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Tan JS, Yang Y, Wang J, Wang Y, Lv T, Shu Y, Xu W, Chong L. Diabetes mellitus, glycemic traits, SGLT2 inhibition, and risk of pulmonary arterial hypertension: A Mendelian randomization study. Biosci Trends 2024; 18:94-104. [PMID: 38325821 DOI: 10.5582/bst.2024.01006] [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: 02/09/2024]
Abstract
This study aimed to investigate the causal role of diabetes mellitus (DM), glycemic traits, and sodium-glucose cotransporter 2 (SGLT2) inhibition in pulmonary arterial hypertension (PAH). Utilizing a two-sample two-step Mendelian randomization (MR) approach, we determined the causal influence of DM and glycemic traits (including insulin resistance, glycated hemoglobin, and fasting insulin and glucose) on the risk of PAH. Moreover, we examined the causal effects of SGLT2 inhibition on the risk of PAH. Genetic proxies for SGLT2 inhibition were identified as variants in the SLC5A2 gene that were associated with both levels of gene expression and hemoglobin A1c. Results showed that genetically inferred DM demonstrated a causal correlation with an increased risk of PAH, exhibiting an odds ratio (OR) of 1.432, with a 95% confidence interval (CI) of 1.040-1.973, and a p-value of 0.028. The multivariate MR analysis revealed comparable outcomes after potential confounders (OR = 1.469, 95%CI = 1.021-2.115, p = 0.038). Moreover, genetically predicted SGLT2 inhibition was causally linked to a reduced risk of PAH (OR = 1.681*10-7, 95%CI = 7.059*10-12-0.004, p = 0.002). Therefore, our study identified the suggestively causal effect of DM on the risk of PAH, and SGLT2 inhibition may be a potential therapeutic target in patients with PAH.
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Affiliation(s)
- Jiang-Shan Tan
- Emergency and Critical Care Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanmin Yang
- Emergency and Critical Care Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingyang Wang
- Emergency and Critical Care Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yimeng Wang
- Emergency and Critical Care Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingting Lv
- Key Laboratory of Pulmonary Vascular Medicine, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuyuan Shu
- Emergency and Critical Care Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Xu
- Emergency and Critical Care Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lingtao Chong
- Key Laboratory of Pulmonary Vascular Medicine, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Rasmi Y, di Bari I, Faisal S, Haque M, Aramwit P, da Silva A, Roshani Asl E. Herbal-based therapeutics for diabetic patients with SARS-Cov-2 infection. Mol Biol Rep 2024; 51:316. [PMID: 38376656 DOI: 10.1007/s11033-024-09291-1] [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: 07/26/2023] [Accepted: 01/26/2024] [Indexed: 02/21/2024]
Abstract
Human SARS Coronavirus-2 (SARS-CoV-2) has infected more than 170 million people worldwide, being responsible for about 3.5 million deaths so far. Despite ongoing investigations, there is still more to understand the mechanism of COVID-19 infection completely. However, it has been evidenced that SARS-CoV-2 can cause Coronavirus disease (COVID-19) notably in diabetic people. Approximately 35% of the patients who died of this disease had diabetes. A growing number of studies have evidenced that hyperglycemia is a significant risk factor for severe SARS-CoV-2 infection and plays a key role in COVID-19 mortality and diabetes comorbidity. The uncontrolled hyperglycemia can produce low-grade inflammation and impaired immunity-mediated cytokine storm that fail multiple organs and sudden death in diabetic patients with SARS-CoV-2 infection. More importantly, SARS-CoV-2 infection and interaction with ACE2 receptors also contribute to pancreatic and metabolic impairment. Thus, using of diabetes medications has been suggested to be beneficial in the better management of diabetic COVID-19 patients. Herbal treatments, as safe and affordable therapeutic agents, have recently attracted a lot of attention in this field. Accordingly, in this review, we intend to have a deep look into the molecular mechanisms of diabetic complications in SARS-CoV-2 infection and explore the therapeutic potentials of herbal medications and natural products in the management of diabetic COVID-19 patients based on recent studies and the existing clinical evidence.
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Affiliation(s)
- Yousef Rasmi
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Orūmīyeh, Iran
- Department of Biochemistry, School of Medicine, Urmia University of Medical Sciences, Orūmīyeh, Iran
| | - Ighli di Bari
- Section of Nephrology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy
| | - Shah Faisal
- Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Munima Haque
- Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Pornanong Aramwit
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences and Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Dusit, Bangkok, 10330, Thailand
| | - Aline da Silva
- Department of Soil and Rural, Centre for Agrarian Science, Campus II, Federal University of Paraiba, Areia, João Pessoa, Brazil.
| | - Elmira Roshani Asl
- Department of Biochemistry, Saveh University of Medical Sciences, Saveh, Iran.
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Castillo-Ortega R, Vega-Vargas J, Durán-Aguero S. Assessment of clinical impact of SARS-CoV-2 in people with type 1 diabetes: A cohort study. Nutrition 2024; 118:112263. [PMID: 37988927 DOI: 10.1016/j.nut.2023.112263] [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: 06/10/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES During the coronavirus 2019 pandemic, there had been more than 758 million COVID-19 cases as of February 13, 2023, and it is the main cause of death in many countries. Due to the variation in disease presentation, scientists determined that people living with type 2 diabetes mellitus were at higher risk of mortality. However, people living with type 1 diabetes have not been thoroughly studied, especially in extreme regions of developing countries. The objective of this study was to analyze the effects of SARS-CoV-2 pandemic restrictions on different variables in a cohort with type 1 diabetes. METHODS This cohort-type study included pediatric and adult patients with type 1 diabetes at Regional Hospital Dr. Juan Noé Crevani in Arica, Chile. Biosocial and anthropometric factors, clinical history, self-care activities, and biochemical parameters were assessed and compared using analysis of variance and paired t tests between March 2020 and March 2021. RESULTS A total of 150 patients were assessed during the SARS-CoV-2 pandemic in Arica, Chile. One year after the pandemic struck, the main causes for metabolic deterioration were a reduction of carbohydrate counting by an average of 8.67% (P = 0.000), a reduction of adherence to treatment by an average of 25% (P = 0.000), and a shift to telemedicine as a main health care service (P = 0.023); these factors raised hemoglobin A1c (HbA1c) levels by 1.81%, 1.78% and 0.075%, respectively. The participants' average body mass index (BMI) increased by 1.26 kg/m2 and HbA1c levels increased by 0.16% during the first year of the pandemic. Also, hospitalizations increased about 2% (P = 0.984), and there was a significant increase in carbohydrate and snack intake (P = 0.330 and P = 0.811, respectively). Children's linear growth decreased by a standard deviation of 0.035 (P = 0.648), and their physical activity decreased by 12.67% (P = 0.383). CONCLUSIONS This study found that adherence to diabetes care was reduced during the pandemic owing to a variety of behavioral reasons and environmental changes (e.g., quarantines and food security). This affected this population's HbA1c levels, BMI, linear growth, and number of hospitalizations as main consequences. Telemedicine remains an important tool, but it must be reconsidered among all different age groups.
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Affiliation(s)
| | - Juan Vega-Vargas
- Departamento de Ingeniería Industrial y de Sistemas, Universidad de Tarapacá, Arica, Chile
| | - Samuel Durán-Aguero
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de Salud, Universidad San Sebastian, Chile
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Galeana-Pizaña JM, Verdeja-Vendrell L, González-Gómez R, Tapia-McClung R. Spatio-temporal patterns of the mortality of diseases associated with malnutrition and their relationship with food establishments in Mexico. Spat Spatiotemporal Epidemiol 2023; 47:100619. [PMID: 38042538 DOI: 10.1016/j.sste.2023.100619] [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: 09/19/2022] [Revised: 06/08/2023] [Accepted: 09/17/2023] [Indexed: 12/04/2023]
Abstract
This study explores the spatio-temporal behavior of mortality due to multiple causes associated with several diseases and their relationship with the physical availability of food. We analyze data for the 2010-2020 period at the municipality level in Mexico. After collecting and standardizing national databases for each disease, we perform SATSCAN temporal and FleXScan spatial cluster analyses. We use the he Kruskal-Wallis test to analyze the differences between municipalities with high relative risk of mortality and their relationship with food retail units and food establishments. We found statistically significant relationships between clusters by disease and the physical availability of food per hundred thousand inhabitants. The main pattern is a higher average density of convenience stores, supermarkets, fast food chains and franchises, and Mexican snack restaurants in high-risk municipalities, while a higher density of grocery stores and inns, cheap kitchens, and menu restaurants exists in the municipalities with low risk. The density of convenience stores, fast food chains and franchises, and Mexican snack restaurants plays a very important role in mortality behavior, so measures must exist to regulate them and encourage and protect convenience stores, grocery stores, and local food preparation units.
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Affiliation(s)
- José Mauricio Galeana-Pizaña
- Centro de Investigación en Ciencias de Información Geoespacial (CentroGeo), Contoy 137, Lomas de Padierna, Tlalpan, 14240, Mexico City, Mexico
| | - Leslie Verdeja-Vendrell
- Centro de Investigación en Ciencias de Información Geoespacial (CentroGeo), Contoy 137, Lomas de Padierna, Tlalpan, 14240, Mexico City, Mexico
| | - Raiza González-Gómez
- Centro de Investigación en Ciencias de Información Geoespacial (CentroGeo), Contoy 137, Lomas de Padierna, Tlalpan, 14240, Mexico City, Mexico
| | - Rodrigo Tapia-McClung
- Centro de Investigación en Ciencias de Información Geoespacial (CentroGeo), Contoy 137, Lomas de Padierna, Tlalpan, 14240, Mexico City, Mexico.
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Muacevic A, Adler JR, Klein S, Bassie M, Gu K, Hille C, Brown C, Daniel M, Drakeley C, Jahnke A, Karim A, Altabbakh O, Phillpotts L. The World-Wide Adaptations of Diabetic Management in the Face of COVID-19 and Socioeconomic Disparities: A Scoping Review. Cureus 2022; 14:e31911. [PMID: 36579222 PMCID: PMC9792358 DOI: 10.7759/cureus.31911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022] Open
Abstract
Diabetes is an increasingly prevalent chronic disease throughout the world. It is imperative for patients to have access to reliable treatment and resources in order to avoid long-term complications. Economic and social factors contribute to the accessibility of these resources and have a direct impact on diabetes management. Socioeconomic status (SES) presents challenges to diabetic management due to financial and geographical access to care, medications, educational resources, healthy food options, and physical activity. The coronavirus (COVID-19) pandemic exacerbated these challenges, especially during the height of lockdowns. Therefore, it is important to gain insight into how the pandemic challenged diabetes management, taking into consideration socioeconomic disparities. The objective is to assess how the COVID-19 pandemic has impacted the care of chronic diabetic patients internationally and determine how these outcomes vary between patients of different socioeconomic classes. The following study was designed as a scoping review and utilized PubMed, EMBASE, CINAHL, and Web of Science. A Boolean search strategy combined search terms as follows: (((COVID-19) AND (diabetes)) AND ((socioeconomic factors) OR (social inequality OR standard of living))) AND (treatment OR management). Inclusion criteria included studies addressing diabetic patients, socioeconomic variables (income, occupation, level of education, and ethnicity), glycemic control, and degree of access to quality healthcare. Studies exploring the pathophysiology of COVID-19 or diabetes mellitus were excluded. In addition, studies were chosen between the years 2020 and 2022. The search resulted in 214 articles. The full-text assessment was then conducted on the remaining 67 articles. After screening for eligibility and relevance, 19 articles were retained for this review. The results of this study indicate that 8 out of the 18 studies revealed worse outcomes for those with diabetes mellitus and concomitant COVID-19 infection. Patients with diabetes were more likely to be hospitalized and represent a larger percentage of COVID-19 fatalities. In addition, patients with diabetes and co-morbid COVID-19 infection were more likely to have a higher hemoglobin A1c (HbA1c), belong to a lower SES, and have worse glycemic control due to pandemic-associated lockdown. In order to combat the effects of the pandemic, many countries created novel and innovative management strategies. Overall, there are positive and negative effects from the pandemic on diabetic management strategies. This scoping review identified successes in diabetic treatment under pandemic conditions and areas that need optimization. The successful adaptations of many nations convey the capacity for new policy implementation to care for diabetic patients regardless of SES.
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Muacevic A, Adler JR. Impact of the COVID-19 Pandemic on the Overall Health of Patients With Pre-diabetes and Diabetes. Cureus 2022; 14:e30477. [PMID: 36415400 PMCID: PMC9674039 DOI: 10.7759/cureus.30477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 12/01/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) impacted those with chronic diseases worldwide, especially those with diabetes. Very few studies have explored the effect of COVID-19 on diabetic patients' health markers. The present retrospective study compared various health markers of diabetic patients before and during the COVID-19 pandemic. Patients (N = 511) displayed a significant increase in systolic blood pressure, hemoglobin A1c (HbA1c), diabetic medications, and dose of insulin (p < 0.05) as well as a decrease in low density lipoprotein (LDL) levels (p = 0.04). When patients were stratified by body mass index (BMI), those in higher BMI categories were more negatively impacted during the pandemic than those in lower categories. Results display the impact that COVID-19 had on the general well-being of diabetic patients, and should encourage providers to increase telehealth visits when in-person visits are not possible.
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McDaniel CC, Kavookjian J, Whitley HP. Telehealth delivery of motivational interviewing for diabetes management: A systematic review of randomized controlled trials. PATIENT EDUCATION AND COUNSELING 2022; 105:805-820. [PMID: 34366228 PMCID: PMC8912910 DOI: 10.1016/j.pec.2021.07.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/15/2021] [Accepted: 07/22/2021] [Indexed: 05/09/2023]
Abstract
OBJECTIVES The objective of this systematic review was to explore and report the evidence and gaps in the literature for randomized controlled trials (RCTs) studying the effects of motivational interviewing (MI)-based telehealth interventions on outcomes among persons with diabetes (PWD) or prediabetes. METHODS Following a modified Cochrane approach, we searched Pubmed, CENTRAL, CINAHL, PsycINFO, and Clinicaltrials.gov. Included studies were RCTs published in English before March 25, 2021 evaluating MI-based telehealth on outcomes for adults with diabetes or prediabetes. RESULTS A total of 21 retained articles captured results for 6436 PWD. Among the most commonly investigated outcomes, 60% of articles documented A1C reductions (ranging from<1% to>3%), 56% documented systolic blood pressure reductions, 57% documented diabetes self-efficacy/empowerment improvements, and 40% documented physical activity improvements. Conversely, diastolic blood pressure, lipid panels, body mass index, depressive symptoms, and quality of life were frequently measured outcomes, where MI-based telehealth yielded minor effects (<30% of articles demonstrating improvements). CONCLUSIONS MI-based telehealth seems most effective for improving A1C, systolic blood pressure, diabetes self-efficacy, and physical activity behaviors. Variability in outcome assessment and intervention heterogeneity were key challenges impeding comparisons across retained articles. PRACTICE IMPLICATIONS MI-based telehealth interventions demonstrate promising results for improving outcomes in PWD.
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Affiliation(s)
- Cassidi C McDaniel
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, AL, USA.
| | - Jan Kavookjian
- Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, AL, USA
| | - Heather P Whitley
- Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, USA
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Hartmann-Boyce J, Rees K, Perring JC, Kerneis SA, Morris EM, Goyder C, Otunla AA, James OA, Syam NR, Seidu S, Khunti K. Risks of and From SARS-CoV-2 Infection and COVID-19 in People With Diabetes: A Systematic Review of Reviews. Diabetes Care 2021; 44:2790-2811. [PMID: 34711637 PMCID: PMC8669527 DOI: 10.2337/dc21-0930] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/10/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND This review was commissioned by the World Health Organization and presents a summary of the latest research evidence on the impact of coronavirus disease 2019 (COVID-19) on people with diabetes (PWD). PURPOSE To review the evidence regarding the extent to which PWD are at increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and/or of suffering its complications, including associated mortality. DATA SOURCES We searched the Cochrane COVID-19 Study Register, Embase, MEDLINE, and LitCOVID on 3 December 2020. STUDY SELECTION Systematic reviews synthesizing data on PWD exposed to SARS-CoV-2 infection, reporting data on confirmed SARS-CoV-2 infection, admission to hospital and/or to intensive care unit (ICU) with COVID-19, and death with COVID-19 were used. DATA EXTRACTION One reviewer appraised and extracted data; data were checked by a second. DATA SYNTHESIS Data from 112 systematic reviews were narratively synthesized and displayed using effect direction plots. Reviews provided consistent evidence that diabetes is a risk factor for severe disease and death from COVID-19. Fewer data were available on ICU admission, but where available, these data also signaled increased risk. Within PWD, higher blood glucose levels both prior to and during COVID-19 illness were associated with worse COVID-19 outcomes. Type 1 diabetes was associated with worse outcomes than type 2 diabetes. There were no appropriate data for discerning whether diabetes was a risk factor for acquiring SARS-CoV-2 infection. LIMITATIONS Due to the nature of the review questions, the majority of data contributing to included reviews come from retrospective observational studies. Reviews varied in the extent to which they assessed risk of bias. CONCLUSIONS There are no data on whether diabetes predisposes to infection with SARS-CoV-2. Data consistently show that diabetes increases risk of severe COVID-19. As both diabetes and worse COVID-19 outcomes are associated with socioeconomic disadvantage, their intersection warrants particular attention.
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Affiliation(s)
- Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, U.K.
| | - Karen Rees
- Freelance systematic reviewer, Warwickshire, U.K
| | - James C Perring
- Medical Sciences Division, University of Oxford, Oxford, U.K
| | - Sven A Kerneis
- Medical Sciences Division, University of Oxford, Oxford, U.K
| | - Elizabeth M Morris
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, U.K
| | - Clare Goyder
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, U.K
| | | | - Olivia A James
- Medical Sciences Division, University of Oxford, Oxford, U.K
| | - Nandana R Syam
- Medical Sciences Division, University of Oxford, Oxford, U.K
| | - Samuel Seidu
- Diabetes Research Centre, University of Leicester, Leicester, U.K
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, U.K
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Felix HC, Andersen JA, Willis DE, Malhis JR, Selig JP, McElfish PA. Control of type 2 diabetes mellitus during the COVID-19 pandemic. Prim Care Diabetes 2021; 15:786-792. [PMID: 34246614 PMCID: PMC8449252 DOI: 10.1016/j.pcd.2021.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022]
Abstract
AIMS Type 2 Diabetes Mellitus (T2DM) is a prevalent chronic condition that can lead to significant complications if not well controlled. The COVID-19 pandemic created disruptions in daily life; however, it is unknown whether the pandemic's disruptions affected the ability for adults with T2DM to control their condition. This study aims to fill the knowledge gap with the experiences of adults with T2DM in Arkansas, U.S. during the COVID-19 pandemic. METHODS This study analyzed cross-sectional, observational survey data collected from adults (≥18 years) who live, work, or receive healthcare in Arkansas; self-reported a diagnosis of T2DM; and completed the diabetes module of the Impact of COVID-19 online survey (n = 131) fielded in July-August 2020. Descriptive statistics were used to characterize the sample and survey responses, and multivariate regression was used to identify demographics, self-care behaviors, and access issues associated with uncontrolled T2DM (HbA1c ≥ 9% or 74.9 mmol/mol) or with an increase in HbA1c. RESULTS 28.2% reported an increase in their HbA1c since the pandemic began, and 18.2% had uncontrolled T2DM. Educational level, eating healthily, and weight gain were negatively associated with uncontrolled T2DM. Eating less healthily and having difficulty accessing diabetes related medication were positively associated with an increase in HbA1c. CONCLUSIONS Adults with T2DM in Arkansas were reasonably able to maintain control of their T2DM during the five months post the first case of COVD-19 diagnosed in the state. However, T2DM self-management interventions targeting those with lower educational levels that are focused on eating habits and/or that improve access to diabetes medication should be considered for future public health emergencies.
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Affiliation(s)
- Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR 72205, United States
| | - Jennifer A Andersen
- Division of Community Health & Research, College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Avenue, Fayetteville, AR 72703-1908, United States
| | - Don E Willis
- Division of Community Health & Research, College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Avenue, Fayetteville, AR 72703-1908, United States
| | - Joseph R Malhis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Avenue, Fayetteville, AR 72703, United States
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR 72205, United States
| | - Pearl A McElfish
- Division of Community Health & Research, College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Avenue, Fayetteville, AR 72703-1908, United States.
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Itani R, Khojah HMJ, Jaffal F, Rahme D, Karout L, Karout S. Provision of pharmaceutical care to suspected high-risk COVID-19 patients through telehealth: a nationwide simulated patient study. BMC Health Serv Res 2021; 21:997. [PMID: 34548092 PMCID: PMC8454989 DOI: 10.1186/s12913-021-07014-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 09/09/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has overburdened the healthcare facilities, which demanded the use of alternative and effective methods for delivering healthcare services. The use of telehealth has become a necessity to provide initial health services. OBJECTIVE To identify the pharmaceutical care provided by community pharmacists to suspected high-risk COVID-19 patients using telehealth. METHODS A simulated patient (SP) phoned 100 randomly-selected community pharmacies throughout Lebanon using a standard scenario of uncontrolled diabetes mellitus with typical symptoms of COVID-19. Pharmacists' responses were compared with pre-defined ideal recommendations using a special form. RESULTS The mean of the retrieved medical information score obtained by the pharmacists was 2.48 ± 2.79 (out of 21), with 34 % of the participants not retrieving any relevant medical data from the SP. The relative patient information, the exposure to COVID-19, and the possible COVID-19 symptoms were not retrieved by 61 %, 70 %, and 41 % of the pharmacists, respectively. Two percent of the pharmacists assured that the SP's symptoms were related to common cold, while 5 % confirmed that the SP is infected with COVID-19. Notably, 35 % of the pharmacists did not offer any recommendation. Among them, 14 % claimed that they were too busy to respond. Only 39 % of the pharmacists provided an appropriate recommendation by referring the SP to her physician to seek medical attention within 24 h since the SP is a high-risk patient, and 41 % recommended doing a PCR test. Antipyretics, antibiotics, and dietary supplements were recommended by 27 %, 7 %, and 16 % of the pharmacists, respectively. Less than 16 % of the pharmacists recommended using protective measures against COVID-19. In addition, the overall communication skills of the pharmacists were generally below expectations. CONCLUSIONS This study is the first to assess the quality of pharmaceutical care provided by community pharmacists in the Middle East via Telehealth. An unsatisfactory level of preparedness through means of telehealth technology was evident. This resulted in the quality of pharmaceutical-care services provided to high-risk patients via telehealth to be below expectations. Therefore, health authorities should encourage community pharmacists to effectively adopt telehealth, by providing appropriate training, as well as recognizing their extra efforts with financial compensations, aiming to optimize patients' health outcomes.
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Affiliation(s)
- Rania Itani
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, P.O. Box: 11- 5020, 1107 2809, Beirut, Lebanon
| | - Hani M J Khojah
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, P.O. Box 30051, 41477, Madinah, Kingdom of Saudi Arabia
| | - Fatima Jaffal
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, P.O. Box: 11- 5020, 1107 2809, Beirut, Lebanon
| | - Deema Rahme
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, P.O. Box: 11- 5020, 1107 2809, Beirut, Lebanon
| | - Lina Karout
- Department of Radiology, American University of Beirut Medical Center, Riad El-Solh, P.O. Box: 11-0236, 1107 2020, Beirut, Lebanon
| | - Samar Karout
- Pharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Riad El Solh, P.O. Box: 11- 5020, 1107 2809, Beirut, Lebanon.
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Chan CB, Popeski N, Hassanabad MF, Sigal RJ, O'Connell P, Sargious P. Use of Virtual Care for Glycemic Management in People With Types 1 and 2 Diabetes and Diabetes in Pregnancy: A Rapid Review. Can J Diabetes 2021; 45:677-688.e2. [PMID: 34045146 DOI: 10.1016/j.jcjd.2021.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/18/2021] [Accepted: 02/28/2021] [Indexed: 11/26/2022]
Abstract
Our objective in this study was to answer the main research question: In patients with diabetes, does virtual care vs face-to-face care provide different clinical, patient and practitioner experience or quality outcomes? Articles (2012 to 2020) describing interventions using virtual care with the capability for 2-way, individualized interactions compared with usual care were included. Studies involving any patients with diabetes and outcomes of glycated hemoglobin (A1C), quality of care and/or patient or health-care practitioner experience were included. Systematic reviews, randomized controlled studies, quasi-experimental trials, implementation trials, observational studies and qualitative analyses were reviewed. MEDLINE and McMaster Health Evidence databases searched in June 2020 identified 59 articles. Virtual care, in particular telemonitoring, combined with a means of 2-way communications provided improvement in A1C similar or superior to usual care, with the strongest evidence for type 2 diabetes. Virtual care was generally acceptable to patients, who expressed satisfaction with their care. Health-care providers recognized benefits but raised issues of technical support, workflow and compensation.
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Affiliation(s)
- Catherine B Chan
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Agricultural, Food and Nutritional Sciences, Li Ka Shing Centre for Health Innovation Research, University of Alberta, Edmonton, Alberta, Canada; Department of Physiology, University of Alberta, Edmonton, Alberta, Canada.
| | - Naomi Popeski
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Mortaza Fatehi Hassanabad
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ronald J Sigal
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Petra O'Connell
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Peter Sargious
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada; Department of Medicine, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
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12
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The Impact of COVID-19 on Rural Food Supply and Demand in Australia: Utilising Group Model Building to Identify Retailer and Customer Perspectives. Nutrients 2021; 13:nu13020417. [PMID: 33525558 DOI: 10.3390/nu13020417] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
Prior to the 2020 outbreak of COVID-19, 70% of Australians' food purchases were from supermarkets. Rural communities experience challenges accessing healthy food, which drives health inequalities. This study explores the impact of COVID-19 on food supply and purchasing behaviour in a rural supermarket. Group model building workshops explored food supply experiences during COVID-19 in a rural Australian community with one supermarket. We asked three supermarket retailers "What are the current drivers of food supply into this supermarket environment?" and, separately, 33 customers: "What are the current drivers of purchases in this supermarket environment?" Causal loop diagrams were co-created with participants in real time with themes drawn afterwards from coded transcripts. Retailers' experience of COVID-19 included 'empty shelves' attributed to media and government messaging, product unavailability, and community fear. Customers reported fear of contracting COVID-19, unavailability of food, and government restrictions resulting in cooking more meals at home, as influences on purchasing behaviour. Supermarket management and customers demonstrated adaptability and resilience to normalise demand and combat reduced supply.
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13
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Barone MTU, Ngongo B, Harnik SB, Oliveira LXD, Végh D, de Luca PV, Pedrosa HC, Giraudo F, Cardona-Hernandez R, Chaudhury N, Menna-Barreto L. COVID-19 associated with diabetes and other noncommunicable diseases led to a global health crisis. Diabetes Res Clin Pract 2021; 171:108587. [PMID: 33307134 PMCID: PMC7724978 DOI: 10.1016/j.diabres.2020.108587] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/03/2020] [Accepted: 11/26/2020] [Indexed: 01/08/2023]
Abstract
COVID-19 has gravely threatened high-risk populations, such as people with diabetes and other noncommunicable diseases, leading to disproportionate hospitalizations and deaths worldwide. It is well documented from previous outbreaks that diabetes increases the risk for poor outcomes due to SARS infection. In the present review, we bring evidence that the country and global level health crisis caused by COVID-19 could have been avoided or extremely minimized if measures to protect high-risk populations were implemented timely. In addition to general lockdowns, testing, tracing, isolation and hygiene measures, other specific interventions for diabetes and comorbidities management were shown crucial to allow the continuation of care services during the pandemic. These interventions included: teleconsultation, digital remote education andmonitoring, e-prescriptions, medicine delivery options, mobile clinics, and home point-of-care tests. In conclusion, we recommend prompt actions to protect the most vulnerable groups, valuing knowledge and experiences from previous outbreaks and lessons learned during the COVID-19 pandemic, in order to shield communities, health systems and the global economy.
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Affiliation(s)
- Mark Thomaz Ugliara Barone
- International Diabetes Federation (IDF), 166 Chaussee de La Hulpe B-1170 Brussels, Belgium; ADJ Diabetes Brasil (ADJ), Rua Padre Antônio Tomás, 213, Zip Code 05003-010, Água Branca, São Paulo, SP, Brazil; Fórum Intersetorial para Combate às DCNTs no Brasil (ForumDCNTs), Rua Padre Antônio Tomás, 213, Zip Code 05003-010, Água Branca, São Paulo, SP, Brazil; Sociedade Brasileira de Diabetes (SBD), Rua Afonso Braz 579, Salas 72/74, Vila Nova Conceição, Zip Code 04511-011, São Paulo, SP, Brazil.
| | - Belinda Ngongo
- Pan African Women in Health (PAWH), P.O. Box 95535, Grant Park, 2051, South Africa
| | - Simone Bega Harnik
- Universidade de São Paulo (USP), Instituto de Matemática e Estatística, Departamento de Estatística, Rua do Matão 1010, Cidade Universitária, Zip Code 05508-090, São Paulo, SP, Brazil
| | - Lucas Xavier de Oliveira
- International Diabetes Federation (IDF), 166 Chaussee de La Hulpe B-1170 Brussels, Belgium; ADJ Diabetes Brasil (ADJ), Rua Padre Antônio Tomás, 213, Zip Code 05003-010, Água Branca, São Paulo, SP, Brazil; Liga de Enfermagem na Atenção ao Diabetes da Escola de Enfermagem da Universidade de São Paulo (LEAD-EE-USP), Av. Dr. Enéas Carvalho de Aguiar, 419, Zip Code 05403-000, Cerqueira César, São Paulo, SP, Brazil
| | - Dániel Végh
- International Diabetes Federation (IDF), 166 Chaussee de La Hulpe B-1170 Brussels, Belgium; Semmelweis University, Faculty of Dentistry, Department of Prosthodontics, Budapest, Hungary
| | - Patrícia Vieira de Luca
- Fórum Intersetorial para Combate às DCNTs no Brasil (ForumDCNTs), Rua Padre Antônio Tomás, 213, Zip Code 05003-010, Água Branca, São Paulo, SP, Brazil; Associação Brasileira de Hipercolesterolemia Familiar (AHF), Rua Machado Bittencourt 190, Vila Clementino, Zip Code 04044-000, São Paulo, Brazil
| | - Hermelinda Cordeiro Pedrosa
- Sociedade Brasileira de Diabetes (SBD), Rua Afonso Braz 579, Salas 72/74, Vila Nova Conceição, Zip Code 04511-011, São Paulo, SP, Brazil; Research Centre, Endocrinology Unit, Regional Taguatinga Hospital, Secretary of Health, Brasilia, Federal District, Brazil
| | - Franco Giraudo
- Institute Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Santiago, Chile; Juvenile Diabetes Foundation of Chile (FDJ), Santiago, Chile
| | | | - Nayanjeet Chaudhury
- Public Health Institute, Oakland, CA, 555 12th Street, Suite 215, Oakland, CA, 94607; Ramaiah International Centre for Public Health Innovations, MS Ramaiah Nagar, MSRIT Post, Bangalore 560097, India
| | - Luiz Menna-Barreto
- Grupo Multidisciplinar de Desenvolvimento e Ritmos Biológicos (GMDRB), Escola de Artes, Ciências eHumanidades da Universidade de São Paulo (EACH-USP), Rua Arlindo Béttio, 1000 - Ermelino Matarazzo, São Paulo, SP 03828-000, Brazil
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14
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Ugliara Barone MT, Harnik SB, Chaluppe M, Vieira de Luca P, Ngongo B, Pedrosa HC, Pirolo V, Franco DR, Malta DC, Giampaoli V. Decentralized COVID-19 measures in Brazil were ineffective to protect people with diabetes. Diabetes Metab Syndr 2020; 14:1973-1978. [PMID: 33075740 PMCID: PMC7538379 DOI: 10.1016/j.dsx.2020.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 09/28/2020] [Accepted: 10/04/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS COVID-19 severity and mortality are elevated in individuals with diabetes. During the pandemic, interventions recommended globally for people with diabetes were to keep blood glucose on target whilst staying at home to curb the spread of the virus. In Brazil, similar measures were proposed. The aim of our observational study was to assess whether these measures achieved their objectives. METHODS An anonymous and untraceable survey was shared from April 22nd to May 4th. States with more than 30 respondents were included in the analysis and Fisher's exact test was performed to identify associations, with p < 0.05 considered significant. RESULTS Type 1 diabetes and female participants were prevalent, 60.76% and 76.12% respectively. 10 out of 26 states were included, in addition to the Federal District (1562 responses). Only in three states (Bahia, Goiás and Pernambuco) less than 50% of the respondents experienced higher glycemia or higher variability during the pandemic. Goiás state, where almost half of the respondents (49.12%) have private insurance, presented the highest percentage of individuals receiving medicines for three months (35.48%) and one of the lowest percentages of blood glucose deterioration (47.17%). In the large states of Minas Gerais, Rio de Janeiro and São Paulo, consultations and/or lab exams were postponed by 37.14%, 34.33% and 40.88%, respectively. CONCLUSIONS The decentralized measures implemented by states in Brazil left most people with diabetes unprotected. Many were forced to venture outside to collect or to purchase their medical supplies monthly and reported increased glycemic levels and/or variability.
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Affiliation(s)
- Mark Thomaz Ugliara Barone
- International Diabetes Federation (IDF), 166 Chaussée de La Hulpe B-1170 Brussels, Belgium; ADJ Diabetes Brasil (ADJ). Rua Padre Antônio Tomás, 213, Zip code, 05003-010, Água Branca, São Paulo, SP, Brazil; Fórum Intersetorial para Combate às DCNTs no Brasil (ForumDCNTs), Rua Padre Antônio Tomás, 213, 05003-010, Água Branca, São Paulo, SP, Brazil; Sociedade Brasileira de Diabetes (SBD), Rua Afonso Braz 579, Salas 72/74, Vila Nova, Conceição, 04511-011, São Paulo SP, Brazil.
| | - Simone Bega Harnik
- Universidade de São Paulo (USP), Instituto de Matemática e Estatística, Departamento de Estatística. Rua do Matão 1010, Cidade Universitária, 05508-090, São Paulo, SP, Brazil
| | - Matheus Chaluppe
- ADJ Diabetes Brasil (ADJ). Rua Padre Antônio Tomás, 213, Zip code, 05003-010, Água Branca, São Paulo, SP, Brazil
| | - Patrícia Vieira de Luca
- Fórum Intersetorial para Combate às DCNTs no Brasil (ForumDCNTs), Rua Padre Antônio Tomás, 213, 05003-010, Água Branca, São Paulo, SP, Brazil; Associação Brasileira de Hipercolesterolemia Familiar (AHF), Rua Machado Bittencourt 190, Vila Clementino, 04044-000, São Paulo, Brazil
| | - Belinda Ngongo
- Pan African Women in Health (PAWH). P.O.Box, 95535, Grant Park 2051, Johannesburg, South Africa
| | - Hermelinda Cordeiro Pedrosa
- Sociedade Brasileira de Diabetes (SBD), Rua Afonso Braz 579, Salas 72/74, Vila Nova, Conceição, 04511-011, São Paulo SP, Brazil; Research Centre, Endocrinology Unit - Regional Taguatinga Hospital - Secretary of Health, Brasilia, Federal District, Brazil
| | - Vanessa Pirolo
- ADJ Diabetes Brasil (ADJ). Rua Padre Antônio Tomás, 213, Zip code, 05003-010, Água Branca, São Paulo, SP, Brazil
| | - Denise Reis Franco
- ADJ Diabetes Brasil (ADJ). Rua Padre Antônio Tomás, 213, Zip code, 05003-010, Água Branca, São Paulo, SP, Brazil; Sociedade Brasileira de Diabetes (SBD), Rua Afonso Braz 579, Salas 72/74, Vila Nova, Conceição, 04511-011, São Paulo SP, Brazil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais (UFMG), Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública. Avenida Alfredo Balena 190, Santa Efigênia, Zip code, 30130-100, Belo Horizonte, MG, Brazil
| | - Viviana Giampaoli
- Universidade de São Paulo (USP), Instituto de Matemática e Estatística, Departamento de Estatística. Rua do Matão 1010, Cidade Universitária, 05508-090, São Paulo, SP, Brazil
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