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Vena W, Pigni S, Betella N, Navarra A, Mirani M, Mazziotti G, Lania AG, Bossi AC. COVID-19 vaccines and blood glucose control: Friend or foe? Hum Vaccin Immunother 2024; 20:2363068. [PMID: 38860457 PMCID: PMC11178329 DOI: 10.1080/21645515.2024.2363068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/30/2024] [Indexed: 06/12/2024] Open
Abstract
PURPOSE To overview the recent literature regarding the relationship between COVID-19 vaccines and glycemic control. METHODS Data were extracted from text and tables of all available articles published up to September 2023 in PubMed Database describing glucose homeostasis data in subjects exposed to COVID-19 vaccines, focusing on patients with diabetes mellitus (DM). RESULTS It is debated if the immune system impairment observed in diabetic patients makes them susceptible to lower efficacy of vaccines, but evidence suggests a possible improvement in immune response in those with good glycemic control. Despite their proven protective role lowering infection rates and disease severity, COVID-19 vaccines can result in diabetic ketoacidosis, new-onset diabetes, or episodes of hyper- or hypoglycemia. CONCLUSIONS Evidence with COVID-19 vaccines highlights the strong relationship existing between DM and immune system function. Clinicians should strive to achieve optimal glucose control before vaccination and promptly manage possible glucose homeostasis derangement following vaccine exposure.
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Affiliation(s)
- Walter Vena
- Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
- Diabetes Center, Humanitas Gavazzeni Institute, Bergamo, Italy
| | - Stella Pigni
- Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy
| | | | | | - Marco Mirani
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy
| | - Gherardo Mazziotti
- Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy
| | - Andrea G. Lania
- Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy
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Jang W, Kim S, Son Y, Kim S, Kim HJ, Jo H, Park J, Lee K, Lee H, Tully MA, Rahmati M, Smith L, Kang J, Woo S, Kim S, Hwang J, Rhee SY, Yon DK. Prevalence, Awareness, Treatment, and Control of Type 2 Diabetes in South Korea (1998 to 2022): Nationwide Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e59571. [PMID: 39190907 DOI: 10.2196/59571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/07/2024] [Accepted: 06/20/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Type 2 diabetes poses an increasing disease burden in South Korea. The development and management of type 2 diabetes are closely related to lifestyle and socioeconomic factors, which have undergone substantial changes over the past few decades, including during the COVID-19 pandemic. OBJECTIVE This study aimed to investigate long-term trends in type 2 diabetes prevalence, awareness, treatment, and control. It also aimed to determine whether there were substantial alterations in the trends during the pandemic and whether these changes were more pronounced within specific demographic groups. METHODS This study examined the prevalence, awareness, treatment, and control of type 2 diabetes in a representative sample of 139,786 South Koreans aged >30 years, using data from the National Health and Nutrition Examination Survey and covering the period from 1998 to 2022. Weighted linear regression and binary logistic regression were performed to calculate weighted β coefficients or odds ratios. Stratified analyses were performed based on sex, age, region of residence, obesity status, educational background, household income, and smoking status. β (difference) was calculated to analyze the trend difference between the prepandemic period and the COVID-19 pandemic. To identify groups more susceptible to type 2 diabetes, we estimated interaction terms for each factor and calculated weighted odds ratios. RESULTS From 1998 to 2022, a consistent increase in the prevalence of type 2 diabetes was observed among South Koreans, with a notable rise to 15.61% (95% CI 14.83-16.38) during the pandemic. Awareness followed a U-shaped curve, bottoming out at 64.37% (95% CI 61.79-66.96) from 2013 to 2015 before increasing to 72.56% (95% CI 70.39-74.72) during the pandemic. Treatment also increased over time, peaking at 68.33% (95% CI 65.95-70.71) during the pandemic. Control among participants with diabetes showed no substantial change, maintaining a rate of 29.14% (95% CI 26.82-31.47) from 2020 to 2022, while control among treated participants improved to 30.68% (95% CI 27.88-33.48). During the pandemic, there was a steepening of the curves for awareness and treatment. However, while the slope of control among participants being treated increased, the slope of control among participants with diabetes showed no substantial change during the pandemic. Older populations and individuals with lower educational level exhibited less improvement in awareness and control trends than younger populations and more educated individuals. People with lower income experienced a deceleration in prevalence during the pandemic. CONCLUSIONS Over the recent decade, there has been an increase in type 2 diabetes prevalence, awareness, treatment, and control. During the pandemic, a steeper increase in awareness, treatment, and control among participants being treated was observed. However, there were heterogeneous changes across different population groups, underscoring the need for targeted interventions to address disparities and improve diabetes management for susceptible populations.
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Affiliation(s)
- Wonwoo Jang
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Seokjun Kim
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Yejun Son
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Soeun Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
| | - Hyesu Jo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
| | - Kyeongmin Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
| | - Hayeon Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, United Kingdom
| | - Masoud Rahmati
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Jiseung Kang
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Selin Woo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Jiyoung Hwang
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Sang Youl Rhee
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Dong Keon Yon
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
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Yu XL, Zhou LY, Huang X, Li XY, Pan QQ, Wang MK, Yang JS. Urgent call for attention to diabetes-associated hospital infections. World J Diabetes 2024; 15:1683-1691. [PMID: 39192868 PMCID: PMC11346093 DOI: 10.4239/wjd.v15.i8.1683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/14/2024] [Accepted: 06/07/2024] [Indexed: 07/25/2024] Open
Abstract
In this editorial, we discuss the recent article by Zhao et al published in the World Journal of Diabetes, which highlights the importance of recognizing the risk indicators associated with diabetes mellitus (DM). Given the severe implications of healthcare-associated infections (HAIs) in hospitalized individuals- such as heightened mortality rates, prolonged hospitalizations, and increased costs- we focus on elucidating the connection between DM and nosocomial infections. Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection, with some already harboring co-infections upon admission. Notably, DM is an important risk factor for nosocomial urinary tract infections and surgical site infections, which may indirectly affect the occurrence of nosocomial bloodstream infections, especially in patients with DM with poor glycemic control. Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive, attention to this potential association is warranted. Hospitalized patients with DM should prioritize meticulous blood glucose management, adherence to standard operating procedures, hand hygiene pra-ctices, environmental disinfection, and rational use of drugs during hospitalization. Further studies are imperative to explore the main risk factors of HAIs in patients with DM, enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.
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Affiliation(s)
- Xue-Lu Yu
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Li-Yun Zhou
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Xiao Huang
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Xin-Yue Li
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Qing-Qing Pan
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Ming-Ke Wang
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Ji-Shun Yang
- Medical Care Center, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
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Zainudin AM, Rasool AHG, Yaacob NM, Muhamad R, Mohamed WMIW. The effect of USM-IAM-based counselling vs standard counselling on insulin adherence, FBS and HbA1c among patients with uncontrolled type 2 diabetes mellitus (T2DM): a randomised controlled trial. BMC Endocr Disord 2024; 24:118. [PMID: 39020348 PMCID: PMC11256455 DOI: 10.1186/s12902-024-01577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/04/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Many patients with T2DM on insulin are not optimally controlled despite receiving standard diabetes education counselling. Poor insulin adherence may be a contributing factor. We developed and evaluated a new module [Universiti Sains Malaysia-Insulin Adherence Module (USM-IAM)] on insulin-treated patients with poorly controlled diabetes. METHODS Eligibility criteria are those diagnosed with T2DM, aged between 18 and 65 years, with HbA1c between 8 and 15% and on insulin therapy for 1 year. Patients were randomly allocated to receive either the USM-IAM-based counselling or the standard counselling (SC) at baseline and the second visit. Patients were instructed to adjust insulin doses based on blood glucose levels. Outcomes were changes in adherence score, FBS and HbA1c levels from baseline to 3 months and baseline to sixth month. RESULTS Ninety patients were randomised to each group. The baseline sociodemographic and clinical characteristics were homogenous among groups. Ninety patients were analysed for each group. Adherence score changes between baseline to 3 months were - 8.30 (- 11.47, - 5.14) in USM-IAM-based counselling group (USM-IAM) and - 7.64 (- 10.89, - 4.40) in standard counselling group (SCG), between baseline to sixth month were - 10.21 (- 13.40, - 7.03) in USM-IAM and - 10.79 (- 14.64, - 6.97) in SCG. FBS changes between baseline to 3 months were 1.374 (0.25, 2.50) in USM-IAM and 0.438 (- 0.66, 1.54) in SCG, and between baseline to sixth month were 1.713 (0.473, 2.95) in USM-IAM and 0.998 (- 0.02, 2.01) in SCG. HbA1c changes between baseline to 3 months were 1.374 (0.25, 2.50) in USM-IAM and 0.547 (0.12, 0.98) in SCG, and between baseline to sixth month were 1.03 (0.65, 1.41) in USM-IAM and 0.617 (0.20, 1.03) in SCG. Between-subjects effects for all outcomes were not statistically significant. CONCLUSION Both groups had significant improvements in adherence score and HbA1c with time, with higher improvement in patients receiving the USM-IAM. FBS reductions were significant in the intervention group but not in the control group. TRIAL REGISTRATION This study protocol is registered with Clicaltrials.gov with ID NCT05125185 dated 17th November 2021.
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Affiliation(s)
- Aida Maziha Zainudin
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 6150, Kota Bharu, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Aida Hanum Ghulam Rasool
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 6150, Kota Bharu, Kelantan, Malaysia
| | - Najib Majdi Yaacob
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
| | - Rosediani Muhamad
- Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
| | - Wan Mohd Izani Wan Mohamed
- Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
- Department of Internal Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia.
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5
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Farman M, Akgül A, Sultan M, Riaz S, Asif H, Agarwal P, Hassani MK. Numerical study and dynamics analysis of diabetes mellitus with co-infection of COVID-19 virus by using fractal fractional operator. Sci Rep 2024; 14:16489. [PMID: 39019935 PMCID: PMC11254938 DOI: 10.1038/s41598-024-60168-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/19/2024] [Indexed: 07/19/2024] Open
Abstract
COVID-19 is linked to diabetes, increasing the likelihood and severity of outcomes due to hyperglycemia, immune system impairment, vascular problems, and comorbidities like hypertension, obesity, and cardiovascular disease, which can lead to catastrophic outcomes. The study presents a novel COVID-19 management approach for diabetic patients using a fractal fractional operator and Mittag-Leffler kernel. It uses the Lipschitz criterion and linear growth to identify the solution singularity and analyzes the global derivative impact, confirming unique solutions and demonstrating the bounded nature of the proposed system. The study examines the impact of COVID-19 on individuals with diabetes, using global stability analysis and quantitative examination of equilibrium states. Sensitivity analysis is conducted using reproductive numbers to determine the disease's status in society and the impact of control strategies, highlighting the importance of understanding epidemic problems and their properties. This study uses two-step Lagrange polynomial to analyze the impact of the fractional operator on a proposed model. Numerical simulations using MATLAB validate the effects of COVID-19 on diabetic patients and allow predictions based on the established theoretical framework, supporting the theoretical findings. This study will help to observe and understand how COVID-19 affects people with diabetes. This will help with control plans in the future to lessen the effects of COVID-19.
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Affiliation(s)
- Muhammad Farman
- Mathematics Research Center, Department of Mathematics, Near East University, Near East Boulevard, 99138, Nicosia, Mersin 10, Turkey
- Department of Computer Science and Mathematics, Lebanese American University, Beirut, Lebanon
| | - Ali Akgül
- Department of Computer Science and Mathematics, Lebanese American University, Beirut, Lebanon.
- Department of Mathematics, Art and Science Faculty, Siirt University, 56100, Siirt, Turkey.
| | - Muhammad Sultan
- Data Analytics, Department of Design and Visual Arts, Computer Studies, Georgian College, Barrie, Canada
| | - Sidra Riaz
- Mathematics Research Center, Department of Mathematics, Near East University, Near East Boulevard, 99138, Nicosia, Mersin 10, Turkey
| | - Hira Asif
- Mathematics Research Center, Department of Mathematics, Near East University, Near East Boulevard, 99138, Nicosia, Mersin 10, Turkey
| | - Praveen Agarwal
- Department of Mathematics, Anand International College of Engineering, Jaipur, India
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Holt RIG, Cockram CS, Ma RCW, Luk AOY. Diabetes and infection: review of the epidemiology, mechanisms and principles of treatment. Diabetologia 2024; 67:1168-1180. [PMID: 38374451 PMCID: PMC11153295 DOI: 10.1007/s00125-024-06102-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/04/2023] [Indexed: 02/21/2024]
Abstract
An association between diabetes and infection has been recognised for many years, with infection being an important cause of death and morbidity in people with diabetes. The COVID-19 pandemic has re-kindled an interest in the complex relationship between diabetes and infection. Some infections occur almost exclusively in people with diabetes, often with high mortality rates without early diagnosis and treatment. However, more commonly, diabetes is a complicating factor in many infections. A reciprocal relationship occurs whereby certain infections and their treatments may also increase the risk of diabetes. People with diabetes have a 1.5- to 4-fold increased risk of infection. The risks are the most pronounced for kidney infection, osteomyelitis and foot infection, but are also increased for pneumonia, influenza, tuberculosis, skin infection and general sepsis. Outcomes from infection are worse in people with diabetes, with the most notable example being a twofold higher rate of death from COVID-19. Hyperglycaemia has deleterious effects on the immune response. Vascular insufficiency and neuropathy, together with altered skin, mucosal and gut microbial colonisation, contribute to the increased risk of infection. Vaccination is important in people with diabetes although the efficacy of certain immunisations may be compromised, particularly in the presence of hyperglycaemia. The principles of treatment largely follow those of the general population with certain notable exceptions.
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Affiliation(s)
- Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Clive S Cockram
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Andrea O Y Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
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7
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Lui DTW, Lee CH, Wong Y, Fong CHY, Tsoi KH, Woo YC, Tan KCB. A Prospective 1-Year Follow-up of Glycemic Status and C-Peptide Levels of COVID-19 Survivors with Dysglycemia in Acute COVID-19 Infection. Diabetes Metab J 2024; 48:763-770. [PMID: 38467385 PMCID: PMC11307110 DOI: 10.4093/dmj.2023.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/13/2023] [Indexed: 03/13/2024] Open
Abstract
BACKGRUOUND We evaluated changes in glycemic status, over 1 year, of coronavirus disease 2019 (COVID-19) survivors with dysglycemia in acute COVID-19. METHODS COVID-19 survivors who had dysglycemia (defined by glycosylated hemoglobin [HbA1c] 5.7% to 6.4% or random glucose ≥10.0 mmol/L) in acute COVID-19 were recruited from a major COVID-19 treatment center from September to October 2020. Matched non-COVID controls were recruited from community. The 75-g oral glucose tolerance test (OGTT) were performed at baseline (6 weeks after acute COVID-19) and 1 year after acute COVID-19, with HbA1c, insulin and C-peptide measurements. Progression in glycemic status was defined by progression from normoglycemia to prediabetes/diabetes, or prediabetes to diabetes. RESULTS Fifty-two COVID-19 survivors were recruited. Compared with non-COVID controls, they had higher C-peptide (P< 0.001) and trend towards higher homeostasis model assessment of insulin resistance (P=0.065). Forty-three COVID-19 survivors attended 1-year reassessment. HbA1c increased from 5.5%±0.3% to 5.7%±0.2% (P<0.001), with increases in glucose on OGTT at fasting (P=0.089), 30-minute (P=0.126), 1-hour (P=0.014), and 2-hour (P=0.165). At baseline, 19 subjects had normoglycemia, 23 had prediabetes, and one had diabetes. Over 1 year, 10 subjects (23.8%; of 42 non-diabetes subjects at baseline) had progression in glycemic status. C-peptide levels remained unchanged (P=0.835). Matsuda index decreased (P=0.007) and there was a trend of body mass index increase from 24.4±2.7 kg/m2 to 25.6±5.2 (P=0.083). Subjects with progression in glycemic status had more severe COVID-19 illness than non-progressors (P=0.030). Reassessment was not performed in the control group. CONCLUSION Subjects who had dysglycemia in acute COVID-19 were characterized by insulin resistance. Over 1 year, a quarter had progression in glycemic status, especially those with more severe COVID-19. Importantly, there was no significant deterioration in insulin secretory capacity.
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Affiliation(s)
- David Tak Wai Lui
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Chi Ho Lee
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Ying Wong
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Carol Ho Yi Fong
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kimberly Hang Tsoi
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Yu Cho Woo
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kathryn Choon Beng Tan
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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8
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Hani NS, Thomas IH. Changes in Pediatric Type 2 Diabetes During the COVID-19 Pandemic. Pediatr Ann 2024; 53:e249-e253. [PMID: 38949870 DOI: 10.3928/19382359-20240502-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
Type 2 diabetes (T2D) is a growing concern among the pediatric population. During the coronavirus disease 2019 (COVID-19) pandemic, the incidence of pediatric T2D increased. This was more notable among males and Black people. Increased rates of T2D may be due to rising obesity rates observed during the pandemic, behavioral and nutritional changes due to the lockdown, and decreased structure typically provided by in-person schooling. New-onset T2D presentations are more severe than in years prior to the pandemic, with higher initial hemoglobin A1C levels and increased rates of diabetic ketoacidosis. Increased severity in presentation may be due to hesitation in seeking care, increased virtual care, and limited access to health care resources. The pathophysiology of the relationship between T2D and COVID-19 in youth is not clear at this time. More studies are needed to understand the true long-term impact of the COVID-19 pandemic on T2D in youth. [Pediatr Ann. 2024;53(7):e249-e253.].
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Sarwal A, Lim J, Sarwal A. Telemedicine for the Underserved Racial and Ethnic Minorities During COVID-19 and Beyond. Telemed J E Health 2024; 30:1588-1593. [PMID: 38739446 DOI: 10.1089/tmj.2023.0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
Objective: To demonstrate that a culturally and linguistically appropriate telehealth protocol can be implemented to improve the glycemic control of patients as an extension of regular clinical services and provide continuity of care. Methods: A telehealth platform was established during COVID-19 pandemic and from numerous telehealth encounters we sampled 498 patients who received telehealth intervention over a 12-month period for specific services: Rx refill, consultation for laboratory results, wellness evaluation and education, and acute or sick visits with appropriate referrals. This telehealth platform was integrated with a remote patient monitoring system utilizing a Bluetooth-enabled glucometer for patients with diabetes compared to their abnormal baseline hemoglobin A1C (HgA1C). The Blood sugar values were recorded at predefined intervals to monitor controls for diabetes. The ethnic diversity and level of education of patients required addressing the digital divide, language interpretation, and navigation at each monitoring step. Results: This method demonstrated that a culturally and linguistically appropriate telehealth protocol can be implemented to improve the glycemic control of patients in an intervention group compared with a control group. Validation of the glycemic control was based on 70 patients identified as eligible for participation based on the inclusion criteria: a HgA1C level of 7% or higher obtained within the last 10 months. Informed consent was obtained for 42 participants based on patient participation constraints during the COVID-19 pandemic. Conclusions: We conclude that telemedicine procedures utilized for patients with little or no prior knowledge of remote self-monitoring methods can support their treatment of chronic diseases, such as diabetes. The outcomes from the implementation of telemedicine services were observed in a well-defined group of underserved racial and ethnic minority patients at our clinic. We now have a protocol to expand this to other chronic diseases and used as a regular clinical procedure.
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Affiliation(s)
- Alok Sarwal
- Colorado Alliance for Health Equity and Practice-Family Medicine Clinic, Denver, Colorado, USA
| | - Jeehyun Lim
- Colorado Christian University, Lakewood, Colorado, USA
| | - Ashwin Sarwal
- Biochemistry and Molecular Cellular and Developmental Biology Program, University of Colorado, Boulder, Colorado, USA
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10
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Barron E, Sharp SJ, Khunti K, Bakhai C, Wareham NJ, Valabhji J. Prediabetes, participation in the English National Health Service Diabetes Prevention Programme, and associations with COVID-19-related mortality: A whole population study. Diabetes Res Clin Pract 2024; 212:111692. [PMID: 38723673 DOI: 10.1016/j.diabres.2024.111692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024]
Abstract
AIMS To assess the effects of non-diabetic hyperglycaemia (NDH, also known as pre-diabetes), including the impact of the NHS Diabetes Prevention Programme (NHS DPP), on COVID-19-related mortality during the pandemic. METHODS This study included all 61,438,225 individuals registered with General Practices in England and alive on 1st March 2020. We assessed COVID-19-related mortality in the 2,290,280(3.7 %) individuals with diagnosed NDH between March 2020 and February 2022 compared to those without diagnosed NDH or diabetes using Cox regression to adjust for demographic factors and cardiovascular comorbidities. Individuals with diagnosed NDH were further sub-categorised based on their contact with the NHS DPP (N = 376,590). Analyses were stratified by age (years) (<50, 50-69 and ≥ 70). RESULTS There were 158,070 COVID-19 deaths; 17,280(11 %) for people with diagnosed NDH. The adjusted hazard ratio (HR) was 0.95(0.93-0.96),p < 0.001 for those with diagnosed NDH compared to those without diagnosed diabetes or NDH. By age (years), HRs were, 2.53(2.23-2.88),p < 0.001 for < 50, 1.29(1.24-1.35),p < 0.001 for 50-69 and 0.87(0.85-0.89),p < 0.001 for ≥ 70. NHS DPP attendance was associated with lower COVID-19 mortality with a dose-response relationship with engagement. CONCLUSIONS Younger people with diagnosed NDH were at higher relative risk of COVID-19 mortality. Attendance at the NHS DPP was associated with significantly lower COVID-19-related mortality.
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Affiliation(s)
- Emma Barron
- NHS England, Wellington House, 122-135 Waterloo Road, London SE1 8UG, UK; Department of Metabolism, Digestion and Reproduction, Imperial College London, South Kensington, London; Chelsea and Westminster hospital NHS Foundation Trust, London, UK.
| | - Stephen J Sharp
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Kamlesh Khunti
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Chirag Bakhai
- NHS England, Wellington House, 122-135 Waterloo Road, London SE1 8UG, UK
| | - Nicholas J Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Jonathan Valabhji
- NHS England, Wellington House, 122-135 Waterloo Road, London SE1 8UG, UK; Department of Metabolism, Digestion and Reproduction, Imperial College London, South Kensington, London; Chelsea and Westminster hospital NHS Foundation Trust, London, UK
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11
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Samuel M, Park RY, Eastwood SV, Eto F, Morton CE, Stow D, Bacon S, Mehrkar A, Morley J, Dillingham I, Inglesby P, Hulme WJ, Khunti K, Mathur R, Valabhji J, MacKenna B, Finer S. Trends in weight gain recorded in English primary care before and during the Coronavirus-19 pandemic: An observational cohort study using the OpenSAFELY platform. PLoS Med 2024; 21:e1004398. [PMID: 38913709 PMCID: PMC11249215 DOI: 10.1371/journal.pmed.1004398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/15/2024] [Accepted: 04/05/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Obesity and rapid weight gain are established risk factors for noncommunicable diseases and have emerged as independent risk factors for severe disease following Coronavirus Disease 2019 (COVID-19) infection. Restrictions imposed to reduce COVID-19 transmission resulted in profound societal changes that impacted many health behaviours, including physical activity and nutrition, associated with rate of weight gain. We investigated which clinical and sociodemographic characteristics were associated with rapid weight gain and the greatest acceleration in rate of weight gain during the pandemic among adults registered with an English National Health Service (NHS) general practitioner (GP) during the COVID-19 pandemic. METHODS AND FINDINGS With the approval of NHS England, we used the OpenSAFELY platform inside TPP to conduct an observational cohort study of routinely collected electronic healthcare records. We investigated changes in body mass index (BMI) values recorded in English primary care between March 2015 and March 2022. We extracted data on 17,742,365 adults aged 18 to 90 years old (50.1% female, 76.1% white British) registered with an English primary care practice. We estimated individual rates of weight gain before (δ-prepandemic) and during (δ-pandemic) the pandemic and identified individuals with rapid weight gain (>0.5 kg/m2/year) in each period. We also estimated the change in rate of weight gain between the prepandemic and pandemic period (δ-change = δ-pandemic-δ-prepandemic) and defined extreme accelerators as the 10% of individuals with the greatest increase in their rate of weight gain (δ-change ≥1.84 kg/m2/year) between these periods. We estimated associations with these outcomes using multivariable logistic regression adjusted for age, sex, index of multiple deprivation (IMD), and ethnicity. P-values were generated in regression models. The median BMI of our study population was 27.8 kg/m2, interquartile range (IQR) [24.3, 32.1] in 2019 (March 2019 to February 2020) and 28.0 kg/m2, IQR [24.4, 32.6] in 2021. Rapid pandemic weight gain was associated with sex, age, and IMD. Male sex (male versus female: adjusted odds ratio (aOR) 0.76, 95% confidence interval (95% CI) [0.76, 0.76], p < 0.001), older age (e.g., 50 to 59 years versus 18 to 29 years: aOR 0.60, 95% CI [0.60, 0.61], p < 0.001]); and living in less deprived areas (least-deprived-IMD-quintile versus most-deprived: aOR 0.77, 95% CI [0.77, 0.78] p < 0.001) reduced the odds of rapid weight gain. Compared to white British individuals, all other ethnicities had lower odds of rapid pandemic weight gain (e.g., Indian versus white British: aOR 0.69, 95% CI [0.68, 0.70], p < 0.001). Long-term conditions (LTCs) increased the odds, with mental health conditions having the greatest effect (e.g., depression (aOR 1.18, 95% CI [1.17, 1.18], p < 0.001)). Similar characteristics increased odds of extreme acceleration in the rate of weight gain between the prepandemic and pandemic periods. However, changes in healthcare activity during the pandemic may have introduced new bias to the data. CONCLUSIONS We found female sex, younger age, deprivation, white British ethnicity, and mental health conditions were associated with rapid pandemic weight gain and extreme acceleration in rate of weight gain between the prepandemic and pandemic periods. Our findings highlight the need to incorporate sociodemographic, physical, and mental health characteristics when formulating research, policies, and interventions targeting BMI in the period of post pandemic service restoration and in future pandemic planning.
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Affiliation(s)
- Miriam Samuel
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Robin Y Park
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Sophie V Eastwood
- MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
| | - Fabiola Eto
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Caroline E Morton
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Daniel Stow
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Sebastian Bacon
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Amir Mehrkar
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jessica Morley
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Iain Dillingham
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Peter Inglesby
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - William J Hulme
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, United Kingdom
| | - Rohini Mathur
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Jonathan Valabhji
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, United Kingdom
| | - Brian MacKenna
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Sarah Finer
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
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12
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Rutter MK, Carr MJ, Wright AK, Kanumilli N, Milne N, Jones E, Elton P, Ceriello A, Misra A, Del Prato S, Barron E, Hambling C, Sattar N, Khunti K, Valabhji J, Feldman EL, Ashcroft DM. Indirect effects of the COVID-19 pandemic on diagnosing, monitoring, and prescribing in people with diabetes and strategies for diabetes service recovery internationally. Diabetes Res Clin Pract 2024; 212:111693. [PMID: 38719027 DOI: 10.1016/j.diabres.2024.111693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/23/2024]
Abstract
The COVID-19 pandemic has caused major disruptions in clinical services for people with chronic long-term conditions. In this narrative review, we assess the indirect impacts of the COVID-19 pandemic on diabetes services globally and the resulting adverse effects on rates of diagnosing, monitoring, and prescribing in people with type 2 diabetes. We summarise potential practical approaches that could address these issues and improve clinical services and outcomes for people living with diabetes during the recovery phase of the pandemic.
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Affiliation(s)
- Martin K Rutter
- Faculty of Medicine, Biology and Health, University of Manchester, Manchester M13 9PL, United Kingdom; Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester M13 0JE, United Kingdom.
| | - Matthew J Carr
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, The University of Manchester, Manchester, United Kingdom; NIHR Greater Manchester Patient Safety Research Collaboration, University of Manchester, Manchester, United Kingdom
| | - Alison K Wright
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Naresh Kanumilli
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester M13 0JE, United Kingdom
| | - Nicola Milne
- Brooklands and Northenden Primary Care Network, Greater Manchester, United Kingdom
| | - Ewan Jones
- Greater Manchester & Eastern Cheshire Strategic Clinical Networks, NHS Greater Manchester Integrated Care, United Kingdom
| | - Peter Elton
- Greater Manchester & Eastern Cheshire Strategic Clinical Networks, NHS Greater Manchester Integrated Care, United Kingdom
| | | | - Anoop Misra
- Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation (India), New Delhi, India
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, Section of Metabolic Diseases and Diabetes, University of Pisa, Pisa, Italy
| | - Emma Barron
- NHS England, Wellington House, 122-135 Waterloo Road, London, UK; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Clare Hambling
- NHS England, Wellington House, 122-135 Waterloo Road, London, UK; Bridge Street Surgery, Norfolk, United Kingdom
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Jonathan Valabhji
- NHS England, Wellington House, 122-135 Waterloo Road, London, UK; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Darren M Ashcroft
- NIHR Greater Manchester Patient Safety Research Collaboration, University of Manchester, Manchester, United Kingdom; Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
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13
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Yu AYX, Austin PC, Jackevicius CA, Chu A, Holodinsky JK, Hill MD, Kamal N, Kumar M, Lee DS, Vyas MV, Joundi RA, Khan NA, Kapral MK, McNaughton CD. Population Trends of New Prescriptions for Antihyperglycemics and Antihypertensives Between 2014 and 2022. J Am Heart Assoc 2024; 13:e034118. [PMID: 38563374 PMCID: PMC11262531 DOI: 10.1161/jaha.123.034118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND In the wake of pandemic-related health decline and health care disruptions, there are concerns that previous gains for cardiovascular risk factors may have stalled or reversed. Population-level excess burden of drug-treated diabetes and hypertension during the pandemic compared with baseline is not well characterized. We evaluated the change in incident prescription claims for antihyperglycemics and antihypertensives before versus during the pandemic. METHODS AND RESULTS In this retrospective, serial, cross-sectional, population-based study, we used interrupted time series analyses to examine changes in the age- and sex-standardized monthly rate of incident prescriptions for antihyperglycemics and antihypertensives in patients aged ≥66 years in Ontario, Canada, before the pandemic (April 2014 to March 2020) compared with during the pandemic (July 2020 to November 2022). Incident claim was defined as the first prescription filled for any medication in these classes. The characteristics of patients with incident prescriptions of antihyperglycemics (n=151 888) or antihypertensives (n=368 123) before the pandemic were comparable with their pandemic counterparts (antihyperglycemics, n=97 015; antihypertensives, n=146 524). Before the pandemic, monthly rates of incident prescriptions were decreasing (-0.03 per 10 000 individuals [95% CI, -0.04 to -0.01] for antihyperglycemics; -0.14 [95% CI, -0.18 to -0.10] for antihypertensives). After July 2020, monthly rates increased (postinterruption trend 0.31 per 10 000 individuals [95% CI, 0.28-0.34] for antihyperglycemics; 0.19 [95% CI, 0.14-0.23] for antihypertensives). CONCLUSIONS Population-level increases in new antihyperglycemic and antihypertensive prescriptions during the pandemic reversed prepandemic declines and were sustained for >2 years. Our findings are concerning for current and future cardiovascular health.
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Affiliation(s)
- Amy Y. X. Yu
- Department of Medicine (Neurology)University of Toronto, Sunnybrook Health Sciences CentreTorontoONCanada
- ICESTorontoONCanada
| | - Peter C. Austin
- ICESTorontoONCanada
- Institute of Health Policy, Management and Evaluation, University of TorontoONCanada
| | - Cynthia A. Jackevicius
- ICESTorontoONCanada
- Institute of Health Policy, Management and Evaluation, University of TorontoONCanada
- College of Pharmacy, Western University of Health SciencesPomonaCA
| | | | - Jessalyn K. Holodinsky
- Department of Clinical Neurosciences and Hotchkiss Brain InstituteUniversity of CalgaryABCanada
- Department of Emergency MedicineUniversity of CalgaryABCanada
- Community Health SciencesUniversity of CalgaryABCanada
| | - Michael D. Hill
- Department of Clinical Neurosciences and Hotchkiss Brain InstituteUniversity of CalgaryABCanada
- Community Health SciencesUniversity of CalgaryABCanada
| | - Noreen Kamal
- Department of Industrial EngineeringDalhousie UniversityHalifaxNSCanada
- Department of Community Health and Epidemiology, Department of Medicine (Neurology)Dalhousie UniversityHalifaxNSCanada
| | - Mukesh Kumar
- Department of Industrial EngineeringDalhousie UniversityHalifaxNSCanada
| | - Douglas S. Lee
- ICESTorontoONCanada
- Department of Medicine (Cardiology)University of Toronto, University Health NetworkTorontoONCanada
| | - Manav V. Vyas
- ICESTorontoONCanada
- Department of Medicine (Neurology)Unity Health Toronto, University of TorontoONCanada
| | - Raed A. Joundi
- Department of MedicineMcMaster UniversityHamiltonONCanada
| | - Nadia A. Khan
- Department of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Moira K. Kapral
- ICESTorontoONCanada
- Department of Medicine (General Internal Medicine)University of Toronto, University Health NetworkTorontoONCanada
| | - Candace D. McNaughton
- ICESTorontoONCanada
- Department of Medicine (Emergency Medicine)University of Toronto, Sunnybrook Health Sciences CentreTorontoONCanada
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14
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Ketaroonrut N, Kiertiburanakul S, Sriphrapradang C. Optimal initial insulin dosage for managing steroid-induced hyperglycemia in hospitalized COVID-19 patients: A retrospective single-center study. SAGE Open Med 2024; 12:20503121241238148. [PMID: 38516643 PMCID: PMC10956164 DOI: 10.1177/20503121241238148] [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] [Received: 09/07/2023] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Objectives To determine the optimal initial insulin dosage for controlling hyperglycemia in COVID-19 patients receiving steroids, an area with limited data. Methods We retrospectively analyzed 156 COVID-19 patients with steroid-induced hyperglycemia treated with insulin. Patients were categorized by their total daily dose of subcutaneous insulin therapy when starting dexamethasone ⩾6 mg/day or equivalent dose of glucocorticoid: Group A (⩽0.29 units/kg), Group B (0.3-0.49 units/kg), Group C (0.5-0.69 units/kg), and Group B (⩾0.7 units/kg). Treatment failure was defined as mean blood glucose level > 280 mg/dL for two consecutive days after initiating insulin or any blood glucose ⩾ 400 mg/dL. Results The mean age was 64 ± 14 years, with 50% male, and a mean body mass index of 26.9 ± 6.9 kg/m2. Most had preexisting type 2 diabetes (62%). Mean admission blood glucose and HbA1c were 233 ± 112 mg/dL and 7.8 ± 2.3%, respectively. Group A had the lowest HbA1c (6.7 ± 1.2%), while group D had the highest (9.8 ± 2.5%). Median daily dexamethasone dosage or equivalent was 36 (IQR 16.72) mg, with no significant differences in among groups. Group A had the lowest treatment failure rate. There were no significant differences in treatment failure rate between Groups B, C, and D. Additionally, there were no statistically significant differences in mean BG across the groups: Group A 232 ± 42 mg/dL, Group B 247 ± 57 mg/dL, Group C 247 ± 61 mg/dL, and Group D 227 ± 67 mg/dL (p = 0.2). Group D had a significantly higher rate of level 1 hypoglycemia (p = 0.008), while no differences in clinically significant hypoglycemia (level 2 or 3) were observed between groups. Conclusions Among patients requiring TDD ⩾ 0.3 units/kg/day, there was no significant difference in treatment failure rate between Groups B, C, and D. Group D had the highest rate of level 1 hypoglycemia. This initial insulin dosage for hospitalized COVID-19 patients on high-dose steroid therapy should be personalized.
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Affiliation(s)
- Nuttavadee Ketaroonrut
- Faculty of Medicine, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sasisopin Kiertiburanakul
- Faculty of Medicine, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chutintorn Sriphrapradang
- Faculty of Medicine, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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15
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Taheri Kondar R, Hassani L, Ghanbarnejad A. The effect of educational intervention based on social support theory on the perceived stress caused by the covid-19 pandemic in patients with diabetes in hormozgan (2020-2021). BMC Public Health 2024; 24:691. [PMID: 38438887 PMCID: PMC10913277 DOI: 10.1186/s12889-024-18180-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND People with diabetes are more at risk of covid-19. Perceived social support plays an important role in maintaining people's health and reducing the negative effects of stress caused by the environment and society. The present study was designed and implemented with the purpose of determining the effect of educational intervention based on social support theory in reducing stress caused by the covid-19 pandemic in people with diabetes. METHODS The current investigation was an interventional and semi-experimental study conducted on 212 patients diagnosed with type 2 diabetes. Eligible participants were diabetic individuals capable of utilizing virtual platforms and not afflicted with COVID-19. Exclusion criteria encompassed unwillingness to continue study participation, absence from multiple training sessions, and development of a specific illness during the study period. Random allocation placed patients into either the control or intervention group. The intervention group received educational materials via WhatsApp, while the control group did not receive any intervention. The researcher administered a questionnaire to collect demographic information and assess perceived social support among the patients. Data analysis involved the use of chi-square tests, independent and paired t-tests, as well as ANCOVA. RESULTS This study revealed that the mean age of patients in the control and intervention groups was 46.35 ± 14.15 and 51.72 ± 11.57, respectively. Most of the diabetic patients in both groups were female, married, had a diploma, were housekeepers, and had an income between 2 and 5 million Tomans. According to the results obtained in all subscales of social support theory as well as the perceived stress score due to the corona pandemic after the educational intervention, a statistically significant difference was observed between the two groups (P < 0.05), so that the score of all subscales of social support theory in the intervention group was higher than the control group. But the perceived stress score caused by Corona in the intervention group was significantly lower than the control group. CONCLUSION The results of this study illustrate the noteworthy influence of social support training in lessening perceived stress among patients with diabetes during the COVID-19 pandemic. Consequently, healthcare providers are encouraged to integrate social support education programs into comprehensive care initiatives for diabetic patients, particularly during periods of heightened stress like the current coronavirus pandemic.
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Affiliation(s)
- Reihaneh Taheri Kondar
- MSc of Health Education and Promotion HUMS, Hormozgan University of Medical Sciences (HUMS), BandarAbbas, Iran
| | - Laleh Hassani
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, BandarAbbas, Iran.
| | - Amin Ghanbarnejad
- Department of community medicine, research institute for health, Hormozgan University of medical sciences, BandarAbbas, Iran
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16
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Tan YJ, Jin Y, Zhou J, Yang YF. Lipid droplets in pathogen infection and host immunity. Acta Pharmacol Sin 2024; 45:449-464. [PMID: 37993536 PMCID: PMC10834987 DOI: 10.1038/s41401-023-01189-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023] Open
Abstract
As the hub of cellular lipid metabolism, lipid droplets (LDs) have been linked to a variety of biological processes. During pathogen infection, the biogenesis, composition, and functions of LDs are tightly regulated. The accumulation of LDs has been described as a hallmark of pathogen infection and is thought to be driven by pathogens for their own benefit. Recent studies have revealed that LDs and their subsequent lipid mediators contribute to effective immunological responses to pathogen infection by promoting host stress tolerance and reducing toxicity. In this comprehensive review, we delve into the intricate roles of LDs in governing the replication and assembly of a wide spectrum of pathogens within host cells. We also discuss the regulatory function of LDs in host immunity and highlight the potential for targeting LDs for the diagnosis and treatment of infectious diseases.
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Affiliation(s)
- Yan-Jie Tan
- Center for Cell Structure and Function, Shandong Provincial Key Laboratory of Animal Resistance Biology, Collaborative Innovation Center of Cell Biology in Universities of Shandong, College of Life Sciences, Shandong Normal University, Jinan, 250014, China
| | - Yi Jin
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, China
| | - Jun Zhou
- Center for Cell Structure and Function, Shandong Provincial Key Laboratory of Animal Resistance Biology, Collaborative Innovation Center of Cell Biology in Universities of Shandong, College of Life Sciences, Shandong Normal University, Jinan, 250014, China.
- State Key Laboratory of Medicinal Chemical Biology, Haihe Laboratory of Cell Ecosystem, College of Life Sciences, Nankai University, Tianjin, 300071, China.
| | - Yun-Fan Yang
- Department of Cell Biology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
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17
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Hossain MJ, Al‐Mamun M, Islam MR. Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Sci Rep 2024; 7:e2004. [PMID: 38524769 PMCID: PMC10958528 DOI: 10.1002/hsr2.2004] [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] [Received: 09/27/2023] [Revised: 03/10/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024] Open
Abstract
Background and Aims Diabetes is recognized as a significant factor in both mortality and morbidity worldwide, affecting various demographics regardless of geographic location, age group, or gender. This correspondence aims to express concern and draw the attention of leaders and policymakers worldwide to this critical public health issue. Methods A thorough literature search was conducted utilizing various databases, including Google Scholar, PubMed, Science Direct, and the International Diabetes Federation (IDF) website, to collect the required data. Keywords were strategically applied to enhance search results, with preference given to English-language articles containing pertinent information. Results According to the 2021 report by the IDF, approximately 537 million individuals globally were affected with diabetes, constituting roughly 10.5% of the world's populace. This condition incurred healthcare expenditures totaling $966 billion. Projections indicate a surge in diabetes cases to 783 million by 2045, with associated healthcare costs estimated to surpass $1054 billion. However, almost half of all people with diabetes are unaware of their medical condition, with the highest prevalence of undiagnosed diabetes Mellitus (DM) found in low and middle-income countries (LMICs) of the regions of Africa, the Western Pacific, and Southeast Asia. Conclusion Collaborating with the World Health Organization (WHO), LMIC governments should improve healthcare accessibility, including more frequent diabetes screenings for individuals aged ≥ 45 years and younger individuals at elevated risk of having a family history.
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Affiliation(s)
- Md. Jamal Hossain
- Department of Pharmacy, School of Pharmaceutical SciencesState University of BangladeshDhakaBangladesh
| | - Md. Al‐Mamun
- Department of SociologyBangabandhu Sheikh Mujibur Rahman Science and Technology UniversityGopalganjBangladesh
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18
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Khamidullina Z, Avzaletdinova D, Gareeva D, Morugova T, Lakman I, Kopp K, Fiedler L, Motloch LJ, Zagidullin N. Long-Term Outcomes of COVID-19 in Hospitalized Type 2 Diabetes Mellitus Patients. Biomedicines 2024; 12:467. [PMID: 38398069 PMCID: PMC10886829 DOI: 10.3390/biomedicines12020467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/09/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
With the onset of the coronavirus pandemic, it has become clear that patients with diabetes are at risk for more severe and fatal COVID-19. Type 2 diabetes mellitus (T2D) is a major risk factor for adverse COVID-19 outcomes. The goal of study was to assess the characteristics and outcomes of hospitalized patients with COVID-19 with or without T2D in the hospital and at 10-month follow-up (FU). METHODS A total of 2486 hospitalized patients in the first wave of COVID-19 were analyzed according to the absence/presence of T2D, with 2082 (84.1%) patients in the control COVID-19 group and 381 (15.5%) in the T2D group. Twenty-three patients had other types of diabetes and were therefore excluded from the study. In-hospital mortality and cardiovascular endpoints (myocardial infarction, stroke, cardiovascular deaths and hospitalizations and composite endpoints) at the 10-month follow-up were analyzed. To remove bias in patients' characteristics disproportion, Propensity Score Matching (PSM) was used for hospital and follow-up endpoints. RESULTS Hospital mortality was considerably greater in T2D than in the control COVID-19 group (13.89% vs. 4.89%, p < 0.0001), and the difference remained after PSM (p < 0.0001). Higher glucose-level T2D patients had a higher mortality rate (p = 0.018). The most significant predictors of hospital death in T2D patients were a high CRP, glucose, neutrophils count, and Charlson Comorbidity Index. The follow-up of patients over 10 months showed a non-significant increase for all endpoints in the T2D group (p > 0.05), and significant increase in stroke (p < 0.042). After the PSM, the difference decreased in stroke (p = 0.090), but became significant in cardiovascular hospitalizations (p = 0.023). CONCLUSION In T2D patients with COVID-19, an increase in hospital mortality, stroke and cardiovascular hospitalizations rates in the follow-up was observed.
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Affiliation(s)
- Zemfira Khamidullina
- Department of Endocrinology, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia; (Z.K.); (D.A.); (T.M.)
| | - Diana Avzaletdinova
- Department of Endocrinology, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia; (Z.K.); (D.A.); (T.M.)
| | - Diana Gareeva
- Department of Internal Medicine, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia;
| | - Tatyana Morugova
- Department of Endocrinology, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia; (Z.K.); (D.A.); (T.M.)
| | - Irina Lakman
- Laboratory for the Study of Socio-Economic Problems of the Regions, Ufa University of Science and Technology, Z. Validi Str. 32, 450076 Ufa, Russia;
| | - Kristen Kopp
- Clinic for Internal Medicine II, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria; (K.K.); (L.J.M.)
| | - Lukas Fiedler
- Department of Internal Medicine, Cardiology, Nephrology and Intensive Care Medicine, Hospital Wiener Neustadt, 2700 Wiener Neustadt, Austria;
| | - Lukas J. Motloch
- Clinic for Internal Medicine II, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria; (K.K.); (L.J.M.)
- Department of Internal Medicine II, Salzkammergut Klinikum, OÖG, 4840 Voecklabruck, Austria
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, 4040 Linz, Austria
| | - Naufal Zagidullin
- Department of Internal Medicine, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia;
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Liu S, Jiang C, Liu Y, Qiu X, Luo J, Wang J, Xu Y. Covid-19 vaccination coverage and associated factors among older hypertensive patients in Hangzhou, China. Int Health 2024:ihae019. [PMID: 38365904 DOI: 10.1093/inthealth/ihae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/03/2023] [Accepted: 02/02/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Vaccination could provide effective protection against coronavirus disease 2019 (COVID-19). This study aims to describe the COVID-19 vaccination coverage and influential factors in Chinese older hypertensive patients. METHODS Using a cross-sectional design, participants were randomly selected from the electronic health records system during the pandemic era in Hangzhou, China. Logistic regression models were employed to compute the OR and 95% CI in order to assess the relationships between variables and the extent of COVID-19 vaccination coverage. RESULTS As of 3 August 2022, among a sample of 77 970 individuals, 75.11% had completed the full COVID-19 vaccination, while 57.66% had received a booster dose. Disparities in coverage were observed across genders, regions and age groups. Unhealthy lifestyles, cardiovascular disease, cancer, uncontrolled blood pressure, abnormal fasting plasma glucose, dyslipidemia and renal dysfunction were risk factors for COVID-19 vaccination coverage. The coverage rates continuously declined along with the number of risk factors. The ORs for full and booster vaccination in subjects with ≥4 risk factors were 2.55 (2.12∼3.07) and 2.60 (2.16∼3.13), compared to individuals without risk factors. CONCLUSION The COVID-19 vaccination program for older hypertensive patients must be strengthened further. Emphasis should be placed on patients who reside in urban areas, have comorbidities or multiple risk factors.
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Affiliation(s)
- Shijun Liu
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Caixia Jiang
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Yan Liu
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Xin Qiu
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Jun Luo
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Jing Wang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Yuyang Xu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
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20
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Liu S, Zhong M, Wu H, Su W, Wang Y, Li P. Potential Beneficial Effects of Naringin and Naringenin on Long COVID-A Review of the Literature. Microorganisms 2024; 12:332. [PMID: 38399736 PMCID: PMC10892048 DOI: 10.3390/microorganisms12020332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused a severe epidemic due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Recent studies have found that patients do not completely recover from acute infections, but instead, suffer from a variety of post-acute sequelae of SARS-CoV-2 infection, known as long COVID. The effects of long COVID can be far-reaching, with a duration of up to six months and a range of symptoms such as cognitive dysfunction, immune dysregulation, microbiota dysbiosis, myalgic encephalomyelitis/chronic fatigue syndrome, myocarditis, pulmonary fibrosis, cough, diabetes, pain, reproductive dysfunction, and thrombus formation. However, recent studies have shown that naringenin and naringin have palliative effects on various COVID-19 sequelae. Flavonoids such as naringin and naringenin, commonly found in fruits and vegetables, have various positive effects, including reducing inflammation, preventing viral infections, and providing antioxidants. This article discusses the molecular mechanisms and clinical effects of naringin and naringenin on treating the above diseases. It proposes them as potential drugs for the treatment of long COVID, and it can be inferred that naringin and naringenin exhibit potential as extended long COVID medications, in the future likely serving as nutraceuticals or clinical supplements for the comprehensive alleviation of the various manifestations of COVID-19 complications.
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Affiliation(s)
- Siqi Liu
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-Evaluation of Post-Market Traditional Chinese Medicine, State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, China; (S.L.); (M.Z.); (H.W.); (W.S.); (Y.W.)
| | - Mengli Zhong
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-Evaluation of Post-Market Traditional Chinese Medicine, State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, China; (S.L.); (M.Z.); (H.W.); (W.S.); (Y.W.)
| | - Hao Wu
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-Evaluation of Post-Market Traditional Chinese Medicine, State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, China; (S.L.); (M.Z.); (H.W.); (W.S.); (Y.W.)
| | - Weiwei Su
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-Evaluation of Post-Market Traditional Chinese Medicine, State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, China; (S.L.); (M.Z.); (H.W.); (W.S.); (Y.W.)
- Maoming Branch, Guangdong Laboratory for Lingnan Modern Agriculture, Maoming 525000, China
| | - Yonggang Wang
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-Evaluation of Post-Market Traditional Chinese Medicine, State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, China; (S.L.); (M.Z.); (H.W.); (W.S.); (Y.W.)
| | - Peibo Li
- Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-Evaluation of Post-Market Traditional Chinese Medicine, State Key Laboratory of Biocontrol, Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, China; (S.L.); (M.Z.); (H.W.); (W.S.); (Y.W.)
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21
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Kleinwechter HJ, Weber KS, Liedtke TP, Schäfer-Graf U, Groten T, Rüdiger M, Pecks U. COVID-19, Pregnancy, and Diabetes Mellitus. Z Geburtshilfe Neonatol 2024; 228:17-31. [PMID: 37918833 DOI: 10.1055/a-2180-7715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
During the severe acute respiratory distress virus coronavirus type 2 (SARS-CoV-2) pandemic, many women were infected during their pregnancies. The SARS-CoV-2-induced coronavirus disease 19 (COVID-19) has an impact on maternal health and pregnancy outcomes; peripartum and perinatal morbidity and mortality are increased. Pregnancy is considered a risk factor for severe COVID-19 course. Additional risk factors during pregnancy are diabetes mellitus, gestational diabetes mellitus (GDM), and obesity. Systemic inflammation can lead to severe metabolic dysregulation with ketoacidosis. The endocrine pancreas is a target organ for SARS-CoV-2 and the fetal risk depends on inflammation of the placenta. Up to now there is no evidence that SARS-CoV-2 infection during pregnancy leads to permanent diabetes in mothers or their offspring via triggering autoimmunity or beta cell destruction. The frequently observed increased prevalence of GDM compared to the years before the pandemic is most likely due to changed lifestyle during lockdown. Furthermore, severe COVID-19 may be associated with the development of GDM due to worsening of glucose tolerance. Vaccination with a mRNA vaccine is safe and highly effective to prevent infection and to reduce hospitalization. Registries support offering evidence-based recommendations on vaccination for pregnant women. Even with the current omicron virus variant, there are increased risks for symptomatic and unvaccinated pregnant women.
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Affiliation(s)
| | | | | | - Ute Schäfer-Graf
- Department of Obstetrics, Berlin Diabetes Center for Pregnant Women, St. Joseph Hospital, Berlin, Germany
| | - Tanja Groten
- Department of Obstetrics, Competence Center for Diabetic Women, Jena University Hospital, Jena, Germany
| | - Mario Rüdiger
- Saxony Center for Fetal-Neonatal Health, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Ulrich Pecks
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Department of Obstetrics, University Hospital Würzburg, Maternal Health and Midwifery Science, Würzburg, Germany
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22
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Ren Y, Wang Z, Wang Q. The trend of hypertension-related chronic kidney disease from 1990 to 2019 and its predictions over 25 years: an analysis of the Global Burden of Disease Study 2019. Int Urol Nephrol 2024; 56:707-718. [PMID: 37542001 DOI: 10.1007/s11255-023-03707-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/20/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND High blood pressure is a key pathogenetic factor that contributes to the deterioration of kidney function. However, the incidence trend of hypertension-related chronic kidney disease (CKD) has rarely been studied; therefore, we aimed to analyze the global, regional, and national patterns, temporal trends as well as burden of hypertension-related CKD. METHODS We extracted data on hypertension-related CKD from the Global Burden of Disease (GBD) study database, including the incidence, prevalence, disability-adjusted life years (DALYs), and mortality numbers and rates (per 100,000 population) and further described according to year, location, sex, age, and socio-demographic index (SDI). The estimated annual percentage changes (EAPCs) were calculated to assess the variation in incidence, DALYs, and mortality. We used an age-period-cohort (APC) model framework to analyze the underlying trends in prevalence by age, period, and birth cohort. Nordpred APC analysis was performed to predict the future morbidity and mortality of hypertension-related CKD. RESULTS In 2019, a total of over 1.57 million new hypertension-related CKD cases were reported worldwide, a 161.97% increase from 1990. Compared to 1990, the age-standardized incidence rates (ASIR) increased in all 21 regions in 2019. In all countries and territories except Iceland, the EAPC in ASIR and the lower boundary of its 95% confidence interval (CI) were higher than 0. ASIR, age-standardized prevalence rates (ASPR), age-standardized DALYs rates (ASDR), and age-standardized mortality rates (ASMR) were not identical among countries with different SDI regions in 2019; additionally, ASIR and ASMR were significantly different among sexes in all SDI regions in 2019. The predicted incidence and mortality counts globally continue to increase to 2044, and there is an upward trend in ASIR for both men and women. CONCLUSIONS Between 1990 and 2019, the ASIR of hypertension-related CKD demonstrated an ascending trend, and according to our projections, it would remain on the rise for the next 25 years. With remarkable global population growth, aging, and an increasing number of patients with hypertension, the burden of disease caused by hypertension-related CKD continues to increase.
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Affiliation(s)
- Yi Ren
- Department of Radiology, Sixth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Zengwu Wang
- State Key Laboratory of Cardiovascular Disease, Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qingjun Wang
- Department of Radiology, Sixth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, China.
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23
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Cioca F, Timar R, Ignuta F, Vlad A, Bratosin F, Rosca O, Jianu AM, Rosca D, Septimiu-Radu S, Burtic SR, Fildan AP, Laitin SMD. Comparative Analysis of COVID-19 Outcomes in Type 1 and Type 2 Diabetes: A Three-Year Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:210. [PMID: 38399498 PMCID: PMC10890714 DOI: 10.3390/medicina60020210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/08/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: This comprehensive retrospective study assesses COVID-19 outcomes in type 1 (T1D) and type 2 diabetes (T2D) patients across three years, focusing on how these outcomes varied with the evolving pandemic and changes in diabetes management. The study aims to determine if COVID-19 outcomes, including severity, intensive care unit (ICU) admission rates, duration of hospitalization, and mortality, are significantly different between these diabetes subtypes. Materials and Methods: The study analyzed data from patients admitted to the Victor Babes Hospital for Infectious Diseases and Pulmonology with confirmed COVID-19 and pre-existing diabetes, from the years 2020, 2021, and 2022. Results: Among 486 patients (200 without diabetes, 62 with T1D, 224 with T2D), T2D patients showed notably higher severity, with 33.5% experiencing severe cases, compared to 25.8% in T1D. Mortality rates were 11.6% in T2D and 8.1% in T1D. T2D patients had longer hospital stays (11.6 ± 7.0 days) compared to T1D (9.1 ± 5.8 days) and were more likely to require ICU admission (OR: 2.24) and mechanical ventilation (OR: 2.46). Hyperglycemia at admission was significantly higher in the diabetes groups, particularly in T2D (178.3 ± 34.7 mg/dL) compared to T1D (164.8 ± 39.6 mg/dL). Conclusions: The study reveals a discernible difference in COVID-19 outcomes between T1D and T2D, with T2D patients having longer hospital admissions, mechanical ventilation necessities, and mortality risks.
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Affiliation(s)
- Flavius Cioca
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (F.C.); (D.R.)
| | - Romulus Timar
- Department of Internal Medicine II, Division of Diabetes, Nutrition and Metabolic Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (R.T.)
| | - Flavia Ignuta
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (F.C.); (D.R.)
| | - Adrian Vlad
- Department of Internal Medicine II, Division of Diabetes, Nutrition and Metabolic Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (R.T.)
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Ovidiu Rosca
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Adelina Maria Jianu
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Daniela Rosca
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (F.C.); (D.R.)
| | - Susa Septimiu-Radu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (F.C.); (D.R.)
| | - Sonia-Roxana Burtic
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (F.C.); (D.R.)
- Department II, Discipline of Medical Communication, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ariadna Petronela Fildan
- Department of Pulmonology, Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
| | - Sorina Maria Denisa Laitin
- Discipline of Epidemiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
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24
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Lim KR, Chun KJ, Kim BS, Lee S. The Effect of Sodium-Glucose Cotransporter-2 Inhibitors on COVID-19 Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study Using the Common Data Model. J Clin Med 2024; 13:431. [PMID: 38256566 PMCID: PMC10815946 DOI: 10.3390/jcm13020431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND There is no clinical evidence about the effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on diabetic patients who have been diagnosed with coronavirus disease 19 (COVID-19). METHODS The dataset is based on insurance benefit claims sent to the Health Insurance Review and Assessment Service of Korea from January, 2018 to April, 2022. Among 9,822,577 patients who were involved in the claims, diabetic patients were divided into two groups based on whether they had a prescription for an SGLT2 inhibitor. The primary outcome was major adverse cardiac and cerebrovascular events (MACCEs), which were a composite of all-cause mortality, myocardial infarction, stroke, and revascularization over 90 days. RESULTS A total of 172,682 patients was analyzed. In the propensity score-matched analysis, the rate of MACCE was lower in the SGLT2 inhibitor group compared to the non-SGLT2 inhibitor group (0.89% vs. 1.31%; hazard ratio, 0.71; 95% confidence interval, 0.53-0.94; p =0.020). Each of the MACCEs showed no differences between the two groups. The rate of pneumonia was similar between the two groups (4.45% vs. 4.39%; hazard ratio, 1.06; 95% confidence interval, 0.91-1.16; p = 0.620). CONCLUSIONS In the diabetic patients who were diagnosed with COVID-19, SGLT2 inhibitors were associated with improved clinical outcomes in terms of MACCEs. SGLT2 inhibitors might be considered for prescription to diabetic patients in the current context of long COVID-19.
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Affiliation(s)
- Kyoung Ree Lim
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea;
| | - Kwang Jin Chun
- Division of Cardiology, Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea;
| | - Bum Sung Kim
- Division of Cardiology, Department of Medicine, Konkuk University Medical Center, Seoul 05029, Republic of Korea;
| | - Seunghwa Lee
- Division of Cardiology, Department of Medicine, Wiltse Memorial Hospital, Suwon 16480, Republic of Korea
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25
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Pantea Stoian A, Bica IC, Salmen T, Al Mahmeed W, Al-Rasadi K, Al-Alawi K, Banach M, Banerjee Y, Ceriello A, Cesur M, Cosentino F, Firenze A, Galia M, Goh SY, Janez A, Kalra S, Kapoor N, Kempler P, Lessan N, Lotufo P, Mikhailidis DP, Nibali L, Papanas N, Powell-Wiley T, Rizvi AA, Sahebkar A, Santos RD, Toth PP, Viswanathan V, Rizzo M. New-Onset Diabetes Mellitus in COVID-19: A Scoping Review. Diabetes Ther 2024; 15:33-60. [PMID: 37751143 PMCID: PMC10786767 DOI: 10.1007/s13300-023-01465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/15/2023] [Indexed: 09/27/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic became superimposed on the pre-existing obesity and diabetes mellitus (DM) pandemics. Since COVID-19 infection alters the metabolic equilibrium, it may induce pathophysiologic mechanisms that potentiate new-onset DM, and we evaluated this issue. METHOD A systematic review of the literature published from the 1 January 2020 until the 20 July 2023 was performed (PROSPERO registration number CRD42022341638). We included only full-text articles of both human clinical and randomized controlled trials published in English and enrolling adults (age > 18 years old) with ongoing or preceding COVID-19 in whom hyperglycemia was detected. The search was based on the following criteria: "(new-onset diabetes mellitus OR new-onset DM) AND (COVID-19) AND adults". RESULTS Articles on MEDLINE (n = 70) and the Web of Science database (n = 16) were included and analyzed by two researchers who selected 20 relevant articles. We found evidence of a bidirectional relationship between COVID-19 and DM. CONCLUSIONS This link operates as a pathophysiological mechanism supported by epidemiological data and also by the clinical and biological findings obtained from the affected individuals. The COVID-19 pandemic raised the incidence of DM through different pathophysiological and psychosocial factors.
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Affiliation(s)
- Anca Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 020021, Bucharest, Romania
| | - Ioana-Cristina Bica
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 020021, Bucharest, Romania.
| | - Teodor Salmen
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 020021, Bucharest, Romania
| | - Wael Al Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | | | - Kamila Al-Alawi
- Department of Training and Studies, Royal Hospital, Ministry of Health, Muscat, Oman
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Lodz, Poland
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Yajnavalka Banerjee
- Department of Biochemistry, Mohamed Bin Rashid University, Dubai, United Arab Emirates
| | | | - Mustafa Cesur
- Clinic of Endocrinology, Ankara Güven Hospital, Ankara, Turkey
| | - Francesco Cosentino
- Unit of Cardiology, Karolinska Institute and Karolinska University Hospital, University of Stockholm, Stockholm, Sweden
| | - Alberto Firenze
- Unit of Research and International Cooperation, University Hospital of Palermo, Palermo, Italy
| | - Massimo Galia
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bind), University of Palermo, Palermo, Italy
| | - Su-Yen Goh
- Department of Endocrinology, Singapore General Hospital, Singapore, Singapore
| | - Andrej Janez
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and Bride, Karnal, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Peter Kempler
- Department of Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Nader Lessan
- The Research Institute, Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Sao Paulo, Brazil
| | - Dimitri P Mikhailidis
- Department of Biochemistry, Mohamed Bin Rashid University, Dubai, United Arab Emirates
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK
| | - Luigi Nibali
- Dental Institute, Periodontology Unit, Centre for Host-Microbiome Interactions, King's College London, London, UK
| | - Nikolaos Papanas
- Diabetes Center, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Tiffany Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ali A Rizvi
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sci-Ences, Mashhad, Iran
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Raul D Santos
- Heart Institute (InCor), University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Peter P Toth
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
- Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medi-Cine, Baltimore, MD, USA
| | | | - Manfredi Rizzo
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Biochemistry, Mohamed Bin Rashid University, Dubai, United Arab Emirates
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMise), School of Medicine, University of Palermo, Palermo, Italy
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26
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Qu D, Liu J, Zhou L, Yang Y, Wu C, Xu X, Zhu Q, Wang C, Zhao X. Association of serum amyloid A and prognosis in people with diabetes and COVID-19: A retrospective cohort study. J Diabetes Investig 2024; 15:44-51. [PMID: 38031656 PMCID: PMC10759722 DOI: 10.1111/jdi.14118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/12/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023] Open
Abstract
AIMS/INTRODUCTION Serum amyloid A (SAA) is an acute phase reactive protein that plays a vital role in the early diagnosis, risk prediction, efficacy observation and prognosis evaluation of infectious diseases. This study aimed to assess the association between SAA levels and the prognosis of patients with coronavirus disease 2019 (COVID-19) and diabetes. MATERIALS AND METHODS We carried out this retrospective cohort study from March 2022 to May 2022. The population was stratified by tertiles of SAA levels: low (<8.5 mg/L), medium (8.5-36 mg/L) and high (>36 mg/L). The primary outcome was whether the patient developed severe COVID-19, and secondary outcomes included the need for invasive mechanical ventilation and length of hospital stay. Logistic regression analyses were carried out to identify risk factors affecting the prognosis of patients with COVID-19 and diabetes. RESULTS We analyzed 910 diabetes patients with COVID-19. The median age of the patients was 69 years, and 52.3% were men. As SAA levels increased, the proportion of severe COVID-19 (6.3% vs 7.3% vs 22.8%, P < 0.001) and the proportion of invasive mechanical ventilation also increased among the three groups. Patients with high SAA levels had a longer length of hospital stay compared with patients with medium SAA and low SAA levels. Univariate logistic regression analysis showed that SAA >36 mg/L further increased the odds ratio to 4.423 (P < 0.001) for the development of severe COVID-19 compared with low SAA. Multivariate logistic regression analysis, adjusted for age and sex, confirmed that SAA >36 mg/L remained an independent risk factor for the development of severe COVID-19 (adjusted odds ratio 3.038, P < 0.001). CONCLUSIONS SAA levels are strongly associated with poor prognosis in patients with COVID-19 and diabetes.
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Affiliation(s)
- Duoduo Qu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Jia Liu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Lihua Zhou
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Yaling Yang
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Chenwei Wu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Xinyue Xu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Qin Zhu
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Chunhong Wang
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
| | - Xiaolong Zhao
- Department of EndocrinologyShanghai Public Health Clinical CenterShanghaiChina
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27
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Zhang S, Mittinty M, Davis EA, Cameron E, Haynes A. Childhood-onset type 1 diabetes in Western Australia: An update on incidence and temporal trends from 2001 to 2022. Diabet Med 2023; 40:e15148. [PMID: 37191883 DOI: 10.1111/dme.15148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/21/2023] [Accepted: 05/12/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To determine the incidence and incidence trends over 2001-2022 of childhood-onset type 1 diabetes (T1D) in Western Australia and assess the impact of the COVID-19 pandemic. METHODS Children newly diagnosed with T1D aged 0-14 years in Western Australia from 1 January 2001 to 31 December 2022 were identified from the population-based Western Australian Children's Diabetes Database. Annual age- and sex-specific incidence was calculated, and Poisson regression was used to analyse trends by calendar year, month, sex and age group at diagnosis. Pandemic era impacts were also examined using the regression model adjusted for sex and age group. RESULTS Between 2001 and 2022, 2311 children (1214 boys, 1097 girls) were newly diagnosed with T1D aged 0-14 years, giving an overall mean annual incidence of 22.9 per 100,000 person-years (95% CI: 22.0, 23.9), with no significant difference observed between boys and girls. A significant linear increasing trend was only observed in 10-14 year olds with boys and girls combined (1.2% per year [IRR 1.012 (95% CI: 1.002, 1.022)]). No significant difference in the incidence was observed between the pre- and post-pandemic period. CONCLUSIONS The incidence of type 1 diabetes in 0-14 year old Western Australian children continues to increase in the oldest age group. Longer term monitoring of the incidence during the COVID-19 pandemic is needed to determine its impact on this globally unique population which experienced a delayed start to the pandemic with severe containment measures remaining in place until January 2022.
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Affiliation(s)
- Song Zhang
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, Southern Australia, Australia
| | - Murthy Mittinty
- College of Medicine and Public Health, Flinders University, Adelaide, Southern Australia, Australia
| | - Elizabeth A Davis
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Western Australia, Australia
- Division of Paediatrics, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Ewan Cameron
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Aveni Haynes
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
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28
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Piernas C, Merino J. Interwoven challenges of covid-19, poor diet, and cardiometabolic health. BMJ 2023; 383:e076810. [PMID: 37813430 PMCID: PMC10561014 DOI: 10.1136/bmj-2023-076810] [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: 10/12/2023]
Affiliation(s)
- Carmen Piernas
- Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jordi Merino
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
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29
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Gazal G, Elmalky W, Zafar MS. Conduct dental care for uncontrolled diabetic patients during COVID-19 pandemic. J Taibah Univ Med Sci 2023; 18:997-998. [PMID: 36811086 PMCID: PMC9934004 DOI: 10.1016/j.jtumed.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023] Open
Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, Taibah University, Almadinah Almunawwarah, KSA
| | - Wael Elmalky
- Department of Restorative, Dentistry, Taibah University, Almadinah Almunawwarah, KSA
| | - Muhammad S. Zafar
- Department of Restorative, Dentistry, Taibah University, Almadinah Almunawwarah, KSA,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan,Corresponding address: Department of Restorative, Dentistry, Taibah University, Almadinah Almunawwarah, KSA
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30
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Kuzuu K, Misawa N, Ashikari K, Tamura S, Kato S, Hosono K, Yoneda M, Nonaka T, Matsushima S, Komatsu T, Nakajima A, Higurashi T. Changes in the Number of Gastrointestinal Cancers and Stage at Diagnosis with COVID-19 Pandemic in Japan: A Multicenter Cohort Study. Cancers (Basel) 2023; 15:4410. [PMID: 37686686 PMCID: PMC10487252 DOI: 10.3390/cancers15174410] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/13/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
This retrospective cohort study compared the number of newly diagnosed patients, stage at diagnosis, and detection process of gastrointestinal cancers based on hospital-based cancer registry data at two tertiary Japanese hospitals. The pre-COVID-19 period was from January 2017 to February 2020, with phase 1 (midst of COVID-19 pandemic) from March to December 2020 and phase 2 (the transition period to the "new normal") from January to December 2021. Each month, the number of patients diagnosed with esophageal, gastric, colorectal, pancreatic, liver, and biliary tract cancers were aggregated, classified by stage and detection process, and compared, including a total of 6453 patients. The number of colorectal Stage 0-II patients decreased significantly in phase 1 and increased in phase 2. The total number of colorectal cancer patients returned to pre-COVID-19 levels (mean monthly patients [SD]: 41.61 [6.81] vs. 36.00 [6.72] vs. 46.00 [11.32]). The number of patients with gastric cancer Stage I significantly decreased in phase 2 following phase 1. The number of gastric cancer patients decreased significantly from pre-COVID-19 levels (30.63 [6.62] vs. 22.40 [5.85] vs. 24.50 [4.15]). During phase 2, the number of patients diagnosed after screening with colorectal cancer increased significantly, whereas that with gastric cancer remained considerably lower. The number of Stage III colorectal and gastric cancer patients increased significantly from the pre-COVID-19 levels. Thus, gastric cancer may not be optimally screened during phases 1 and 2. There was a significant increase in patients with Stage III colorectal and gastric cancers from the pre-COVID-19 period; hence, the stage at diagnosis may have progressed.
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Affiliation(s)
- Kento Kuzuu
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Noboru Misawa
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Keiichi Ashikari
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Shigeki Tamura
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Shingo Kato
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Kunihiro Hosono
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Takashi Nonaka
- National Hospital Organization Yokohama Medical Center, 3-60-2 Harazyuku, Totuka-ku, Yokohama 245-8575, Japan; (T.N.); (S.M.); (T.K.)
| | - Shozo Matsushima
- National Hospital Organization Yokohama Medical Center, 3-60-2 Harazyuku, Totuka-ku, Yokohama 245-8575, Japan; (T.N.); (S.M.); (T.K.)
| | - Tatsuji Komatsu
- National Hospital Organization Yokohama Medical Center, 3-60-2 Harazyuku, Totuka-ku, Yokohama 245-8575, Japan; (T.N.); (S.M.); (T.K.)
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
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31
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Perakakis N, Harb H, Hale BG, Varga Z, Steenblock C, Kanczkowski W, Alexaki VI, Ludwig B, Mirtschink P, Solimena M, Toepfner N, Zeissig S, Gado M, Abela IA, Beuschlein F, Spinas GA, Cavelti-Weder C, Gerber PA, Huber M, Trkola A, Puhan MA, Wong WWL, Linkermann A, Mohan V, Lehnert H, Nawroth P, Chavakis T, Mingrone G, Wolfrum C, Zinkernagel AS, Bornstein SR. Mechanisms and clinical relevance of the bidirectional relationship of viral infections with metabolic diseases. Lancet Diabetes Endocrinol 2023; 11:675-693. [PMID: 37524103 DOI: 10.1016/s2213-8587(23)00154-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/09/2023] [Accepted: 05/19/2023] [Indexed: 08/02/2023]
Abstract
Viruses have been present during all evolutionary steps on earth and have had a major effect on human history. Viral infections are still among the leading causes of death. Another public health concern is the increase of non-communicable metabolic diseases in the last four decades. In this Review, we revisit the scientific evidence supporting the presence of a strong bidirectional feedback loop between several viral infections and metabolic diseases. We discuss how viruses might lead to the development or progression of metabolic diseases and conversely, how metabolic diseases might increase the severity of a viral infection. Furthermore, we discuss the clinical relevance of the current evidence on the relationship between viral infections and metabolic disease and the present and future challenges that should be addressed by the scientific community and health authorities.
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Affiliation(s)
- Nikolaos Perakakis
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany.
| | - Hani Harb
- Medical Microbiology and Virology, Technische Universität Dresden, Dresden 01307, Germany
| | - Benjamin G Hale
- Institute of Medical Virology, University of Zürich, Zürich, Switzerland
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University of Zürich, Zürich, Switzerland
| | - Charlotte Steenblock
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany
| | - Waldemar Kanczkowski
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany
| | - Vasileia Ismini Alexaki
- Institute for Institute of Clinical Chemistry and Laboratory Medicine, Technische Universität Dresden, Dresden 01307, Germany
| | - Barbara Ludwig
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Peter Mirtschink
- Institute for Institute of Clinical Chemistry and Laboratory Medicine, Technische Universität Dresden, Dresden 01307, Germany
| | - Michele Solimena
- Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; Department of Molecular Diabetology, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Nicole Toepfner
- Department of Pediatrics, Technische Universität Dresden, Dresden 01307, Germany
| | - Sebastian Zeissig
- Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden 01307, Germany; Department of Medicine I, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden 01307, Germany
| | - Manuel Gado
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Irene Alma Abela
- Institute of Medical Virology, University of Zürich, Zürich, Switzerland; Department of Infectious Diseases and Hospital Epidemiology, University of Zürich, Zürich, Switzerland
| | - Felix Beuschlein
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zürich, University of Zürich, Zürich, Switzerland; Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Giatgen A Spinas
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Claudia Cavelti-Weder
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Philipp A Gerber
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Michael Huber
- Institute of Medical Virology, University of Zürich, Zürich, Switzerland
| | - Alexandra Trkola
- Institute of Medical Virology, University of Zürich, Zürich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Wendy Wei-Lynn Wong
- and Department of Molecular Life Science, University of Zürich, Zürich, Switzerland
| | - Andreas Linkermann
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu, India
| | - Hendrik Lehnert
- Presidential Office, Paris Lodron Universität Salzburg, Salzburg, Austria
| | - Peter Nawroth
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany
| | - Triantafyllos Chavakis
- Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; Institute for Institute of Clinical Chemistry and Laboratory Medicine, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany; Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Geltrude Mingrone
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Division of Diabetes and Nutritional Sciences, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Christian Wolfrum
- Laboratory of Translational Nutrition Biology, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zürich, Schwerzenbach, Switzerland
| | - Annelies S Zinkernagel
- Department of Infectious Diseases and Hospital Epidemiology, University of Zürich, Zürich, Switzerland
| | - Stefan R Bornstein
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany; Division of Diabetes and Nutritional Sciences, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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32
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Bellaver P, Schneider L, Schaeffer AF, Henrique LR, Camargo JL, Gerchman F, Leitão CB, Rech TH. Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia: No diabetes paradox in COVID-19. Heliyon 2023; 9:e18554. [PMID: 37576227 PMCID: PMC10412986 DOI: 10.1016/j.heliyon.2023.e18554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023] Open
Abstract
Background Diabetes mellitus (DM) is not associated with increased mortality in critically ill patients, a phenomenon known as the "diabetes paradox". However, DM is a risk factor for increased mortality in patients with COVID-19. This study aims to investigate the association of DM and stress-induced hyperglycemia at intensive care unit (ICU) with mortality in this population. Methods This is a retrospective study. Electronic medical records from patients admitted from March 2020 to September 2020 were reviewed. Primary outcome was mortality. Secondary outcomes were ICU and hospital mortality and stay, and need for mechanical ventilation and renal replacement therapy. Results 187 patients were included. Overall mortality was 43.2%, higher in patients with DM (55.7% vs. 34%; p = 0.007), even after adjustment for age, hypertension, and disease severity. When patients were separated into groups, named normoglycemia (without DM and glycemia ≤140 mg/dL), stress-induced hyperglycemia (without DM and glycemia >140 mg/dL), and DM (previous diagnosis or HbA1c ≥ 6.5%), the mortality rate was 25.8%, 37.3%, and 55.7%, respectively (p = 0.021). Mortality was higher in patients with higher glycemic variability. No statistical difference related to secondary outcomes was observed. Conclusions DM, hyperglycemia, and glycemic variability associated with increased mortality in critically ill patients with severe COVID-19, but did not increase the rates of other clinical outcomes. More than stress-induced hyperglycemia, DM was associated with mortality.
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Affiliation(s)
- Priscila Bellaver
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Larissa Schneider
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Ariell F. Schaeffer
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Lilian Rodrigues Henrique
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Joíza Lins Camargo
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Fernando Gerchman
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Cristiane B. Leitão
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Tatiana H. Rech
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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33
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Schmitt VH, Hobohm L, Sagoschen I, Sivanathan V, Hahad O, Espinola-Klein C, Münzel T, Keller K. Diabetes Mellitus and Its Association with Adverse In-Hospital Outcomes in Patients with COVID-19-A Nationwide Study. Viruses 2023; 15:1627. [PMID: 37631970 PMCID: PMC10457863 DOI: 10.3390/v15081627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/21/2023] [Accepted: 07/23/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) represents a relevant risk factor regarding morbidity and mortality worldwide. However, only limited data exist regarding the impact of DM on the clinical outcome of patients with COVID-19 infection. METHODS All hospitalized patients with confirmed COVID-19-infection (ICD-code U07.1) during the year 2020 in Germany were included in the present study. Patients were stratified regarding the co-prevalence of DM (ICD-codes E10-E14), and the impact of DM on in-hospital case fatality and in-hospital adverse events was analyzed. RESULTS Overall, 176,137 hospitalizations with confirmed COVID-19 infection were documented; of these, 45,232 (25.7%) patients had an additional diagnosis of DM. Diabetic patients with COVID-19 were more often of male sex and 7 years older (median 76.0 (IQR: 66.0-83.0) vs. 69.0 (52.0-81.0) years, p < 0.001). COVID-19 patients with DM demonstrated an aggravated comorbidity profile, as reflected by a higher Charlson comorbidity index (6.0 (IQR: 4.0-8.0) vs. 3.0 (1.0-5.0), p < 0.001). Risk for pneumonia (OR 1.38 (95% CI: 1.35-1.41), p < 0.001), acute respiratory distress syndrome (OR 1.53 (95% CI: 1.47-1.60), p < 0.001), and need for intensive care (21.3% vs. 13.3%, p < 0.001) were increased in DM patients. DM was an independent risk factor for acute kidney failure (OR 1.49 (95% CI: 1.44-1.53), p < 0.001), dialysis (OR 1.56 (95% CI: 1.47-1.66), p < 0.001), mechanical ventilation (OR: 1.49 (95% CI: 1.43-1.56), p < 0.001), extracorporeal membrane oxygenation (OR 1.44 (95% CI: 1.27-1.62), p < 0.001), major adverse cardiac and cerebrovascular events (OR: 1.24 (95% CI: 1.20-1.27), p < 0.001), and in-hospital mortality (OR: 1.26 (95% CI: 1.22-1.30), p < 0.001). CONCLUSIONS In patients with COVID-19-infection, DM is a relevant risk factor for adverse events, including mortality. The vulnerable patient group of diabetics with COVID-19 requires intense medical care and monitoring during hospitalization.
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Affiliation(s)
- Volker H. Schmitt
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Lukas Hobohm
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Ingo Sagoschen
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
| | - Visvakanth Sivanathan
- Department of Gastroenterology, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Omar Hahad
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Christine Espinola-Klein
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Karsten Keller
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
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Liu S, Jiang C, Liu Y, Zhang Y, Qiu X, Luo J, Xu Y, Wang J. The effectiveness of COVID-19 vaccination against all-cause mortality in patients with type 2 diabetes mellitus: the observation during the initial period of the cancellation of the "Dynamic Zero Policy" in mainland China. Diabetes Res Clin Pract 2023; 200:110694. [PMID: 37164159 PMCID: PMC10165863 DOI: 10.1016/j.diabres.2023.110694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/21/2023] [Accepted: 05/02/2023] [Indexed: 05/12/2023]
Abstract
AIMS This study aims to assess the effectiveness of COVID-19 vaccination against all-cause death in patients with type 2 diabetes mellitus (T2DM). METHODS Subjects were patients with T2DM who were administered by general practitioner (GP). Use electronic exchange platform to obtain the information on COVID-19 vaccination, all-cause deaths and risk factors. Logistic regression models were used to calculate the odd ratio (OR) and 95% CI for the association between COVID-19 vaccination and mortality. The vaccine effectiveness (VE) was calculated as (1- adjusted OR) ×100%. RESULTS A total of 27,156 subjects had 53.81%, 17.65%, and 23.43% coverage for the booster, full, and partial COVID-19 vaccination, reported 328 deaths and a mortality of 1.2%. The adjusted OR (95%CI) was 0.85(0.60-1.21) for those received partial vaccination, 0.31(0.22-0.43) for those received full vaccination, and 0.12(0.08-0.18) for those received booster vaccination, compared to the unvaccinated individuals. The VE (95%CI) was 88.00(82.30-91.80) of booster vaccination, 69.30(56.60-78.30) of full vaccination, and 17.60(-17.10-42.00) of partial vaccination. CONCLUSION COVID-19 vaccination could effectively prevent the all-cause death in patients with T2DM during the omicron variant outbreak period, after the cancellation of the "Dynamic Zero Policy" in mainland China.
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Affiliation(s)
- Shijun Liu
- HangZhou Center for Disease Control and prevention, HangZhou, ZheJiang, China.
| | - Caixia Jiang
- HangZhou Center for Disease Control and prevention, HangZhou, ZheJiang, China
| | - Yan Liu
- HangZhou Center for Disease Control and prevention, HangZhou, ZheJiang, China
| | - Yan Zhang
- HangZhou Center for Disease Control and prevention, HangZhou, ZheJiang, China
| | - Xin Qiu
- HangZhou Center for Disease Control and prevention, HangZhou, ZheJiang, China
| | - Jun Luo
- HangZhou Center for Disease Control and prevention, HangZhou, ZheJiang, China
| | - Yuyang Xu
- HangZhou Center for Disease Control and prevention, HangZhou, ZheJiang, China
| | - Jing Wang
- HangZhou Center for Disease Control and prevention, HangZhou, ZheJiang, China
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Knip M, Parviainen A, Turtinen M, But A, Härkönen T, Hepojoki J, Sironen T, Iheozor-Ejiofor R, Uğurlu H, Saksela K, Lempainen J, Ilonen J, Vapalahti O. SARS-CoV-2 and type 1 diabetes in children in Finland: an observational study. Lancet Diabetes Endocrinol 2023; 11:251-260. [PMID: 36958868 DOI: 10.1016/s2213-8587(23)00041-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Some epidemiological studies have suggested an increase in incidence of type 1 diabetes during the COVID-19 pandemic, however the mechanism(s) behind such an increase have yet to be identified. In this study we aimed to evaluate the possible role of the SARS-CoV-2 virus in the reported increase in the rate of type 1 diabetes. METHODS In this observational cohort study using data from the Finnish Pediatric Diabetes Register (FPDR), we assessed the incidence of type 1 diabetes (number of children with newly diagnosed type 1 diabetes per 100 000 person-years during the pandemic and the reference period) during the first 18 months of the COVID-19 pandemic in children in Finland younger than 15 years old compared with a reference period which included three corresponding pre-pandemic periods also obtained from the FPDR. Children with confirmed monogenic diabetes were excluded. We also compared the phenotype and HLA genotype of the disease between these two cohorts, and analysed the proportion of newly diagnosed people with type 1 diabetes testing positive for SARS-CoV-2 antibodies. FINDINGS 785 children and adolescents in Finland were diagnosed with type 1 diabetes from March 1, 2020, to Aug 31, 2021. In the reference period, which comprised three similar 18-month terms (from March 1, 2014, to Aug 31, 2015; March 1, 2016, to Aug 31, 2017; and March 1, 2018, to Aug 31, 2019) 2096 children and adolescents were diagnosed. The incidence of type 1 diabetes was 61·0 per 100 000 person-years (95% CI 56·8-65·4) among children younger than 15 years old during the pandemic, which was significantly higher than during the reference period (52·3 per 100 000 person-years; 50·1-54·6). The incidence rate ratio adjusted for age and sex for the COVID-19 pandemic was 1·16 (1·06-1·25; p=0·0006) when compared with the reference period. The children diagnosed during the COVID-19 pandemic had more often diabetic ketoacidosis (p<0·001), had a higher HbA1c (p<0·001), and tested more frequently positive for glutamic acid debarboxylase antibodies at diagnosis (p<0·001) than those diagnosed before the pandemic. There were no significant differences in the distribution of HLA genotypes between the two periods. Only five of those diagnosed during the pandemic (0·9%) of 583 tested positive for infection-induced SARS-CoV-2 antibodies. INTERPRETATION Children and adolescents diagnosed with type 1 diabetes during the pandemic had a more severe disease at diagnosis. The observed increase in type 1 diabetes incidence during the first 18 months could be a consequence of lockdown and physical distancing rather than a direct effect of SARS-CoV-2 infection. FUNDING Helsinki University Hospital Research Funds, EU Horizon 2020 (Versatile emerging infectious disease observatory project), Academy of Finland, Sigrid Jusélius Foundation, Jane & Aatos Erkko Foundation, and Medicinska understödsföreningen Liv och Hälsa. TRANSLATIONS For the Finnish and Swedish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Mikael Knip
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Anna Parviainen
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Maaret Turtinen
- Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anna But
- Biostatistics consulting, Department of Public Health, University Hospital, University of Helsinki, Helsinki, Finland
| | - Taina Härkönen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Hepojoki
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland
| | - Tarja Sironen
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland; Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
| | | | - Hasan Uğurlu
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland
| | - Kalle Saksela
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland; Virology and Immunology, Diagnostic Center, Helsinki University Hospital (HUSLAB), Helsinki, Finland
| | - Johanna Lempainen
- Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland; Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Olli Vapalahti
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland; Virology and Immunology, Diagnostic Center, Helsinki University Hospital (HUSLAB), Helsinki, Finland; Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
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Misra AK, Rangari G, C M, Sharma S. Current management of diabetes patients with COVID-19. Expert Rev Endocrinol Metab 2023:1-9. [PMID: 36890686 DOI: 10.1080/17446651.2023.2187375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/01/2023] [Indexed: 03/08/2023]
Abstract
INTRODUCTION Diabetes mellitus (DM) and the 2019 coronavirus (COVID-19) appear to interact in both directions. There is mounting proof that patients with DM have a worse COVID-19 prognosis than those without it. Pharmacotherapy is also known to affect in view of the possible interplay between drugs and the pathophysiology of the above conditions in a given patient. AREAS COVERED In this review, we discuss the pathogenesis of COVID-19 and its connections with diabetes mellitus. We also analyze the treatment modalities for COVID-19 and diabetes patients. The possible mechanisms of the different medications and their management limitations are also systematically reviewed. EXPERT OPINION COVID-19 management as well as its knowledge base is changing constantly. The Pharmacotherapy and the choice of drugs also need to be specifically considered in view of the concomitant presence of these conditions in a patient. Anti-diabetic agents must be carefully evaluated in diabetic patients in view of the disease's severity, blood glucose level, appropriate treatment, and other components that could aggravate adverse events. A methodical technique is anticipated to enable the safe and rational use of drug therapy in COVID-19-positive diabetic patients to take.
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Affiliation(s)
- Arup Kumar Misra
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
| | - Gaurav Rangari
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
| | - Madhavrao C
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
| | - Sushil Sharma
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
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Amsah N, Md Isa Z, Ahmad N, Abdul Manaf MR. Impact of COVID-19 Pandemic on Healthcare Utilization among Patients with Type 2 Diabetes Mellitus: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4577. [PMID: 36901588 PMCID: PMC10002238 DOI: 10.3390/ijerph20054577] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
As the COVID-19 pandemic continues, healthcare services have been grossly overwhelmed by the pandemic. Due to this circumstance, routine care for individuals with type 2 diabetes mellitus (T2DM) has been temporarily disrupted. The purpose of this systematic review was to summarize the evidence regarding the impact of the COVID-19 pandemic on healthcare utilization among patients with T2DM. A systematic search was conducted in the Web of Science, Scopus, and PubMed databases. The process of identifying the final articles followed the PRISMA guidelines. The inclusion criteria were articles published between 2020 and 2022, written in English, and studies focusing on the research question. Any proceedings and books were excluded. A total of fourteen articles relevant to the research question were extracted. Following that, the included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT) and the Joanna Briggs Institute Critical Appraisal Tool to assess the quality of the studies. The findings were further classified into three themes: reduced healthcare utilization among T2DM patients in routine healthcare services, a surge of telemedicine usage, and delay in the delivery of healthcare services. The key messages include demands for monitoring the long-term effects of the missed care and that better preparedness is crucial for any pandemic in the future. A tight diagnostic workup at the community level and regular follow-ups are crucial in managing the impact of the pandemic among T2DM patients. Telemedicine should be on the agenda of the health system to maintain and complement healthcare services. Future research is warranted to determine effective strategies to deal with the impact of the pandemic on healthcare utilization and delivery among T2DM patients. A clear policy is essential and should be established.
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Misra AK, Rangari G, C M, Sharma S. Current management of diabetes patients with COVID-19. Expert Rev Endocrinol Metab 2023; 18:199-207. [PMID: 36882971 DOI: 10.1080/17446651.2023.2187215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/01/2023] [Indexed: 03/05/2023]
Abstract
INTRODUCTION Diabetes mellitus (DM) and the 2019 coronavirus (COVID-19) appear to interact in both directions. There is mounting proof that patients with DM have a worse COVID-19 prognosis than those without it. Pharmacotherapy is also known to affect in view of the possible interplay between drugs and the pathophysiology of the above conditions in a given patient. AREAS COVERED In this review, we discuss the pathogenesis of COVID-19 and its connections with diabetes mellitus. We also analyze the treatment modalities for COVID-19 and diabetes patients. The possible mechanisms of the different medications and their management limitations are also systematically reviewed. EXPERT OPINION COVID-19 management as well as its knowledge base is changing constantly. The Pharmacotherapy and the choice of drugs also need to be specifically considered in view of the concomitant presence of these conditions in a patient. Anti-diabetic agents must be carefully evaluated in diabetic patients in view of the disease's severity, blood glucose level, appropriate treatment, and other components that could aggravate adverse events. A methodical technique is anticipated to enable the safe and rational use of drug therapy in COVID-19-positive diabetic patients to take.
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Affiliation(s)
- Arup Kumar Misra
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
| | - Gaurav Rangari
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
| | - Madhavrao C
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
| | - Sushil Sharma
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
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