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Yazdanpanah L, Shahbazian H, Hesam S, Ahmadi B, Zamani AM. Two-year incidence and risk factors of diabetic foot ulcer: second phase report of Ahvaz diabetic foot cohort (ADFC) study. BMC Endocr Disord 2024; 24:46. [PMID: 38622562 PMCID: PMC11017491 DOI: 10.1186/s12902-024-01572-x] [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: 01/31/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
AIM/INTRODUCTION This study was designed as the second phase of a prospective cohort study to evaluate the incidence and risk factors of diabetic foot ulcers (DFU). MATERIALS AND METHODS The study was conducted in a university hospital in Iran. Each participant was checked and followed up for two years in terms of developing newfound DFU as ultimate outcome. We investigated the variables using univariate analysis and then by backward elimination multiple logistic regression. RESULTS We followed up 901 eligible patients with diabetes for two years. The mean age of the participants was 53.24 ± 11.46 years, and 58.53% of them were female. The two-year cumulative incidence of diabetic foot ulcer was 8% (95% CI 0.071, 0.089) [Incidence rate: 49.9 /1000 person-years]. However, the second-year incidence which was coincident with the COVID-19 pandemic was higher than the first-year incidence (4.18% and 1.8%, respectively). Based on our analysis, the following variables were the main risk factors for DFU incidence: former history of DFU or amputation [OR = 76.5, 95% CI(33.45,174.97), P value < 0.001], ill-fitting foot-wear [OR = 10.38, 95% CI(4.47,24.12), P value < 0.001], smoking [OR = 3.87,95%CI(1.28, 11.71),P value = 0.016], lack of preventive foot care [OR = 2.91%CI(1.02,8.29),P value = 0.045], and insufficient physical activity[OR = 2.25,95% CI(0.95,5.35),P value = 0.066]. CONCLUSION Overall, the two-year cumulative incidence of diabetic foot ulcer was 8% [Incidence rate: 49.9 /1000 person-years]; however, the second-year incidence was higher than the first-year incidence which was coincident with the COVID-19 pandemic (4.18% and 1.8%, respectively). Independent risk factors of DFU occurrence were prior history of DFU or amputation, ill-fitting footwear, smoking, lack of preventive foot care, and insufficient physical activity.
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Affiliation(s)
- Leila Yazdanpanah
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran.
| | - Hajieh Shahbazian
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran
| | - Saeed Hesam
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Ahmadi
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amir Mohammad Zamani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Mujuru TN, Mahlangu NP, Ngwetjana SJ, Bekker LC, Tanyanyiwa DM. The impact of lockdown measures during the SARS-CoV-2 pandemic on the management of diabetes in a Northern Gauteng Region of South Africa. Pan Afr Med J 2023; 45:129. [PMID: 37790163 PMCID: PMC10543907 DOI: 10.11604/pamj.2023.45.129.39255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 06/26/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction coronavirus disease 2019 (SARS-CoV-2), a global pandemic, popularised the term "lockdown" due to its rapid spread around the world. "Lockdown" was used as an emergency measure to temporarily prevent people from entering or leaving their communities in an effort to reduce the spread of the virus. The effects of the "lockdown" measures on the management of chronic medical conditions in African populations have been inconsistent. This study aimed to assess the effects of the lockdown on glycaemic control in patients with diabetes. Methods retrospective study that examined metadata from 1st January 2019 to 31st December 2021, to assess the impact of the national SARS-CoV-2 response on the quantity and average level of haemoglobin A1c and random glucose in patients with diabetes at Dr. George Mukhari Academic Hospital. The data was retrieved from the National Health Laboratory Services corporate data warehouse. Results from 2019 to 2021, a total of 9,039 tests were performed, with females accounting for 63.21% (n = 5,714) and males for 36.08% (n = 3,261), while 0.7% (n = 70) did not have an assigned gender. Mean age was 49, with a standard deviation (SD) of 21.71. The testing rate (TR) in 2019 was 10.74 per day, 2020 had a TR of 6.07, and 2021 had a TR of 7.95. During the pandemic phase, all other age groups had TRs below 1.85, except the 50-59, 60-69, and 70+ year-old groups. Conclusion the study revealed that SARS-CoV-2 lockdown measures were linked to poor diabetes control in patients. As a result, the consequences of managing SARS-CoV-2 had a direct influence on diabetes management.
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Affiliation(s)
- Tatenda Nyasha Mujuru
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
- Department of Chemical Pathology, National Health Laboratory Service, Dr. George Mukhari Academic Hospital, Johannesburg, Gauteng, South Africa
| | - Nelly Petunia Mahlangu
- Department of Chemical Pathology, National Health Laboratory Service, Dr. George Mukhari Academic Hospital, Johannesburg, Gauteng, South Africa
- Department of Chemical Pathology, Sefako Makgatho Health Sciences University, Pretoria North, Gauteng Province, South Africa
| | - Sekwedi Jackson Ngwetjana
- Department of Chemical Pathology, National Health Laboratory Service, Dr. George Mukhari Academic Hospital, Johannesburg, Gauteng, South Africa
| | - Lasya Christina Bekker
- Department of Chemical Pathology, Sefako Makgatho Health Sciences University, Pretoria North, Gauteng Province, South Africa
| | - Donald Moshen Tanyanyiwa
- Department of Chemical Pathology, National Health Laboratory Service, Dr. George Mukhari Academic Hospital, Johannesburg, Gauteng, South Africa
- Department of Chemical Pathology, Sefako Makgatho Health Sciences University, Pretoria North, Gauteng Province, South Africa
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Sundarakumar JS, Mensegere AL, Malo PK, Ravindranath V. Impact of the COVID-19 pandemic on some modifiable risk factors of dementia in an aging, rural Indian population. Front Psychiatry 2023; 14:954557. [PMID: 37275968 PMCID: PMC10237042 DOI: 10.3389/fpsyt.2023.954557] [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: 05/27/2022] [Accepted: 04/25/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction The impact of the COVID-19 pandemic and associated lockdowns is likely to have caused adverse changes in lifestyle-related/cardiovascular risk factors and other such modifiable risk factors of dementia. We aimed to examine the pandemic's impact on some modifiable risk factors of dementia among rural Indians belonging to a large, prospective aging cohort-Srinivaspura Aging, NeuoSenescence, and COGnition (SANSCOG). Methods This was a cross-sectional study among adults aged ≥ 45 years (n = 3,148; 1,492 males and 1,656 females) residing in the villages of Srinivaspura in Karnataka state, India. SANSCOG study data (clinical and biochemical assessments) of these participants were obtained from three distinct periods: (i) the "pre-COVID period"-before India's nationwide lockdown on 24 March 2020, (ii) the "COVID period"-during the first and second waves of the pandemic, wherein the social restrictions were prominent (25 March 2020 to 30 September 2021), and (iii) the "post-COVID period"-after easing of restrictions (from 1 October 2021 onward). Proportions of participants with diabetes, hypertension, obesity, dyslipidemia (diagnosed using standard criteria), and depression (diagnosed using the Geriatric Depression Scale) were compared between the above three periods. Results The odds of having obesity, abnormal triglycerides, and depression among individuals in the COVID period were 1.42 times, 1.38 times, and 2.65 times more than the odds in the pre-COVID period, respectively. The odds of having hypertension, obesity, abnormal total cholesterol, abnormal triglycerides, abnormal LDL, and depression among individuals in the post-COVID period were 1.27 times, 1.32 times, 1.58 times, 1.95, 1.23, and 3.05 times more than the odds in the pre-COVID period, respectively. The odds of diabetes did not differ between any of the three periods. Discussion We found significantly higher odds of some of the studied risk factors in the COVID and post-COVID periods compared to the pre-COVID period, suggesting that the pandemic adversely impacted the physical and psychological health of this marginalized, rural Indian population. We call for urgent public health measures, such as multimodal, lifestyle-based, and psychosocial interventions, to mitigate this negative impact and reduce the future risk of dementia.
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Hafidz F, Adiwibowo IR, Kusila GR, Ruby M, Saut B, Jaya C, Baros WA, Revelino D, Dhanalvin E, Oktavia A. Out-of-pocket expenditure and catastrophic costs due to COVID-19 in Indonesia: A rapid online survey. Front Public Health 2023; 11:1072250. [PMID: 37033026 PMCID: PMC10081577 DOI: 10.3389/fpubh.2023.1072250] [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: 10/17/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background The Corona Virus Disease 2019 (COVID-19) pandemic has created a substantial socioeconomic impact, particularly in developing countries such as Indonesia. Purposes/objectives This study aimed to describe the COVID-19-related out-of-pocket spending of Indonesian citizens and the proportion of whom experienced catastrophic health spending during the COVID-19 pandemic using the patient's perspective. Methodology We conducted a rapid cross-sectional online survey across provinces in Indonesia to capture participants' experiences due to COVID-19. Data were collected between September 23rd to October 7th of 2021 including demographics, income, and expenditures. Descriptive statistics were used to analyze the respondents' characteristics. Patients's perspective of total cost was estimated from out-of-pocket of COVID-19 direct costs and compared them to total expenditure. If the proportion of COVID-19 total costs exceeded 40% of the total expenditure, the respondents were deemed to have faced catastrophic costs. Results A total of 1,859 respondents answered the questionnaire. The average monthly income and expenditure of respondents were 800 USD, and 667 USD respectively. The monthly expenditure was categorized into food expenditure (367 USD) and non-food expenditure (320 USD). The average of COVID-19-related monthly expenditure was 226 USD, including diagnostic expenditure (36 USD), preventive expenditure (58 USD), medical expenditure (37 USD for COVID-19 treatment; and 57 USD for post-COVID-19 medical expenses), and non-medical expenditure (30 USD). Analysis showed that 18.6% of all respondents experienced catastrophic costs while 38.6% of the respondents who had COVID-19 treatment experienced catastrophic costs. Conclusion The high proportion of catastrophic costs among respondents suggests the need for COVID-19 social protection, especially for COVID-19 diagnostic and prevention costs. The survey findings have led the government to increase the benefit coverage other than medical costs at the hospitals.
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Affiliation(s)
- Firdaus Hafidz
- Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- *Correspondence: Firdaus Hafidz
| | - Insan Rekso Adiwibowo
- Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gilbert Renardi Kusila
- Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mahlil Ruby
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | - Benyamin Saut
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | - Citra Jaya
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | | | - Dedy Revelino
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | - Erzan Dhanalvin
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
| | - Ayunda Oktavia
- Badan Penyelenggara Jaminan Sosial Kesehatan, Jakarta, Indonesia
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Halushko OA, Protsiuk OV, Pogorila OI, Synytsyn MM. HYPOGLYCEMIA IN PATIENTS WITH COVID-19: A COINCIDENCE OR A TREND? WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1075-1082. [PMID: 37326092 DOI: 10.36740/wlek202305128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim: The purpose of this work is to analyze the available scientific information on causes and risk factors of hypoglycemia during treatment of patients with COVID-19. PATIENTS AND METHODS Materials and methods: A search and analysis of full-text articles was carried out in the PubMed, Web of Science, Google Scholar, and Scopus databases. The search was conducted using the keywords: «hypoglycemia in COVID-19 patients», «treatment of COVID-19 and hypoglycemia» and «COVID-19 vaccination and hypoglycemia» from the beginning of the pandemic in December 2019 to July 1, 2022. CONCLUSION Conclusions: Hypoglycemia can be an incidental clinical finding. But it can also be a natural consequence of treatment if it is carried out without taking into account the possible hypoglycemic effects of drugs and without careful monitoring of the patient's condition. In the case of determining the program of treatment and vaccination against COVID-19 in patients with DM, the known and possible hypoglycemic effects of drugs and vaccines should be taken into account, the level of glycemia should be carefully controlled, and sudden changes in the type and dose of drugs, polypharmacy and the use of dangerous combinations of drugs should be avoided.
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Affiliation(s)
| | - Olga V Protsiuk
- SHUPYK NATIONAL UNIVERSITY OF HEALTH CARE OF UKRAINE, KYIV, UKRAINE
| | | | - Maksym M Synytsyn
- "FEOFANIYA" CLINICAL HOSPITAL OF STATE MANAGEMENT OF AFFAIRS OF UKRAINE, KYIV, UKRAINE
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Hernández-Vásquez A, Barrenechea-Pulache A, Portocarrero-Bonifaz A, Rojas-Roque C, Gamboa-Unsihuay JE. Multimorbidity analysis and hospitalizations for diabetes before and after lockdown due to the COVID-19 pandemic in Peru. Prev Med Rep 2022; 28:101884. [PMID: 35813397 PMCID: PMC9251897 DOI: 10.1016/j.pmedr.2022.101884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Corresponding author at: Universidad San Ignacio de Loyola, Av. La Fontana 550, La Molina, Lima, Peru.
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Kang G. The SARS-CoV2 pandemic and routine immunisation. Lancet Glob Health 2022; 10:e155-e156. [PMID: 35063102 PMCID: PMC8765762 DOI: 10.1016/s2214-109x(21)00543-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Gagandeep Kang
- Christian Medical College Vellore, Vellore 632004, India.
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Tantengco OAG. Increased global online interest in diabetes during the COVID-19 pandemic: An infodemiology study. OBESITY MEDICINE 2021; 28:100374. [PMID: 36210964 PMCID: PMC9525567 DOI: 10.1016/j.obmed.2021.100374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/04/2021] [Accepted: 11/11/2021] [Indexed: 02/07/2023]
Abstract
Background The public utilize the internet as their main source for health-related information during the pandemic. This was shown by the increase in global online searches related to health during the pandemic. In this study, the dynamics of public interest and awareness in diabetes before and during the pandemic was investigated and the possible factors associated with online interest in diabetes were determined. Methods Global online search interest for diabetes was measured using Google Trends™ database. The search terms “diabetes”, “type 1 diabetes”, “type 2 diabetes”, and “gestational diabetes” were used. The results were limited to the years 2010 until 2020 from all countries. Correlation between country-specific characteristics and search volume index (SVI) was determined using Spearman's rank-order correlation. Results This study showed a steady increase in global online interest in diabetes during the last decade. SVI for all the diabetes search terms included in this study increased from 2019 to 2020. People searching for the term “diabetes” also searched for the different types of diabetes, causes, signs and symptoms, diagnostic tests, and treatments for diabetes. The increasing online interest in diabetes was positively correlated with percentage of individuals using the internet and the number of physicians in a country. Conclusions The results of this study showed an increasing global online interest in diabetes during the last decade. This increased global interest in diabetes should be maximized by medical doctors and public health officials in providing evidence-based information regarding prevention and control of diabetes in the internet.
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Affiliation(s)
- Ourlad Alzeus G Tantengco
- College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines
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