied Specialties, Chirag Enclave, New Delhi, India
| | - Koel Dutta
- Fortis CDOC Hospital for Diabetes and Allied Specialties, Chirag Enclave, New Delhi, India
| | - Amerta Ghosh
- Fortis CDOC Hospital for Diabetes and Allied Specialties, Chirag Enclave, New Delhi, India
| | | | - Anoop Misra
- Fortis CDOC Hospital for Diabetes and Allied Specialties, Chirag Enclave, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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150
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Aravind S, Saboo B, Misra A. Strict glycemic control is needed in times of COVID19 epidemic in India: A Call for action for all physicians. Diabetes Metab Syndr 2020; 14:1579-1581. [PMID: 32947758 PMCID: PMC7416708 DOI: 10.1016/j.dsx.2020.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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