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Nagpal MS, Jalali N, Sherifali D, Morita PP, Cafazzo JA. Managing Type 2 Diabetes During the COVID-19 Pandemic: Scoping Review and Qualitative Study Using Systematic Literature Review and Reddit. Interact J Med Res 2024; 13:e49073. [PMID: 39116432 PMCID: PMC11342012 DOI: 10.2196/49073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 04/18/2024] [Accepted: 06/07/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic impacted how people accessed health services and likely how they managed chronic conditions such as type 2 diabetes (T2D). Social media forums present a source of qualitative data to understand how adaptation might have occurred from the perspective of the patient. OBJECTIVE Our objective is to understand how the care-seeking behaviors and attitudes of people living with T2D were impacted during the early part of the pandemic by conducting a scoping literature review. A secondary objective is to compare the findings of the scoping review to those presented on a popular social media platform Reddit. METHODS A scoping review was conducted in 2021. Inclusion criteria were population with T2D, studies are patient-centered, and study objectives are centered around health behaviors, disease management, or mental health outcomes during the COVID-19 pandemic. Exclusion criteria were populations with other noncommunicable diseases, examining COVID-19 as a comorbidity to T2D, clinical treatments for COVID-19 among people living with T2D, genetic expressions of COVID-19 among people living with T2D, gray literature, or studies not published in English. Bias was mitigated by reviewing uncertainties with other authors. Data extracted from the studies were classified into thematic categories. These categories reflect the findings of this study as per our objective. Data from the Reddit forums related to T2D from March 2020 to early March 2021 were downloaded, and support vector machines were used to classify if a post was published in the context of the pandemic. Latent Dirichlet allocation topic modeling was performed to gather topics of discussion specific to the COVID-19 pandemic. RESULTS A total of 26 studies conducted between February and September 2020, consisting of 13,673 participants, were included in this scoping literature review. The studies were qualitative and relied mostly on qualitative data from surveys or questionnaires. Themes found from the literature review were "poorer glycemic control," "increased consumption of unhealthy foods," "decreased physical activity," "inability to access medical appointments," and "increased stress and anxiety." Findings from latent Dirichlet allocation topic modeling of Reddit forums were "Coping With Poor Mental Health," "Accessing Doctor & Medications and Controlling Blood Glucose," "Changing Food Habits During Pandemic," "Impact of Stress on Blood Glucose Levels," "Changing Status of Employment & Insurance," and "Risk of COVID Complications." CONCLUSIONS Topics of discussion gauged from the Reddit forums provide a holistic perspective of the impact of the pandemic on people living with T2D, which were found to be comparable to the findings of the literature review. The study was limited by only having 1 reviewer for the literature review, but biases were mitigated by consulting authors when there were uncertainties. Qualitative analysis of Reddit forms can supplement traditional qualitative studies of the behaviors of people living with T2D.
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Affiliation(s)
- Meghan S Nagpal
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Niloofar Jalali
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Diana Sherifali
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Plinio P Morita
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Joseph A Cafazzo
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
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Kuwajima S, Itoh T, Sato T, Ino S, Shibata S, Ohno K, Hotta H, Matsumoto T, Ooiwa H, Kubo H, Miki T. Influence of the COVID-19 pandemic on the achievement of guideline targets for HbA1c, blood pressure, and LDL cholesterol in people with diabetes in Japan. Diabetol Int 2024; 15:507-517. [PMID: 39101168 PMCID: PMC11291788 DOI: 10.1007/s13340-024-00715-8] [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: 08/22/2023] [Accepted: 03/18/2024] [Indexed: 08/06/2024]
Abstract
Objective In this study, we investigated whether the COVID-19 pandemic affected achievement of guideline targets for HbA1c, blood pressure (BP), and low-density lipoprotein (LDL) cholesterol in people with diabetes mellitus (DM). Materials and methods Data for 556 people with DM who were treated regularly for 4 years before and during the COVID-19 pandemic in Japan were analyzed in this retrospective study. Achieved targets were defined as HbA1c < 7.0%, BP < 130/80 mmHg, and LDL cholesterol < 100 or < 120 mg/dL depending on the presence or absence of coronary artery disease. Results In 2019, before the start of the COVID-19 pandemic, achievement rates of guideline targets for HbA1c, BP and LDL cholesterol were 53.4%, 45.9% and 75.7%, respectively. In 2020, the achievement rates for HbA1c and BP targets were significantly decreased to 40.8% and 31.3%, respectively. The achievement rates for the HbA1c target gradually recovered to 49.3% in 2021 and to 51.1% in 2022. However, recovery in achieving the BP target was slow, remaining at 40.5% even in 2022. On the other hand, the achievement rate for the LDL cholesterol target was not affected and remained relatively high during the COVID-19 pandemic. Conclusions The rates of achieving therapeutic targets for HbA1c and BP have not been high enough in people with DM, and the rates were further reduced by lifestyle changes due to the COVID-19 pandemic. Although there has been a trend toward improvement with the lifting of behavioral restrictions, more intensified treatment is necessary to achieve good control. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-024-00715-8.
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Affiliation(s)
- Shingo Kuwajima
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Takahito Itoh
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Tatsuya Sato
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shoya Ino
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Satoru Shibata
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Kouhei Ohno
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Hiroyuki Hotta
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Tomoaki Matsumoto
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
- Medical Record Administration Center, Oji General Hospital, Tomakomai, Japan
| | - Hitoshi Ooiwa
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
| | - Hirofumi Kubo
- Medical Record Administration Center, Oji General Hospital, Tomakomai, Japan
| | - Takayuki Miki
- Department of Cardiology and Diabetes, Oji General Hospital, 3-4-8, Wakakusa-Cho, Tomakomai, 053-8506 Japan
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Wijeweera C, Muhfaza U, Lord RV, Petocz P, Chen J, Preda V. Socioeconomic status and the effect of prolonged pandemic confinement on anthropometric and glycaemic outcomes in adults with type 2 diabetes mellitus. Prim Care Diabetes 2024; 18:308-318. [PMID: 38448261 DOI: 10.1016/j.pcd.2024.02.002] [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: 09/11/2023] [Revised: 12/03/2023] [Accepted: 02/09/2024] [Indexed: 03/08/2024]
Abstract
AIM This systematic review and meta-analysis aimed to investigate the impact of COVID19 lockdown on the anthropometric and glycaemic outcomes of adults with type 2 diabetes mellitus (T2DM) and assess whether socioeconomic status (SES) was relevant to these changes. METHODS A search of three databases was conducted. Meta-analyses using random effects models were undertaken to combine anthropometric and glycaemic measures pre- and post-confinement. Subgroup analyses according to SES were also conducted. RESULTS This systematic review of 19 articles demonstrated that prolonged pandemic-related confinement is associated with a deterioration in both anthropometric and glycaemic outcomes among adults with T2DM. Furthermore, SES was found to be relevant to these changes. Specifically, BMI (kg/m2) showed an increase in mean difference of 0.72 (95% CI; 0.13, 1.31; p<0.05) between pre and post lockdown cohorts. High income countries displayed a greater increase in BMI compared to their lower middle-income counterparts. Regarding, fasting blood glucose (FBG), a statistically significant difference was observed in the upper middle-income group (mean difference: 5.10; 95% CI: 2.92, 7.27), and high-income group (mean difference: 6.03; 95% CI: 0.04, 12.02). There were no significant changes to weight, waist circumference, or HbA1C over the lockdown period. CONCLUSION Our findings suggest adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. Clinics and care providers may need to adopt more intensive contact and treatment plans in the post lockdown period to prevent lasting impacts on disease progression and metabolic sequelae.
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Affiliation(s)
- Chandana Wijeweera
- Macquarie University Faculty of Medicine and Health Sciences, Australia.
| | - Ummul Muhfaza
- Healthy Weight Clinic, Macquarie University Hospital, Macquarie Park, Australia
| | - Reginald V Lord
- Department of Surgery, University of Notre Dame School of Medicine, Sydney Australia
| | - Peter Petocz
- Macquarie University, Department of Statistics, Macquarie Park, Australia
| | - Juliana Chen
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Veronica Preda
- Healthy Weight Clinic, Macquarie University Hospital, Macquarie Park, Australia
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Cláudio MM, Garcia VG, Freitas RM, Rodrigues JVS, Wainwright M, Casarin RCV, Duque C, Theodoro LH. Association of active oxygen-releasing gel and photodynamic therapy in the treatment of residual periodontal pockets in type 2 diabetic patients: A randomized controlled clinical study. J Periodontol 2024; 95:360-371. [PMID: 38112075 DOI: 10.1002/jper.23-0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/14/2023] [Accepted: 09/18/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of active oxygen-releasing gel as an adjuvant, with and without antimicrobial photodynamic therapy (aPDT), in the treatment of residual pockets in periodontal patients with type 2 diabetes mellitus (DM2). METHODS Patients with residual pockets with probing depth (PD) ≥4 mm and bleeding on probing (BOP) were divided into the following groups: SI (n = 17)-subgingival instrumentation in a single session; BM (n = 17)-SI followed by local application of active oxygen-releasing gel inside the periodontal pocket for 3 min; BM + aPDT (n = 17)-SI followed by application of BM for 3 min and pocket irrigation with methylene blue, and 660-nm diode laser irradiation at 100 mW for 50 s. The periodontal clinical parameters, serum levels of glycated hemoglobin, and immunological analysis of crevicular fluid were evaluated. All data were submitted to statistical analysis (α = 5%). RESULTS A significant reduction in BOP was verified at 90 and 180 days in the BM + aPDT group. The percentage of sites with PD ≥ 4 mm was significantly reduced at 90 days in BM + aPDT and BM, whereas after 180 days only BM showed a significant reduction. In the BM + aPDT group, there was a significant reduction in tumor necrosis factor α levels at 90 days. There were no differences between the treatments. CONCLUSION The use of adjuvant active oxygen-releasing gel, with or without aPDT, resulted in the same clinical benefits as SI in the treatment of residual pockets in poorly controlled DM2 patients.
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Affiliation(s)
- Marina M Cláudio
- Department of Diagnostics and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Valdir G Garcia
- Latin American Institute of Dental Research and Teaching (ILAPEO), Curitiba, PR, Brazil
| | - Rubens M Freitas
- Latin American Institute of Dental Research and Teaching (ILAPEO), Curitiba, PR, Brazil
| | - João Victor S Rodrigues
- Department of Diagnostics and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba, SP, Brazil
| | - Mark Wainwright
- Department of Biology, Edge Hill University, Ormskirk, Lancashire, UK
| | - Renato C V Casarin
- Department of Periodontics, State University of Campinas, Piracicaba, SP, Brazil
| | - Cristiane Duque
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Leticia H Theodoro
- Department of Diagnostics and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba, SP, Brazil
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Schäfer I, Tajdar D, Walther L, Bittner L, Lühmann D, Scherer M. Impact of two COVID-19 lockdowns on HbA1c levels in patients with type 2 diabetes and associations with patient characteristics: a multicentre, observational cohort study over three years. Front Public Health 2024; 11:1272769. [PMID: 38249413 PMCID: PMC10796585 DOI: 10.3389/fpubh.2023.1272769] [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: 08/04/2023] [Accepted: 12/08/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Glycemic effects of COVID-19 lockdowns on patients with type 2 diabetes (T2D) are controversial. In this long-term observation, we aimed (1) to analyze changes in HbA1c levels during lockdowns in Germany, and (2) to investigate whether diabetes medication, comorbidities, and sociodemographic data influenced these changes. Materials and methods This cohort study observed 1,089 patients aged ≥18 years over the years 2019 to 2021. Patients were recruited from 14 physicians specialized on diabetes. As dependent variable, 7,987 HbA1c values were analyzed by multivariable linear regression adjusted for random effects of physicians and patients. Results Patients had a median age of 68 (60/76) years and 623 (57.2%) were male. Before the pandemic, median HbA1c level (in %) was 6.9 (6.3/7.7). Average HbA1c level increased during first lockdown (0.21,0.11/0.31,p < 0.001), after first lockdown (0.23,0.18/0.28,p < 0.001), during second lockdown (0.40,0.33/0.47,p < 0.001) and after second lockdown (0.27,0.18/0.36,p < 0.001). The increase of HbA1c levels was more pronounced in male patients (0.08,0.01/0.15,p = 0.019), if patients did not have German as native language (0.12,0.01/0.23,p = 0.041) and if they were widowed (0.19,0.05/0.32,p = 0.008). End organ damages (0.12,0.01/0.23,p = 0.039), atherosclerotic cardiovascular disease (ASCVD; 0.23,0.10/0.36,p = 0.001) and cardiovascular events (0.25,0.10/0.40,p = 0.001) as well as oral medication (0.09,0.03/0.15,p = 0.002), intermediate- or long-acting insulins (0.24,0.16/0.32,p < 0.001), and fast-acting or mixed insulins (0.30,0.23/0.36,p < 0.001) were also related to a greater increase in HbA1c levels. Conclusion Both lockdowns resulted in a significant increase in HbA1c levels. In particular, patients with ASCVD, cardiovascular events, and insulin therapy appear to be at risk for worsening glycemic control in crisis and thus require special medical attention. Clinical Trial Registration ClinicalTrials.gov (NCT04821921).
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Rodrigues SN, Delevatti RS, Carvalho MTX, Bullo V, Bergamin M, Alberton CL. Cardiometabolic, functional, and psychosocial effects of a remotely supervised home-based exercise program in individuals with type 2 diabetes (RED study): study protocol for a randomized clinical trial. Trials 2023; 24:679. [PMID: 37858161 PMCID: PMC10588211 DOI: 10.1186/s13063-023-07704-3] [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: 03/20/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2D) is a serious global health problem, and exercise is considered an essential non-pharmacological tool in T2D prevention and treatment. During periods of social isolation experienced by the COVID-19 pandemic, home-based exercise programs were strongly recommended as a strategy to facilitate exercise practice and reduce the negative impacts of social isolation. Remotely supervised exercise stands out as an easily accessible strategy after the pandemic, as it is a tool that aims to facilitate access to exercise by this population. The purpose of the RED study is to verify the effects of a remotely supervised home-based exercise program compared to a control group on cardiometabolic, functional, and psychosocial outcomes in patients with T2D. METHODS Participants are randomized into the control group (CG) and the intervention group (IG). Participants allocated to the CG receive recommendations for the practice of physical activity based on information from chapters of the Physical Activity Guide for the Brazilian Population, while the IG will perform a 12-week home-based exercise program supervised remotely by video call. The intervention has a weekly frequency of two sessions per week on non-consecutive days during the first 6 weeks and three sessions per week on non-consecutive days for the remaining 6 weeks. The RED study has HbA1c as the primary outcome, and the participants' cardiometabolic, functional, and psychosocial parameters are assessed at baseline (week 0) and post-intervention (week 13). DISCUSSION Expected results of the proposed study will provide the knowledge base of health professionals and deliver more evidence for a growing area, i.e., home-based exercise and T2D. Additionally, this protocol aims to verify and demonstrate whether this program can be accessible and effective for different health outcomes in patients with T2D. TRIAL REGISTRATION The RED study protocol was prospectively registered at ClinicalTrials.gov (NCT05362071). Date registered April 6, 2022. https://clinicaltrials.gov/ct2/show/NCT05362071 .
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Affiliation(s)
| | | | | | | | - Marco Bergamin
- Department of Medicine, University of Padova, Padua, Italy
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de Souza E, Meneses-Santos D, Santos JC, Aidar FJ, Carvalho CRDO, dos Santos JL, Marçal AC. "Does Physical Exercise Promote Health Benefits for Diabetic Patients during the COVID-19 Pandemic?": A Systematic Review. Sports (Basel) 2023; 11:192. [PMID: 37888519 PMCID: PMC10610946 DOI: 10.3390/sports11100192] [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: 07/19/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/28/2023] Open
Abstract
Patients affected by COVID-19 are prone to facing disorders in multiple systems and organs, which can lead to deleterious diseases; in addition, people with pre-existing diseases may be more prone to the worst outcomes, and the most vulnerable are patients with type 1 and type 2 diabetes mellitus. The aim of this systematic review was to evaluate the effects of physical activity and/or physical exercise prescribed to individuals with diabetes on the maintenance of plasma glucose and glycated hemoglobin during the COVID-19 pandemic. Studies were found by searching PubMed, SCOPUS, Embase, Web of Science, SciELO, LILACS, SportDiscus, Bireme/BVS and Google Scholar databases. The inclusion criteria were articles that addressed only patients with type 1 or type 2 diabetes (T1D and T2D) who had evaluated the level of physical activity or physical exercise and described the effects on plasma glucose and/or glycated hemoglobin in cross-sectional, retrospective, and observational studies, meeting the main criteria established by GRADE. The PICO and GRADE strategies were used to select and assess the methodological quality of studies. Two reviewers searched and selected the articles in databases independently and blindly, during which oppositions and disagreements about the inclusion of articles were discussed and resolved by a third reviewer. Evidence corroborates that levels of physical activity were reduced due to the lockdown, leading to increased body weight and worse glycemic control. On the other hand, individuals with diabetes mellitus (DM) (T1D and T2D) who maintained and/or increased levels of physical activity or physical exercise showed reduced plasma glucose and glycated hemoglobin (HbA1c) levels. Adequate levels of physical exercise and physical activity are beneficial for glucose and HbA1c control in diabetic patients (type 1 or type 2). In addition, maintaining adequate levels of physical activity can contribute to reducing health problems when these patients are infected with COVID-19.
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Affiliation(s)
- Erivaldo de Souza
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
| | - Daniela Meneses-Santos
- Department of Morphology, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil;
| | - Josué Cruz Santos
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
| | - Felipe J. Aidar
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
- Department of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil
| | | | - Jymmys Lopes dos Santos
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
| | - Anderson Carlos Marçal
- Postgraduate Program of Physical Education, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil; (E.d.S.); (J.C.S.); (F.J.A.); (J.L.d.S.)
- Department of Morphology, Universidade Federal de Sergipe, São Cristóvão 49100-000, SE, Brazil;
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Kawate Y, Hashimoto Y, Ushigome E, Kosaka S, Takahashi F, Sawamura A, Yumen Y, Hamaguchi M, Yamazaki M, Fukui M. Comparison of Diet, Sleep, and Stress During the Emergency Coronavirus Disease Curfew in Men and Women with Hemodialysis. J Ren Nutr 2023; 33:666-675. [PMID: 37302719 PMCID: PMC10256582 DOI: 10.1053/j.jrn.2023.06.002] [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: 11/02/2022] [Revised: 04/13/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE To investigate the effect of coronavirus disease 2019 (COVID-19) on diet, stress, and sleep in Japanese patients with hemodialysis. METHODS Data on nutritional intake, frequency of food intake by cuisine, dietary behavior, and frequency of food use before and during the declaration of the state of emergency due to COVID-19, were collected. RESULTS For the 81 participants (47 men), changes were observed in the following diet-related items: nutrition and nutrient content (one item for men, three for women), eating behavior, and frequency of food use (1 item for men, six for women), and the total number of items was two for men and nine for women. Nine out of 12 questions addressed stress and six out of eight questions addressed sleep, with a higher percentage of women adversely affected and no item with a higher percentage of men adversely affected. The mean score for stress was 25.3 ± 5.1 for men and 29.5 ± 5.0 for women, P < .001, and for sleep disturbance was 11.6 ± 3.0 for men and 14.4 ± 4.4 for women, P < .001. CONCLUSIONS In patients with hemodialysis, the effect of refraining from going out due to the spread of COVID-19 on diet, sleep, and stress was suggested to be more significant in women than in men.
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Affiliation(s)
- Yuka Kawate
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Nutrition, Kyoto Katsura Hospital, Kyoto, Japan; Kyoto working committee on foods for patients with dialysis and kidney diseases, Kyoto, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Osaka, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shiho Kosaka
- Kyoto working committee on foods for patients with dialysis and kidney diseases, Kyoto, Japan
| | - Fuyuko Takahashi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Nutrition, Saiseikai Suita Hospital, Osaka, Japan
| | - Atsuko Sawamura
- Kyoto working committee on foods for patients with dialysis and kidney diseases, Kyoto, Japan; Fundamental Nursing, Faculty of Nursing, Toho University, Tokyo, Japan
| | - Yukina Yumen
- Kyoto working committee on foods for patients with dialysis and kidney diseases, Kyoto, Japan; Kyoto College of Nutritional & Medical Sciences, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Diabetes Endocrinology & Rheumatology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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Huang H, Su HL, Huang CH, Lin YH. Retrospective Study on the Impact of COVID-19 Lockdown on Patients with Type 2 Diabetes in Northern Taiwan. Diabetes Metab Syndr Obes 2023; 16:2539-2547. [PMID: 37645235 PMCID: PMC10461745 DOI: 10.2147/dmso.s422617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023] Open
Abstract
Background During the COVID-19 pandemic, the national lockdown had a significant impact on healthcare systems and diabetes management. The results of relevant studies were inconsistent. The aim of the study was to investigate the impact of lockdown on glycemic control among patients with type 2 diabetes mellitus(T2D) in Taiwan. Methods This was a retrospective study conducted in a single regional hospital in Northern Taiwan. The clinic characteristics of the patients were summarized. Anthropometric and biochemical data before and after the lockdown were collected and analyzed. Stepwise multiple regression analysis was performed to identify the independent determinants of variables, including baseline characteristics and laboratory parameters, for the changes in glycated hemoglobin(HbA1c). Results A total of 943 (females 48.5%) patients with T2D were enrolled. The mean age of the patients was 60.6±12.3years, with a mean HbA1c of 7.0±1.0%, a mean diabetes duration of 7.3±4.6years, and a mean body mass index(BMI) of 26.5±4.5kg/m2. The overall means of HbA1c and fasting blood glucose were significantly improved after the lockdown compared to before (7.0±1.0 vs 6.8±0.9, p<0.001 and 132.2±33.3 vs 124.4±30.0, p<0.001, respectively). The proportion of patients achieving HbA1c target (≤7%) was higher after the lockdown compared to before (61.5% vs 68.9%, p<0.001). Stepwise multiple regression analysis revealed that baseline HbA1c before the lockdown was a positive contributor to the change in HbA1c after the lockdown, whereas BMI and co-morbidity with dyslipidemia were negative contributors (standardized coefficient +0.16, p<0.001; -0.07, p=0.025; -0.12, p=0.001, respectively). Conclusion Our study highlights the benefits of lockdown measures on diabetic control in Northern Taiwan as a single-center experience with the improvement of HbA1c and fasting blood glucose. Understanding these consequences of national lockdown can help healthcare providers to improve diabetes care during the pandemic.
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Affiliation(s)
- Hsuan Huang
- Division of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hsiao-Ling Su
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Chih-Hsung Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Yi-Hsin Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, Taiwan
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10
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Bouchi R, Sugiyama T, Goto A, Ohsugi M, Yoshioka N, Katagiri H, Mita T, Hirota Y, Ikegami H, Matsuhisa M, Araki E, Yokoyama H, Minami M, Yamazaki K, Jinnouchi H, Ikeda H, Fujii H, Nogawa M, Kaneshige M, Miyo K, Ueki K. Impact of COVID-19 pandemic on behavioral changes and glycemic control and a survey of telemedicine in patients with diabetes: A multicenter retrospective observational study. J Diabetes Investig 2023; 14:994-1004. [PMID: 37183588 PMCID: PMC10360386 DOI: 10.1111/jdi.14027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/05/2023] [Accepted: 04/25/2023] [Indexed: 05/16/2023] Open
Abstract
AIMS/INTRODUCTION To investigate whether the COVID-19 pandemic affected behavioral changes and glycemic control in patients with diabetes and to conduct a survey of telemedicine during the pandemic. MATERIALS AND METHODS In this retrospective study, a total of 2,348 patients were included from 15 medical facilities. Patients were surveyed about their lifestyle changes and attitudes toward telemedicine. Hemoglobin A1c (HbA1c) levels were compared among before (from June 1 to August 31, 2019) and in the first (from June 1 to August 31, 2020) and in the second (from June 1 to August 31, 2021) year of the pandemic. A survey of physician attitudes toward telemedicine was also conducted. RESULTS The HbA1c levels were comparable between 2019 (7.27 ± 0.97%), 2020 (7.28 ± 0.92%), and 2021 (7.25 ± 0.94%) without statistical difference between each of those 3 years. Prescriptions for diabetes medications increased during the period. The frequency of eating out was drastically reduced (51.7% in 2019; 30.1% in 2020), and physical activity decreased during the pandemic (48.1% in 2019; 41.4% in 2020; 43.3% in 2021). Both patients and physicians cited increased convenience and reduced risk of infection as their expectations for telemedicine, while the lack of physician-patient interaction and the impossibility of consultation and examination were cited as sources of concern. CONCLUSIONS Our data suggest that glycemic control did not deteriorate during the COVID-19 pandemic with appropriate intensification of diabetes treatment in patients with diabetes who continued to attend specialized diabetes care facilities, and that patients and physicians shared the same expectations and concerns about telemedicine.
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Affiliation(s)
- Ryotaro Bouchi
- Department of Diabetes, Endocrinology and Metabolism, Center HospitalNational Center for Global Health and MedicineTokyoJapan
- Diabetes and Metabolism Information Center, Research InstituteNational Center for Global Health and MedicineTokyoJapan
| | - Takehiro Sugiyama
- Diabetes and Metabolism Information Center, Research InstituteNational Center for Global Health and MedicineTokyoJapan
- Department of Public Health/Health Policy, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Atsushi Goto
- Department of Health Data Science, Graduate School of Data ScienceYokohama City UniversityYokohamaJapan
| | - Mitsuru Ohsugi
- Department of Diabetes, Endocrinology and Metabolism, Center HospitalNational Center for Global Health and MedicineTokyoJapan
- Diabetes and Metabolism Information Center, Research InstituteNational Center for Global Health and MedicineTokyoJapan
| | | | - Hideki Katagiri
- Department of Metabolism and DiabetesTohoku University Graduate School of MedicineSendaiJapan
| | - Tomoya Mita
- Department of Metabolism & Endocrinology, Graduate School of MedicineJuntendo UniversityTokyoJapan
| | - Yushi Hirota
- Division of Diabetes and Endocrinology, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Hiroshi Ikegami
- Department of Endocrinology, Metabolism and DiabetesKindai University Faculty of MedicineOsakaJapan
| | - Munehide Matsuhisa
- Diabetes Therapeutics and Research Center, Institute of Advanced Medical SciencesTokushima UniversityTokushimaJapan
| | - Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life SciencesKumamoto UniversityKumamotoJapan
| | | | - Masae Minami
- Minami Diabetes Clinical Research CenterFukuokaJapan
| | | | | | | | | | | | | | - Kengo Miyo
- Center for Medical Informatics IntelligenceNational Center for Global Health and MedicineTokyoJapan
| | - Kohjiro Ueki
- Department of Diabetes, Endocrinology and Metabolism, Center HospitalNational Center for Global Health and MedicineTokyoJapan
- Diabetes Research CenterNational Center for Global Health and MedicineTokyoJapan
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11
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Che M, Zhou Q, Lin W, Yang Y, Sun M, Liu X, Liu H, Zhang C. Healthy Lifestyle Score and Glycemic Control in Type 2 Diabetes Mellitus Patients: A City-Wide Survey in China. Healthcare (Basel) 2023; 11:2037. [PMID: 37510476 PMCID: PMC10379053 DOI: 10.3390/healthcare11142037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Few studies have investigated the combined impact of healthy lifestyle factors on glycemic control. Our study aimed to examine the associations of a healthy lifestyle score (HLS) with glycemic control and to explore the interactive effects of lifestyle factors among patients with type 2 diabetes mellitus (T2DM) in China. METHODS This cross-sectional study was conducted among T2DM patients based on the health management of residents from Guangzhou, China. Good glycemic control was defined as fasting plasma glucose < 7.0 mmol/L. HbA1c < 7.0% was also defined as good glycemic control in sensitivity analysis. The HLS was defined as including physical activity, waist circumference, body mass index, dietary habit, smoking, and alcohol consumption. Logistic regression models were used to examine the associations and interactions between the lifestyle factors and glycemic control. RESULTS Compared with participants with an HLS ≤ 2, the odds ratios (95% confidence intervals) for an HLS of 3, 4, 5, and 6 were 0.82 (0.77-0.87), 0.74 (0.70-0.79), 0.61 (0.57-0.65), and 0.56 (0.53-0.60), respectively. Significant interactions of healthy lifestyle factors in relation to glycemic control were shown (Pinteraction < 0.05). CONCLUSIONS A healthier lifestyle was significantly associated with good glycemic control in patients with T2DM, and combined healthy lifestyle factors had a better effect than considering them individually.
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Affiliation(s)
- Mengmeng Che
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qin Zhou
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Weiquan Lin
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Yunou Yang
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Minying Sun
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Xiangyi Liu
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Hui Liu
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Caixia Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
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12
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Rodrigues JVS, Cláudio MM, Franciscon JPS, Rosa RAC, Cirelli T, de Molon RS, Figueredo CMS, Garcia VG, Theodoro LH. The Effect of Non-Surgical Periodontal Treatment on Patients with Combined Refractory Arterial Hypertension and Stage III, Grade B Periodontitis: A Preliminary Prospective Clinical Study. J Clin Med 2023; 12:4277. [PMID: 37445313 DOI: 10.3390/jcm12134277] [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: 06/14/2023] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
We sought to evaluate the effects of non-surgical periodontal treatment (NSPT) on periodontal clinical parameters, systemic blood pressure (BP), and plasma levels of systemic inflammation markers in patients with combined refractory arterial hypertension (RAH) and stage III grade B periodontitis. Twenty-seven participants with RAH and periodontitis received NSPT. The analyzed clinical parameters were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI). An assessment was performed for systemic BP, complete blood count, coagulogram, creatinine measurement, C-reactive protein (CRP), glycated hemoglobin, cholesterol, glutamic oxaloacetic transaminase, glutamate pyruvic transaminase, waist-hip ratio, and body mass index. In the follow-up period, twenty-two patients were evaluated at baseline and after 90 and 180 days. The data were submitted for statistical analysis (α = 0.05%). As expected, the clinical results showed a significant improvement in the percentages of PI, BOP, PD, and CAL, which were statistically significant at 90 and 180 days (p < 0.0001). Importantly, NSPT significantly reduced the blood level of CRP (p < 0.02). However, no significant reduction in BP parameters was noted in the evaluated follow-up periods. NSPT, despite the benefits in periodontal clinical parameters, reduced the plasma level of CRP but not the BP in patients with combined RAH and periodontitis.
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Affiliation(s)
- João Victor Soares Rodrigues
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba 16015-050, SP, Brazil
| | - Marina Módulo Cláudio
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - João Paulo Soares Franciscon
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Rossana Abud Cabrera Rosa
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Thamiris Cirelli
- Department of Dentistry, University Center of Associated School-UNIFAE, São João da Boa Vista 13870-377, SP, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Carlos Marcelo S Figueredo
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4111, Australia
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, OF Odontologi, OF Orala sjukdomar, 171 77 Stockholm, Sweden
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Education (ILAPEO), Curitiba 80710-150, PR, Brazil
| | - Leticia Helena Theodoro
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba 16015-050, SP, Brazil
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13
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Hu Z, Youn HM, Quan J, Lee LLS, Mak IL, Yu EYT, Chao DVK, Ko WWK, Wong ICK, Lau GKK, Lau CS, Lam CLK, Wan EYF. The indirect impact of the COVID-19 pandemic on people with type 2 diabetes mellitus and without COVID-19 infection: Systematic review and meta-analysis. Prim Care Diabetes 2023; 17:229-237. [PMID: 36872178 PMCID: PMC9977626 DOI: 10.1016/j.pcd.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND The effect directly from the coronavirus disease 2019 (COVID-19) infection on health and fatality has received considerable attention, particularly among people with type 2 diabetes mellitus (T2DM). However, evidence on the indirect impact of disrupted healthcare services during the pandemic on people with T2DM is limited. This systematic review aims to assess the indirect impact of the pandemic on the metabolic management of T2DM people without a history of COVID-19 infection. METHODS PubMed, Web of Science, and Scopus were systematically searched for studies that compared diabetes-related health outcomes between pre-pandemic and during-pandemic periods in people with T2DM and without the COVID-19 infection and published from January 1, 2020, to July 13, 2022. A meta-analysis was performed to estimate the overall effect on the diabetes indicators, including hemoglobin A1c (HbA1c), lipid profiles, and weight control, with different effect models according to the heterogeneity. RESULTS Eleven observational studies were included in the final review. No significant changes in HbA1c levels [weighted mean difference (WMD), 0.06 (95% CI -0.12 to 0.24)] and body weight index (BMI) [0.15 (95% CI -0.24 to 0.53)] between the pre-pandemic and during-pandemic were found in the meta-analysis. Four studies reported lipid indicators; most reported insignificant changes in low-density lipoprotein (LDL, n = 2) and high-density lipoprotein (HDL, n = 3); two studies reported an increase in total cholesterol and triglyceride. CONCLUSIONS This review did not find significant changes in HbA1c and BMI among people with T2DM after data pooling, but a possible worsening in lipids parameters during the COVID-19 pandemic. There were limited data on long-term outcomes and healthcare utilization, which warrants further research. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022360433.
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Affiliation(s)
- Zhuoran Hu
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Hin Moi Youn
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Jianchao Quan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Lily Luk Siu Lee
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Ivy Lynn Mak
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - David Vai-Kiong Chao
- Department of Family Medicine and Primary Health Care, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong Hospital Authority, Hong Kong Special Administrative Region of China
| | - Welchie Wai Kit Ko
- Department of Family Medicine and Primary Health Care, Hong Kong Hospital Authority West Cluster, Hong Kong Special Administrative Region of China
| | - Ian Chi Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region of China; Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom; Aston Pharmacy School, Aston University, Birmingham, United Kingdom
| | - Gary Kui Kai Lau
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Chak Sing Lau
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region of China.
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14
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Holland D, Heald AH, Stedman M, Hanna F, Wu P, Duff C, Green L, Robinson S, Halsall I, Gaskell N, Pemberton J, Bloor C, Fryer AA. Assessment of the effect of the COVID-19 pandemic on UK HbA1c testing: implications for diabetes management and diagnosis. J Clin Pathol 2023; 76:177-184. [PMID: 34645702 PMCID: PMC8520598 DOI: 10.1136/jclinpath-2021-207776] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/08/2021] [Indexed: 01/23/2023]
Abstract
AIMS The COVID-19 pandemic, and the focus on mitigating its effects, has disrupted diabetes healthcare services worldwide. We aimed to quantify the effect of the pandemic on diabetes diagnosis/management, using glycated haemoglobin (HbA1c) as surrogate, across six UK centres. METHODS Using routinely collected laboratory data, we estimated the number of missed HbA1c tests for 'diagnostic'/'screening'/'management' purposes during the COVID-19 impact period (CIP; 23 March 2020 to 30 September 2020). We examined potential impact in terms of: (1) diabetes control in people with diabetes and (2) detection of new diabetes and prediabetes cases. RESULTS In April 2020, HbA1c test numbers fell by ~80%. Overall, across six centres, 369 871 tests were missed during the 6.28 months of the CIP, equivalent to >6.6 million tests nationwide. We identified 79 131 missed 'monitoring' tests in people with diabetes. In those 28 564 people with suboptimal control, this delayed monitoring was associated with a 2-3 mmol/mol HbA1c increase. Overall, 149 455 'screening' and 141 285 'diagnostic' tests were also missed. Across the UK, our findings equate to 1.41 million missed/delayed diabetes monitoring tests (including 0.51 million in people with suboptimal control), 2.67 million screening tests in high-risk groups (0.48 million within the prediabetes range) and 2.52 million tests for diagnosis (0.21 million in the pre-diabetes range; ~70 000 in the diabetes range). CONCLUSIONS Our findings illustrate the widespread collateral impact of implementing measures to mitigate the impact of COVID-19 in people with, or being investigated for, diabetes. For people with diabetes, missed tests will result in further deterioration in diabetes control, especially in those whose HbA1c levels are already high.
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Affiliation(s)
| | - Adrian H Heald
- Department of Diabetes and Endocrinology, Salford Royal NHS Foundation Trust, Salford, UK
- The School of Medicine and Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | | | - Fahmy Hanna
- Department of Diabetes and Endocrinology, Univerisity Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
- Centre for Health and Development, Staffordshire University Faculty of Health Sciences, Stoke-on-Trent, UK
| | - Pensee Wu
- Academic Department of Obstetrics and Gynaecology, Univerisity Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
- School of Medicine, Keele University, Keele, UK
| | - Christopher Duff
- School of Medicine, Keele University, Keele, UK
- Department of Clinical Biochemistry, Univerisity Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Lewis Green
- Department of Clinical Biochemistry, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
| | - Sarah Robinson
- Department of Clinical Biochemistry, Univerisity Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Ian Halsall
- Department of Clinical Biochemistry, Addenbrooke's Hospital, Cambridge, UK
| | - Neil Gaskell
- Department of Pathology, Warrington & Halton Teaching Hospitals NHS Foundation Trust, Warrington, UK
| | | | | | - Anthony A Fryer
- School of Medicine, Keele University, Keele, UK
- Department of Clinical Biochemistry, Univerisity Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
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15
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Ray JL, Srinath R, Mechanick JI. The Negative Impact of Routine, Dietary Pattern, and Physical Activity on Obesity and Dysglycemia During the COVID-19 Pandemic. Am J Lifestyle Med 2023; 17:219-230. [PMID: 36883128 PMCID: PMC9024091 DOI: 10.1177/15598276221084923] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The global coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, has disrupted routines in education, work, exercise, and dining habits. To prevent viral spread, communal spaces including offices, schools, restaurants, and gyms have closed or drastically limited their capacity. Additionally, government-mandated lockdown orders have forced people to spend more time at home. Studies have shown that these COVID-19 restrictions have led to unhealthier eating patterns, increased sedentary behaviors, and decreased physical activity, leading to weight gain, dysglycemia, and increased metabolic risk. While strict social distancing measures have been necessary to curb the spread of the SARS-CoV-2 virus, people have been forced to adapt by altering their daily routines. Based on existing literature, a model is proposed for intentionally creating daily routines to ensure healthy habits, minimize weight gain, and prevent worsening dysglycemia.
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Affiliation(s)
- Justina L Ray
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Reshmi Srinath
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeffrey I Mechanick
- Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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de Moura SS, de Menezes-Júnior LAA, Rocha AMS, Batista AP, de Menezes MC, Carraro JCC, Machado-Coelho GLL, Meireles AL. High Levels of Glycated Hemoglobin (HbA1c) Are Associated with Physical Inactivity, and Part of This Association Is Mediated by Being Overweight. Nutrients 2023; 15:1191. [PMID: 36904190 PMCID: PMC10005515 DOI: 10.3390/nu15051191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
The COVID-19 pandemic has generated substantial changes in the lives of the population, such as increased physical inactivity, which can lead to being overweight and, consequently, repercussions on glucose homeostasis. A cross-sectional study based on the adult population of Brazil was conducted by stratified, multistage probability cluster sampling (October and December 2020). Participants were classified as physically active or inactive during leisure time according to the recommendations of the World Health Organization. HbA1c levels were categorized as normal (≤6.4%) or with glycemic changes (≥6.5%). The mediating variable was being overweight (overweight and obese). Descriptive, univariate, and multivariate logistic regression analyses examined the association between physical inactivity and glycemic changes. Mediation was analyzed using the Karlson-Holm-Breen method to verify the influence of being overweight on the association. We interviewed 1685 individuals, mostly women (52.4%), 35-59 years old (45.8%), race/ethnicity brown (48.1%), and overweight (56.5%). The mean HbA1c was 5.68% (95% CI: 5.58-5.77). Mediation analysis verified that physically inactive participants during leisure time were 2.62 times more likely to have high levels of HbA1c (OR: 2.62, 95% CI: 1.29-5.33), and 26.87% of this effect was mediated by over-weight (OR: 1.30: 95% CI: 1.06-1.57). Physical inactivity at leisure increases the chances of high levels of HbA1c, and part of this association can be explained by being overweight.
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Affiliation(s)
- Samara Silva de Moura
- Postgraduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
- Epidemiology Laboratory, Medical School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
| | - Luiz Antônio Alves de Menezes-Júnior
- Postgraduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
- Epidemiology Laboratory, Medical School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
| | - Ana Maria Sampaio Rocha
- Epidemiology Laboratory, Medical School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
| | - Aline Priscila Batista
- Epidemiology Laboratory, Medical School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
- Postgraduate Program in Biological Sciences, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
| | | | - Júlia Cristina Cardoso Carraro
- Postgraduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
| | - George Luiz Lins Machado-Coelho
- Postgraduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
- Epidemiology Laboratory, Medical School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
| | - Adriana Lúcia Meireles
- Postgraduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto 35400000, MG, Brazil
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Taniguchi H, Okuda N, Arima H, Satoh A, Abe M, Nishi N, Higashiyama A, Suzuki H, Ohkubo T, Kadota A, Miura K, Ueshima H, Okayama A. Body weight and lifestyle changes under the COVID-19 pandemic in Japan: a cross-sectional study from NIPPON DATA2010. BMJ Open 2022; 12:e063213. [PMID: 36450420 PMCID: PMC9716411 DOI: 10.1136/bmjopen-2022-063213] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has had an impact on people's lifestyles such as causing body weight changes. This study examined associations among lifestyle changes and body weight during the COVID-19 pandemic among the Japanese population. DESIGN A cross-sectional study. SETTING A nationwide survey of the general Japanese population. PARTICIPANTS Total participants were 2244 men and women, of which 911 young/middle-aged (30-69 years old) and 899 older adults (70 years and older) were analysed separately. OUTCOME Changes in lifestyle (physical activity, dietary habits and alcohol intake) and body weight during the first wave of COVID-19 in spring 2020. RESULTS Under the COVID-19 pandemic, 24.1% and 10.1% of Japanese respondents reported weight gain and reduction, respectively. Multivariable-adjusted stepwise logistic regression analyses revealed that the young/middle-aged respondents in the group increased body weight, weight gain was significantly associated with decrease in physical activity (OR 4.01, 95% CI 2.83 to 5.69) and both increase (OR 5.82, 95% CI 3.85 to 8.80) and decrease (OR 2.73, 95% CI 1.52 to 4.93) in eating between meals. In the group that decreased body weight, body weight reduction was significantly associated with increase in physical activity (OR 3.66, 95% CI 1.94 to 6.90), decrease in eating between meals (OR 5.97, 95% CI 3.11 to 11.48) and both increase and decrease in alcohol intake in the young/middle age. For the older adults, body weight gain was higher in women than in men, and significantly associated with higher quartile of regional COVID-19 infection, decrease in physical activity (OR 2.98, 95% CI 1.98 to 4.49), increase in home-cooked meals and increase in eating between meals (OR 4.22, 95% CI 2.55 to 6.99). On the other hand, body weight reduction was significantly associated with decreases in physical activity (OR 2.63, 95% CI 1.62 to 4.27), home-cooked meals and eating between meals (OR 1.95, 95% CI 1.05 to 3.61) in the older adults. CONCLUSION Changes in physical activity and eating between meals were associated with body weight change under the COVID-19 pandemic among Japanese.
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Affiliation(s)
- Hirokazu Taniguchi
- Division of Applied Life Sciences, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan
| | - Nagako Okuda
- Division of Applied Life Sciences, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Atsushi Satoh
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Makiko Abe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Aya Higashiyama
- Department of Hygiene, Wakayama Medical University, Wakayama, Japan
| | - Harumitsu Suzuki
- Department of Hygiene, Wakayama Medical University, Wakayama, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University, Tokyo, Japan
| | - Aya Kadota
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Hirotsugu Ueshima
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
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Moyano DL, Lopez MV, Cavallo A, Candia JP, Kaen A, Irazola V, Beratarrechea A. The Use of 2 e-Learning Modalities for Diabetes Education Using Facebook in 2 Cities of Argentina During the COVID-19 Pandemic: Qualitative Study. JMIR Form Res 2022; 6:e38862. [DOI: 10.2196/38862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/28/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background
The COVID-19 pandemic and the confinement that was implemented in Argentina generated a need to implement innovative tools for the strengthening of diabetes care. Diabetes self-management education (DSME) is a core element of diabetes care; however, because of COVID-19 restrictions, in-person diabetes educational activities were suspended. Social networks have played an instrumental role in this context to provide DSME in 2 cities of Argentina and help persons with diabetes in their daily self-management.
Objective
The aim of this study is to evaluate 2 diabetes education modalities (synchronous and asynchronous) using the social media platform Facebook through the content of posts on diabetes educational sessions in 2 cities of Argentina during the COVID-19 pandemic.
Methods
In this qualitative study, we explored 2 modalities of e-learning (synchronous and asynchronous) for diabetes education that used the Facebook pages of public health institutions in Chaco and La Rioja, Argentina, in the context of confinement. Social media metrics and the content of the messages posted by users were analyzed.
Results
A total of 332 messages were analyzed. We found that in the asynchronous modality, there was a higher number of visualizations, while in the synchronous modality, there were more posts and interactions between educators and users. We also observed that the number of views increased when primary care clinics were incorporated as disseminators, sharing educational videos from the sessions via social media. Positive aspects were observed in the posts, consisting of messages of thanks and, to a lesser extent, reaffirmations, reflections or personal experiences, and consultations related to the subject treated. Another relevant finding was that the educator/moderator role had a greater presence in the synchronous modality, where posts were based on motivation for participation, help to resolve connectivity problems, and answers to specific user queries.
Conclusions
Our findings show positive contributions of an educational intervention for diabetes care using the social media platform Facebook in the context of the COVID-19 pandemic. Although each modality (synchronous vs asynchronous) could have differential and particular advantages, we believe that these strategies have potential to be replicated and adapted to other contexts. However, more documented experiences are needed to explore their sustainability and long-term impact from the users' perspective.
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19
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Mekanna AN, Panchal SK, Li L. Beyond lockdowns: a systematic review of the impacts of COVID-19 lockdowns on dietary pattern, physical activity, body weight, and food security. Nutr Rev 2022:6762057. [PMID: 36250794 PMCID: PMC9619764 DOI: 10.1093/nutrit/nuac088] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Context COVID-19 lockdowns may have impacted dietary patterns and nutritional outcomes in many populations. Objective The aim of this review was to evaluate the impacts of COVID-19 lockdowns on nutritional patterns, investigating behaviors in the periods before, during, and after lockdowns. Data Source This systematic review followed the PRISMA-P methodology. The articles included were identified by searching the key words in Web of Science, PubMed, and Scopus. The key words used in the search included: “COVID19” AND “diet*”, “coronavirus” AND “diet*”, “coronavirus 2” AND “diet*”, “COVID19” AND “nutri*”, “coronavirus” AND “nutri*”, “coronavirus 2” AND “nutri*”, “COVID19” AND “food”. Data Extraction Twenty-two original studies were included in this review. Data extraction tables were created for recording author names, year of publication, location of study, duration, lockdown phase, design, methods, aims, number of participants, age, gender, health status, education, socioeconomic status, dietary patterns, food security, physical activity, body weight change or body mass index, and associations with sociodemographic characteristics. Data Analysis Impacts of lockdowns on eating patterns, physical activity, body weight or body mass index, and food security were the primary outcomes investigated. Secondary outcomes investigated were associations with sociodemographic characteristics. Conclusion COVID-19 lockdowns were associated with significant changes in dietary and lifestyle behaviors of worldwide populations. Impacts were seen during and post-lockdown likely due to more time spent at home, working from home, decreased food availability and accessibility, and augmented stress associated with lockdown.
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Affiliation(s)
| | - Sunil K Panchal
- School of Science, Western Sydney University, Richmond, New South Wales, Australia.,Global Centre for Land-Based Innovation, Western Sydney University, Richmond, New South Wales, Australia
| | - Li Li
- School of Science, Western Sydney University, Richmond, New South Wales, Australia
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20
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GÖKGÖZ DURMAZ F, CİHAN FG. Evaluation of Health Promoting Lifestyle Habits During Pandemic Period: A cross-sectional study. KONURALP TIP DERGISI 2022. [DOI: 10.18521/ktd.1160147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objective: The COVID-19 pandemic imposed lifestyle changes. The aim of this study was to evaluate the health-promoting lifestyle habits of individuals who applied to a primary care center during the pandemic period.
Methods: This descriptive and cross-sectional study was conducted with the voluntary participation of 524 individuals. The data was collected through a research questionnaire form and the Health Promoting Lifestyle Scale (HPLS).
Results: Women accounted for 58.2% (n=305) of all participants, 45.2% of them (n=237) had chronic disease and 32.1% (n=168) were smoking. Mean age was 41.26±14.28 (min:18, max:75) years old. Among these participants, %53.2 had equal income to their expenses (n=279), 52.3% experienced sleep pattern changes (n=274), 35.7% had COVID-19 disease and 66.6% vaccinated for COVID-19. The mean HPLS score was 162.75±8.10 points. Interpersonal relationships, stress management and total HPLS scores were higher in women (p
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21
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Menekli T, Yaprak B, Türeyen A, Şentürk S. Investigation of COVID-19 fear, treatment compliance, and metabolic control of patients with type 2 diabetes mellitus during the pandemic. Prim Care Diabetes 2022; 16:658-663. [PMID: 36030171 PMCID: PMC9376335 DOI: 10.1016/j.pcd.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/04/2022] [Accepted: 08/11/2022] [Indexed: 01/08/2023]
Abstract
AIMS This study was carried out to investigate fear levels, treatment compliance, and metabolic control of type II Diabetes Mellitus patients during the COVID-19 pandemic. METHODS The study employed a single-center, observational design and was conducted between January and April 2021. The study consisted of 303 patients who attended the internal medicine outpatient clinic of a university hospital in Turkey. For data collection, the Patient Identification Form, COVID-19 Fear Scale, and the Type II Diabetes Treatment Compliance Scale were used. The study complied with the Helsinki Declaration criteria. IBM SPSS v25.0 statistics package program was used for data analysis. RESULTS The mean age of the patients was 45.8 ± 7.5 years, the mean duration of illness was 8.2 ± 3.6 years. Moreover, 40.6% of patients presented with poor levels of treatment compliance. In addition, the mean FCV-19S score of the patients was 29.1 ± 3.05. It was noticeable that those with high mean scores of FCV-19S had poor compliance with treatment and metabolic control during the pandemic (p < 0.05). PRACTICE IMPLICATIONS Fear of COVID-19 negatively affects treatment compliance and metabolic control of type II diabetes patients. The patients avoided attending their regular follow-ups at the hospital due to fear of contracting COVID-19. In order to reduce the fear of COVID-19 it is paramount to maintain optimum metabolic control and treatment compliance.
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Affiliation(s)
- Tuğba Menekli
- Department of Internal Medicine Nursing, Malatya Turgut Özal University, Faculty of Health Sciences, Battalgazi, Malatya, Turkey.
| | - Bülent Yaprak
- Department of Internal Medicine, Malatya Turgut Özal University, Faculty of Medicine, Battalgazi, Malatya, Turkey.
| | - Aynur Türeyen
- Department of Internal Medicine Nursing, Faculty of Nursing, Ege University, Bornova, İzmir, Turkey.
| | - Sibel Şentürk
- Department of Internal Medicine Nursing, Burdur Mehmet Akif Ersoy University, Bucak Health School, Bucak, Burdur, Turkey.
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22
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Lashkarbolouk N, Mazandarani M, Pourghazi F, Eslami M, Khonsari NM, Ghonbalani ZN, Ejtahed HS, Qorbani M. How did lockdown and social distancing policies change the eating habits of diabetic patients during the COVID-19 pandemic? A systematic review. Front Psychol 2022; 13:1002665. [PMID: 36211913 PMCID: PMC9540372 DOI: 10.3389/fpsyg.2022.1002665] [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: 07/28/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background After the declaration of the COVID-19 pandemic, governments established national lockdowns and social distancing as an effective plan to control this disease. As a result of the lockdown policies, diabetic patients` access to food products, medication, and routine follow-ups is disrupted, making it difficult for them to control their disease. Methods International databases, including PubMed/Medline, Web of Science, and Scopus, were searched until April 2022. All observational studies included assessing the impact of lockdown and social distancing on eating habits (as primary outcome), and glycemic and anthropometric indices (as secondary outcomes) of diabetic patients during the COVID-19 pandemic. The Newcastle-Ottawa Quality Scale was used to assess the quality rating of the studies. Results Overall, 22 studies were included in this systematic review, the results of which varied in different communities. In most studies, consumption of grains, fruits, and vegetables was reported to increase. On the other hand, consumption of snacks and sweets was reported to increase in other surveys. During the COVID-19 lockdown, most diabetic patients preferred to cook meals at home, using less takeout, fast foods, and alcoholic drinks. Although the patients mostly improved their eating habits, the glycemic and anthropometric indices were contradictory in different studies. Studies showed that the eating habits of diabetic patients vary from country to country, even in some cases and studies done in the same country showed different results. For example, all the studies done in Japan showed an increase in the consumption of snacks and sweets, leading to weight gain in the patients. However, conflicting results in eating habits have been observed in studies conducted in India. Conclusion The lockdown policies have led to a beneficial change in the eating habits of diabetic patients to consume more fruits and vegetables and reduce the consumption of animal protein products and alcoholic beverages. While some diabetic patients have increased consumption of snacks and sweets, leading to a disturbance in their glycemic and anthropometric indices control. Understanding the consequences of lockdown and social distancing of the diabetic patient during the COVID-19 pandemic can help public health authorities make better recommendations to improve glycemic control.
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Affiliation(s)
- Narges Lashkarbolouk
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Mazandarani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Pourghazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maysa Eslami
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Nouri Ghonbalani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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23
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Ramirez Zegarra R, Dall’Asta A, Revelli A, Ghi T. COVID-19 and Gestational Diabetes: The Role of Nutrition and Pharmacological Intervention in Preventing Adverse Outcomes. Nutrients 2022; 14:nu14173562. [PMID: 36079820 PMCID: PMC9460671 DOI: 10.3390/nu14173562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/14/2022] [Accepted: 08/23/2022] [Indexed: 12/15/2022] Open
Abstract
Pregnant women with GDM affected by COVID-19 seem to be at higher risk of adverse maternal and neonatal outcomes, especially those with overweight or obesity. Good glycemic control seems to be the most effective measure in reducing the risk of GDM and severe COVID-19. For such purposes, the Mediterranean diet, micronutrient supplementation, and physical activity are considered the first line of treatment. Failure to achieve glycemic control leads to the use of insulin, and this clinical scenario has been shown to be associated with an increased risk of adverse maternal and neonatal outcomes. In this review, we explore the current evidence pertaining to the pathogenesis of SARS-CoV-2 leading to the main complications caused by COVID-19 in patients with GDM. We also discuss the incidence of complications caused by COVID-19 in pregnant women with GDM according to their treatment.
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Affiliation(s)
- Ruben Ramirez Zegarra
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Department of Obstetrics and Gynaecology, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Andrea Dall’Asta
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Alberto Revelli
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Tullio Ghi
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
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24
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Anxiety, Distress and Stress among Patients with Diabetes during COVID-19 Pandemic: A Systematic Review and Meta-Analysis. J Pers Med 2022; 12:jpm12091412. [PMID: 36143195 PMCID: PMC9506161 DOI: 10.3390/jpm12091412] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/20/2022] Open
Abstract
The prevalence of mental health disorders has increased during the COVID-19 pandemic. Patients with chronic diseases, such as diabetes, are a particularly vulnerable risk group. This study aims to assess the levels and prevalence of anxiety, distress, and stress in patients with diabetes during the COVID-19 pandemic. A systematic review was conducted in CINAHL, Cochrane, LILACS, Medline, SciELO, and Scopus in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Thirty-seven articles with a total of 13,932 diabetic patients were included. Five meta-analyses were performed. The prevalence of anxiety was 23% (95% CI = 19–28) in T1DM and 20% (95% CI = 6–40) in T2DM patients. For diabetes distress it was 41% (95% CI = 24–60) for T1DM and 36% in T2DM patients (95% CI = 2–84). For stress, the prevalence was 79% (95% CI = 49–98) in T1DM patients. People with diabetes have significant psychiatric comorbidity as well as psychological factors that negatively affect disease management, increasing their vulnerability in an emergency situation. To establish comprehensive care in diabetic patients addressing mental health is essential, as well as including specific policy interventions to reduce the potential psychological harm of the COVID-19 pandemic.
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Tsukaguchi R, Murakami T, Yoshiji S, Shide K, Fujita Y, Ogura M, Inagaki N. Year-long effects of COVID-19 restrictions on glycemic control and body composition in patients with glucose intolerance in Japan: A single-center retrospective study. J Diabetes Investig 2022; 13:2063-2072. [PMID: 35980313 PMCID: PMC9538039 DOI: 10.1111/jdi.13893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/25/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022] Open
Abstract
Aims/Instruction During the coronavirus disease 2019 (COVID‐19) pandemic, the lockdowns in Europe raised concerns about negative effects on glycemic control and body composition in patients with diabetes. In Japan, voluntary‐based restrictions were imposed as the declaration of a state of emergency (DSE), whose metabolic consequences have not been fully investigated. We carried out a single‐center retrospective study to evaluate changes in glycemic control and body composition in outpatients with glucose intolerance after the DSE. Materials and Methods We enrolled outpatients with glucose intolerance: (i) for whom longitudinal data about body composition were available; (ii) who participated in dietary follow up with nutritionists; and (iii) whose laboratory data included glycated hemoglobin (HbA1c) levels before and after the DSE. Results Among 415 patients, we found no significant changes in HbA1c overall after the DSE. Bodyweight and fat mass increased significantly, whereas skeletal mass decreased significantly. HbA1c changes after the DSE were significantly correlated with changes in bodyweight and fat mass. In 128 patients whose HbA1c levels increased ≥0.3%, changes in bodyweight and fat mass were significantly larger than those in the other 287 patients. With regard to lifestyle changes, increased snacking was likely to worsen glycemic control (odds ratio 1.76, P = 0.036). Conclusions COVID‐19 restrictions in Japan had unfavorable metabolic consequences for patients with glucose intolerance, highlighted by increased bodyweight and body fat, and decreased skeletal muscle. In addition, lifestyle changes, such as increased snacking, might worsen glycemic control. Clinical attention and interventions are required to prevent such metabolic changes.
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Affiliation(s)
- Ryo Tsukaguchi
- Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takaaki Murakami
- Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Yoshiji
- Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kenichiro Shide
- Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, Kyoto, Japan
| | - Yoshihito Fujita
- Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahito Ogura
- Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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26
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Olesen K, Joensen LE, Madsen KP, Willaing I. How has the COVID-19 Pandemic Affected Diabetes Self-Management in People With Diabetes? - A One-Year Follow-Up Study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:867025. [PMID: 36992738 PMCID: PMC10012120 DOI: 10.3389/fcdhc.2022.867025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/10/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND AND AIM In Denmark, the COVID-19 pandemic resulted in two lockdowns, one from March to May 2020 and another from December 2020 to April 2021, which had severe impact on everyday life. The aim of this study was to explore changes in diabetes self-management behaviors during the pandemic and to examine how specific population characteristics were associated with changes in diabetes management. METHODS AND PARTICIPANTS In a cohort study from March 2020 to April 2021, two online questionnaires were collected from a total of 760 people with diabetes. Descriptive statistics were used to assess the proportion of participants experiencing improvements, deterioration, and status quo in diabetes self-management during the pandemic. Using logistic regressions, baseline characteristics were explored as potential predictors of change. RESULTS Approximately half of the participants reported that they experienced lower physical activity in April 2021 compared to before the pandemic, approximately one fifth reported diabetes self-management to be more difficult than prior to the pandemic, and one fifth reported eating more unhealthily than before the pandemic. Some participants reported higher frequency of high blood glucose levels (28%), low blood glucose levels (13%) and more frequent blood glucose variability (33%) compared to before. Easier diabetes self-management was reported by relatively few participants, however, 15% reported eating more healthily, and 20% reported being more physically active. We were largely unable to identify predictors of change in exercise activities. The few baseline characteristics identified as predictors of difficulties in diabetes self-management and adverse blood glucose levels due to the pandemic were sub-optimal psychological health, including high diabetes distress levels. CONCLUSION Findings indicate that many people with diabetes changed diabetes self-management behaviors during the pandemic, mostly in a negative direction. Particularly high diabetes distress levels in the beginning of the pandemic was a predictor of both positive and negative change in diabetes self-management, indicating that people with high diabetes distress levels could potentially benefit from increased support in diabetes care during a period of crisis.
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Affiliation(s)
- Kasper Olesen
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Lene Eide Joensen
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Kristoffer Panduro Madsen
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Ingrid Willaing
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
- Section of Health Services Research, Department of Public Health, Copenhagen University, Copenhagen, Denmark
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27
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Satoh M, Murakami T, Obara T, Metoki H. Time-series analysis of blood pressure changes after the guideline update in 2019 and the coronavirus disease pandemic in 2020 using Japanese longitudinal data. Hypertens Res 2022; 45:1408-1417. [PMID: 35718828 PMCID: PMC9206892 DOI: 10.1038/s41440-022-00961-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 02/07/2023]
Abstract
We assessed blood pressure (BP) changes during fiscal years (April to March of the following year) 2015–2020 to clarify the effect of the state of emergency due to the coronavirus disease 2019 (COVID-19) pandemic in 2020. We then considered BP in 2019 separately, as the Japanese hypertension guidelines were updated in 2019. The present retrospective cohort study extracted data from 157,510 Japanese individuals aged <75 years (mean age: 50.3 years, men: 67.5%) from the annual health check-up data of the DeSC database. The trends in BP were assessed using a repeated measures linear mixed model. After adjusting for the month of health check-ups to exclude seasonal BP variation, systolic BP linearly increased during fiscal years 2015–2018. From the value estimated by the trend in 2015–2018, systolic BP was lower by ≤1 mmHg in fiscal year 2019 among the treated participants. Meanwhile, systolic/diastolic BP (95% confidence interval) increased by 2.11 (1.97–2.24)/1.05 (0.96–1.14) mmHg for untreated women (n = 43,292), 1.60 (1.51–1.70)/1.17 (1.11–1.24) mmHg for untreated men (n = 88,479), 1.92 (1.60–2.23)/0.46 (0.25–0.67) mmHg for treated women (n = 7855), and 1.00 (0.79–1.21)/0.39 (0.25–0.53) mmHg for treated men (n = 17,884) in fiscal year 2020. These increases remained time-dependent covariates after adjustments for age, body mass index, alcohol consumption, smoking, physical activity, and blood sampling indices. Social change due to the pandemic might have increased BP by approximately 1–2/0.5–1 mmHg. Meanwhile, only a slight decrease in BP was observed immediately after the guideline update in Japan. ![]()
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Affiliation(s)
- Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan. .,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Taku Obara
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
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Shikuma J, Nagai Y, Sakurai M, Udagawa K, Ito R, Miwa T, Suzuki R. Impact of gender differences on lifestyle and glycemic control in Japanese patients with diabetes during COVID-19 lockdowns. Prim Care Diabetes 2022; 16:350-354. [PMID: 35283067 PMCID: PMC8904171 DOI: 10.1016/j.pcd.2022.03.004] [Citation(s) in RCA: 3] [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: 01/06/2022] [Revised: 03/01/2022] [Accepted: 03/06/2022] [Indexed: 11/14/2022]
Abstract
AIMS The COVID-19 pandemic has drastically changed global lifestyles. Some reports about lifestyle changes during this pandemic have been published. However, these studies have not assessed gender differences. Thus, we analyzed three lifestyle changes to determine gender differences. METHODS We analyzed physical activity, snacking habits, and drinking habits in 323 patients with diabetes. Gender differences in lifestyle habits were analyzed using the ꭓ2 test, and comparisons of HbA1c between 2019 and 2020 were analyzed using the paired t-test. The factors that influenced the deterioration of HbA1c were determined using multivariate logistic regression analyses. RESULTS Of the 323 patients, 212 were male and 111 were female. When examined by quarter, the HbA1c values increased significantly in 2020 compared with that in 2019 in the July-September period. In terms of gender differences in the changes of lifestyle habits, decreased physical activity was higher in women. The factors that affected deterioration in HbA1c were snacking habits for the overall and the male populations. CONCLUSIONS The lifestyle changes differed between the genders during the pandemic. A balanced diet is important for all patients with diabetes. Additionally, more attention should be paid to physical inactivity in women.
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Affiliation(s)
- Jumpei Shikuma
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Yoshiyuki Nagai
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo 160-0023, Japan
| | - Mamoru Sakurai
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo 160-0023, Japan
| | - Kana Udagawa
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo 160-0023, Japan
| | - Rokuro Ito
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo 160-0023, Japan
| | - Takashi Miwa
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo 160-0023, Japan
| | - Ryo Suzuki
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo 160-0023, Japan
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Vilafranca Cartagena M, Tort-Nasarre G, Romeu-Labayen M, Vidal-Alaball J. The experiences of patients with diabetes and strategies for their management during the first COVID-19 lockdown: a qualitative study. BMC Nurs 2022; 21:124. [PMID: 35610635 PMCID: PMC9126747 DOI: 10.1186/s12912-022-00911-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/09/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND During the pandemic, primary care systems prioritised attention to COVID-19 patients; chronically ill patients, such as people with Type 2 Diabetes were obliged to take more responsibility for their own care. We aimed to analyse the experiences of patients with Type 2 Diabetes Mellitus during the stay-at-home order that was in place during the first wave of the COVID-19 pandemic and identify the strategies and resources used in managing their care. METHOD We conducted a qualitative descriptive study. The participants were ten patients with type 2 Diabetes Mellitus who experienced strict lockdown during the first wave of the COVID-19 pandemic in Catalonia, Spain, selected using intentional sampling. We recorded semi-structured interviews with the participants and conducted thematic analysis. RESULTS We identified 14 subthemes, which we then grouped into three overarching themes: 1) anxiety, fear, and vulnerability (anxiety, fear, vulnerability, rethinking life, loneliness, sadness), 2) insufficient diabetes monitoring by the health system (health care received, glycaemic control, view of treatment by health providers) and proactive self-care (changes in daily routine, diet, physical activity, medication, personal protective equipment & social distancing). CONCLUSION Despite the exceptional nature of the situation and the stress, worry, and changes in their daily lives, many respondents reported that they had successfully modified their lifestyles. Self-care was effective during confinement and was based on a process of adaptation using the resources available, without face-to-face contact with primary care health staff. RELEVANCE TO CLINICAL PRACTICE These results can help to guide the design and implementation of self-care-focused strategies and also to explore new ways of empowering patients without access to health care personnel.
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Affiliation(s)
- Mireia Vilafranca Cartagena
- Department of Nursing, Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), Av. Universitaria 4-6, 08242 Manresa, Spain
- Althaia Fundation, C/Dr Joan Soler 1-3, 08243 Manresa, Spain
| | - Glòria Tort-Nasarre
- Department of Nursing, Faculty of Nursing and Physiotherapy, University of Lleida, C/Montserrat Roig, 25198 Lleida, Spain
- SAP ANOIA. Gerencia Territorial Catalunya Central. Institut Català de La Salut, 087272 Sant Fruitós del Bages, Spain
- AFIN Research Group and Outreach Centre, Autonomous University of Barcelona. Campus Bellaterra, Cerdanyola del Vallès, Spain
| | - Maria Romeu-Labayen
- AFIN Research Group and Outreach Centre, Autonomous University of Barcelona. Campus Bellaterra, Cerdanyola del Vallès, Spain
- Department of Public Health, Mental Health and Mother-Infant Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, L’Hospitalet del Llobregat, Spain
| | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerència Territorial de La Catalunya Central, Institut Català de La Salut, 08272 Sant Fruitós de Bages, Spain
- Unitat de Suport a La Recerca de La Catalunya Central, Fundació Institut Universitari Per a La Recerca a L’Atenció Primària de Salut Jordi Gol I Gurina, 08272 Sant Fruitós de Bages, Spain
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Onishi Y, Ichihashi R, Yoshida Y, Tahara T, Kikuchi T, Kobori T, Kubota T, Iwamoto M, Hamano S, Kasuga M. Substitution of telemedicine for clinic visit during the COVID-19 pandemic of 2020-comparison of telemedicine and clinic visit. J Diabetes Investig 2022; 13:1617-1625. [PMID: 35524476 PMCID: PMC9348048 DOI: 10.1111/jdi.13826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/23/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
Aims/Introduction The purpose of this retrospective observational cohort study was to compare outpatient diabetes care and glycated hemoglobin (HbA1c) level during the coronavirus disease 2019 pandemic in 2020 with 2019, and to compare the glucose‐lowering effect of telemedicine and clinic visits during the state of emergency in Japan declared from 7 April to 25 May (inter‐period) 2020. Materials and Methods A total of 13 weeks before and after the inter‐period were designated as the pre‐period and post‐period, respectively. The number of study participants who had clinic visits during the pre‐period and the post‐period were 3,333 in 2020 and 3,608 in 2019. Propensity score matching was carried out to compare the effect of telemedicine and clinic visits on diabetes control in 2020 among diabetes patients with insufficient glucose control (HbA1c ≥7%). The primary outcome was post‐period HbA1c. Results The major difference between 2020 and 2019 was the use of telemedicine in 2020. After adjustment for age, sex, diabetes type, pre‐period HbA1c and pre‐period body mass index, glycemic control evaluated by HbA1c was significantly worse in the post‐period of 2020 than 2019. In the propensity score‐matched 618 pairs, the clinic visit group had significantly better post‐period HbA1c than the telemedicine group (7.5% vs 7.4%, P = 0.023). Conclusions Glycemic control was slightly, but significantly, worse in 2020 than 2019. Although telemedicine significantly improved glycemic control during the coronavirus disease 2019 pandemic in 2020, clinic visits improved HbA1c significantly more. The substitution of telemedicine for clinic visits appears to be a viable option under emergency conditions, but clinic visits might be a better option when possible.
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Affiliation(s)
- Yukiko Onishi
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
| | - Rieko Ichihashi
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
| | - Yoko Yoshida
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
| | - Tazu Tahara
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
| | - Takako Kikuchi
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
| | - Toshiko Kobori
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
| | - Tetsuya Kubota
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
| | - Masahiko Iwamoto
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
| | - Shoko Hamano
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
| | - Masato Kasuga
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6, Nihonbashi-Bakurocho, Chuo-ku, Tokyo, Japan
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Mak IL, Wan EYF, Wong TKT, Lee WWJ, Chan EWY, Choi EPH, Chui CSL, Ip MSM, Lau WCS, Lau KK, Lee SF, Wong ICK, Yu EYT, Lam CLK. The Spill-Over Impact of the Novel Coronavirus-19 Pandemic on Medical Care and Disease Outcomes in Non-communicable Diseases: A Narrative Review. Public Health Rev 2022; 43:1604121. [PMID: 35574567 PMCID: PMC9091177 DOI: 10.3389/phrs.2022.1604121] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 03/07/2022] [Indexed: 12/15/2022] Open
Abstract
Objectives: The coronavirus-19 (COVID-19) pandemic has claimed more than 5 million lives worldwide by November 2021. Implementation of lockdown measures, reallocation of medical resources, compounded by the reluctance to seek help, makes it exceptionally challenging for people with non-communicable diseases (NCD) to manage their diseases. This review evaluates the spill-over impact of the COVID-19 pandemic on people with NCDs including cardiovascular diseases, cancer, diabetes mellitus, chronic respiratory disease, chronic kidney disease, dementia, mental health disorders, and musculoskeletal disorders. Methods: Literature published in English was identified from PubMed and medRxiv from January 1, 2019 to November 30, 2020. A total of 119 articles were selected from 6,546 publications found. Results: The reduction of in-person care, screening procedures, delays in diagnosis, treatment, and social distancing policies have unanimously led to undesirable impacts on both physical and psychological health of NCD patients. This is projected to contribute to more excess deaths in the future. Conclusion: The spill-over impact of COVID-19 on patients with NCD is just beginning to unravel, extra efforts must be taken for planning the resumption of NCD healthcare services post-pandemic.
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Affiliation(s)
- Ivy Lynn Mak
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, China
| | - Teenie Kwan Tung Wong
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wendy Woo Jung Lee
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Esther Wai Yin Chan
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Celine Sze Ling Chui
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, China
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mary Sau Man Ip
- Division of Respiratory Medicine, Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wallace Chak Sing Lau
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shing Fung Lee
- Department of Clinical Oncology, Queen Mary Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
- Department of Clinical Oncology, Tuen Mun Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
- Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore
| | - Ian Chi Kei Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, China
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
| | - Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Ito S, Kobayashi K, Chin K, Umezawa S, Yamamoto H, Nakano S, Takada N, Hatori N, Tamura K. The impact of the first announced state of emergency owing to coronavirus disease-2019 on stress and blood pressure levels among patients with type 2 diabetes mellitus in Japan. J Diabetes Investig 2022; 13:1607-1616. [PMID: 35437922 PMCID: PMC9114982 DOI: 10.1111/jdi.13813] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/31/2022] [Accepted: 04/18/2022] [Indexed: 12/15/2022] Open
Abstract
Aims/Introduction After the first coronavirus disease 2019 state of emergency announcement, there was an increase in stress that might have affected the self‐management of patients with type 2 diabetes mellitus. This study identified the changes in clinical findings and stress among patients with type 2 diabetes mellitus, and investigated the characteristics of patients who experienced an increase in blood pressure (BP) after the announcement. Materials and Methods Retrospectively, we scrutinized 310 patients with type 2 diabetes mellitus who were treated by the Sagamihara Physicians Association. After the announcement, 164 and 146 patients showed an increase (ΔBP >0 group) and decrease in BP (ΔBP ≤0 group), respectively. The propensity score matching method was used to compare the differences in clinical findings and stress‐related questionnaire responses between the two groups. Results After the announcement, 47% of patients experienced an increase in daily stress. Furthermore, 17% and 36% reported worsening dietary intake and a decrease in exercise, respectively. More patients reported that their dietary and salt intake had worsened in the ΔBP >0 group than in the ΔBP ≤0 group (9% vs 20%, P = 0.02, and 3% vs 10%, P = 0.04, respectively). Additionally, both systolic and diastolic BP measured in the office were significantly increased (P = 0.02 and P = 0.03, respectively); however, systolic BP measured at home significantly decreased (P = 0.01). The total stress scores were higher in the ΔBP >0 group than in the ΔBP ≤0 group (0.05 ± 2.61 and 0.93 ± 2.70, respectively, P = 0.03). Conclusions An increase in stress and, particularly, worsening dietary and salt intake were noted among patients with type 2 diabetes mellitus who experienced an increase in BP after the state of emergency announcement.
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Affiliation(s)
- Shun Ito
- Sagamihara Physicians Association, Sagamihara, Japan
| | - Kazuo Kobayashi
- Sagamihara Physicians Association, Sagamihara, Japan.,Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Keiichi Chin
- Sagamihara Physicians Association, Sagamihara, Japan
| | | | | | - Shiro Nakano
- Sagamihara Physicians Association, Sagamihara, Japan
| | | | - Nobuo Hatori
- Department of Cardiology, Kobayashi Hospital, Odawara, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
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Cummings C, Seng K, Tweet R, Wagner J. Lifestyles Under Lockdown: A Scoping Review of International Studies on Type 2 Diabetes Self-Management Behaviors During COVID-19. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:830353. [PMID: 36992763 PMCID: PMC10012117 DOI: 10.3389/fcdhc.2022.830353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022]
Abstract
Background The effect of the COVID-19 pandemic on diabetes self-management behaviors is unclear. Objectives This paper is a scoping review of studies examining health behaviors among people with type 2 diabetes during the COVID-19 pandemic. Eligibility Criteria We searched articles available in English using the Search terms "COVID" and "diabetes", and, separately, each of the following terms: "lifestyle", "health behavior", "self-care", "self-management", "adherence", "compliance", "eating", "diet", "physical activity", "exercise", "sleep", "self-monitoring of blood glucose", or "continuous glucose monitoring". Sources of Evidence We searched PubMed, PsychInfo, and Google Scholar databases from December 2019 through August 2021. Charting Methods Data were extracted by 4 calibrated reviewers and study elements were charted. Results The search identified 1,710 articles. After screening for relevance and eligibility, 24 articles were included in this review. Findings show the strongest evidence for reduced physical activity and stable glucose monitoring and substance use. There was equivocal evidence for deleterious changes in sleep, diet, and medication intake. With one minor exception, there was no evidence for favorable changes in health behaviors. Limitations of the literature include small samples, predominantly cross-sectional study designs, reliance on retrospective self-reports, sampling through social media, and few standardized measures. Conclusions Early studies of health behaviors among people with type 2 diabetes during the COVID-19 pandemic suggest a need for novel interventions to support diabetes self-management, especially targeting physical activity. Future studies should go beyond documenting changes in health behaviors and examine predictors of change over time.
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Affiliation(s)
- Caroline Cummings
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States
| | - Kagnica Seng
- Department of Psychological Sciences, Central Connecticut State University, New Britain, CT, United States
| | - Ryan Tweet
- Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, School of Medicine, Portland, OR, United States
| | - Julie Wagner
- Division of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine and Department of Psychiatry, School of Medicine, Farmington, CT, United States
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McGee SA, Barnum M, Nesbit RD. The Epidemiology of Necrotizing Fasciitis at a Rural Level 1 Trauma Center During the COVID-19 Pandemic. Am Surg 2022:31348221074251. [PMID: 35128968 PMCID: PMC8819579 DOI: 10.1177/00031348221074251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The impact of the COVID-19 pandemic on non‐COVID-19 pathologies has been experienced worldwide. While people appropriately avoided social interactions, many also avoided essential medical care for acute and chronic conditions. This delay in seeking care has been associated with increased morbidity and mortality in several conditions, including life-threatening infections such as necrotizing fasciitis. Methods We retrospectively reviewed the records of patients that presented to the University of Vermont Medical Center for necrotizing fasciitis during the 1-year period following the declaration of a global pandemic on March 11, 2020. We subsequently compared this data with that of the previous 4 years. Results During the period of March 12, 2020 to March 12, 2021, there were 17 cases of newly diagnosed necrotizing fasciitis. Compared with an average per year of 8 cases over the previous 4 years, this represents a 113% percent increase in cases of necrotizing fasciitis during the study period ( P = .071861). Out of the 17 cases, 4 patients died during their admission, producing a case-fatality rate of 23.5%. This represents a statistically significant increase from previous years ( P = .003248), where the average case-fatality rate was 6.3%. Conclusion Our study demonstrates a substantial increase in cases of necrotizing fasciitis following the onset of the coronavirus pandemic. A significant increase in the case-fatality rate was also observed. Given the growing body of literature describing the negative impact of the pandemic on non-COVID-19 morbidity and mortality, our study posits necrotizing fasciitis as one of many affected pathologies. Level of Evidence Level IV. Epidemiological
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Affiliation(s)
- Shayan A. McGee
- Larner College of Medicine at the University of Vermont, Colchester, VT, USA
| | - Michael Barnum
- Larner College of Medicine at the University of Vermont, Colchester, VT, USA
| | - Robert D. Nesbit
- Larner College of Medicine at the University of Vermont, Colchester, VT, USA
- Departments of Plastic and Reconstructive Surgery, University of Vermont Medical Center, Burlington, VT, USA
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Maruo Y, Irie Y, Obata Y, Takayama K, Yamaguchi H, Kosugi M, Hazama Y, Yasuda T. Medium-term Influence of the Coronavirus Disease 2019 Pandemic on Patients with Diabetes: A Single-center Cross-sectional Study. Intern Med 2022; 61:303-311. [PMID: 34803093 PMCID: PMC8866774 DOI: 10.2169/internalmedicine.8010-21] [Citation(s) in RCA: 3] [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] [Indexed: 11/06/2022] Open
Abstract
Objective This study evaluated the lifestyle changes in patients with diabetes and their independent associations with glycemic and body weight control. In addition, the correlation between changes in mental health and lifestyles was evaluated. Methods This single-center cross-sectional study included 340 patients with diabetes who periodically visited our department. Changes in dietary habits, activities of daily living, and mental health before and during approximately six months after the onset of the coronavirus disease 2019 (COVID-19) pandemic were evaluated using a questionnaire, including the International Physical Activity Questionnaire-Short Form. Results Approximately 20%, 30%, and over 50% of patients had worsened dietary habits, decreased activities of daily living, and deteriorated mental health, respectively. A multiple regression analysis showed that irregular meal timing was significantly associated with change in HbA1c (β=0.328, p=0.001), and decreased walking time was significantly associated with changes in body weight (β=-0.245, p=0.025). The change in fear and anxiety was positively associated with changes in meal timing regularity (r=0.129, p=0.019) and carbohydrate consumption (r=0.127, p=0.021). Subsequently, the change in depressed mood was positively associated with changes in carbohydrate (r=0.142, p=0.010) and alcohol (r=0.161, p=0.037) consumption, and the change in psychological stress was positively associated with changes in carbohydrates (r=0.183, p=0.001) and snack (r=0.151, p=0.008) consumption as well as sedentary time (r=0.158, p=0.004). Conclusion The COVID-19 pandemic has had a considerable medium-term impact on the lifestyle and mental health of patients with diabetes. Lifestyle changes were associated with glycemic and body weight control, and mental health changes were associated with lifestyle changes. These findings may provide important information on diabetes care during the pandemic.
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Affiliation(s)
- Yumiko Maruo
- Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
| | - Yoko Irie
- Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
| | - Yoshinari Obata
- Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
| | - Kana Takayama
- Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
| | - Hiroki Yamaguchi
- Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
| | - Motohiro Kosugi
- Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
| | - Yoji Hazama
- Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
| | - Tetsuyuki Yasuda
- Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
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Takahara M, Watanabe H, Shiraiwa T, Maeno Y, Yamamoto K, Shiraiwa Y, Yoshida Y, Nishioka N, Katakami N, Shimomura I. Lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 pandemic in Japan. J Diabetes Investig 2022; 13:375-385. [PMID: 33768726 PMCID: PMC8250997 DOI: 10.1111/jdi.13555] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/16/2021] [Accepted: 03/23/2021] [Indexed: 12/31/2022] Open
Abstract
AIMS/INTRODUCTION This study aimed to reveal lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Japan. MATERIALS AND METHODS We retrospectively analyzed 1,402 outpatients with diabetes at a clinic in Osaka, Japan, who responded to an interview sheet regarding lifestyle changes during the COVID-19 pandemic between 28 March and 30 May 2020. The association of lifestyle changes with hemoglobin A1c (HbA1c) and weight changes from February to May 2020 was investigated using the linear regression model. We also investigated the association with clinically important change of HbA1c (by ≥0.3%) and bodyweight (by ≥3%), using the cumulative link model. RESULTS Leisure time and other outside physical activities were decreased in one-quarter of patients during the COVID-19 pandemic, whereas the amount of meals and snacks was decreased and increased in approximately 10%, respectively. The change in leisure time physical activities was inversely associated with HbA1c and weight changes, whereas the quantitative change of meals with the decline in eating out and that of snacks were positively associated with HbA1c and weight changes (all P < 0.05). The quantitative change of meals without the decline in eating out was also positively associated with weight change (P = 0.012). The cumulative link model for clinically important HbA1c and weight change showed broadly similar associations, except for that between snacks and bodyweight (P = 0.15). CONCLUSIONS A considerable number of outpatients with diabetes experienced lifestyle changes during the COVID-19 pandemic. The lifestyle changes were associated with HbA1c and weight changes.
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Affiliation(s)
- Mitsuyoshi Takahara
- Department of Diabetes Care MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Hirotaka Watanabe
- Department of Metabolic MedicineOsaka University Graduate School of MedicineSuitaJapan
| | | | | | | | | | | | | | - Naoto Katakami
- Department of Metabolic MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Iichiro Shimomura
- Department of Metabolic MedicineOsaka University Graduate School of MedicineSuitaJapan
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Terakawa A, Bouchi R, Kodani N, Hisatake T, Sugiyama T, Matsumoto M, Ihana-Sugiyama N, Ohsugi M, Ueki K, Kajio H. Living and working environments are important determinants of glycemic control in patients with diabetes during the COVID-19 pandemic: a retrospective observational study. J Diabetes Investig 2022; 13:1094-1104. [PMID: 35088564 PMCID: PMC9153838 DOI: 10.1111/jdi.13758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/09/2022] [Accepted: 01/24/2022] [Indexed: 11/26/2022] Open
Abstract
AIM To investigate 1) the association of lifestyle changes and living and working conditions with glycemic control and 2) whether treatment was intensified appropriately in diabetes patients under the first COVID-19 state of emergency in Japan. MATERIALS AND METHODS A total of 321 participants were included. Participants completed a questionnaire regarding lifestyle changes, including diet, physical activity, and living and working conditions during the COVID-19 pandemic. We estimated the change in hemoglobin A1c (HbA1c) levels between before (from June 1, 2019, to August 31, 2019) and during (from June 1, 2020, to August 31, 2020) the pandemic. Factors associated with changes in HbA1c levels were examined by multiple linear regression analysis. Proportion of patients who received treatment intensification for diabetes was compared between before and during the pandemic. RESULTS There was no significant change in HbA1c levels between before and during the pandemic (7.13 ± 0.98% versus 7.18 ± 1.01%, P=0.186). Teleworking (estimate 0.206, P=0.004) and living with a dog (estimate -0.149, P=0.038) were significantly associated with changes in HbA1c levels after adjusting for covariates. There was no significant difference in the proportion of patients who received treatment intensification for diabetes between during the pandemic and before the pandemic in either the elderly or non-elderly patients. CONCLUSIONS Overall glycemic control did not worsen during the pandemic. Nonetheless, environmental factors, including telework, were found to influence glycemic control in diabetes patients. Further studies are needed to clarify whether the COVID-19 pandemic could affect treatment intensification for diabetes.
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Affiliation(s)
- Aiko Terakawa
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryotaro Bouchi
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kodani
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomoko Hisatake
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Medical corporation Rikkuikai Tokyo, Japan
| | - Takehiro Sugiyama
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Public Health/Health Policy, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Michihiro Matsumoto
- Department of Molecular Metabolic Regulation, Diabetes Research Center, Research Institute national Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Ihana-Sugiyama
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuru Ohsugi
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kohjiro Ueki
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Kajio
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
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Ojo O, Wang XH, Ojo OO, Orjih E, Pavithran N, Adegboye ARA, Feng QQ, McCrone P. The Effects of COVID-19 Lockdown on Glycaemic Control and Lipid Profile in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031095. [PMID: 35162117 PMCID: PMC8834313 DOI: 10.3390/ijerph19031095] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 01/08/2023]
Abstract
The impact of the COVID-19 lockdown on glycaemic control and other metabolic parameters in patients with type 2 diabetes is still evolving. Aim: This systematic review and meta-analysis aims to examine the effects of COVID-19 lockdown on glycaemic control and lipid profile in patients with type 2 diabetes. Methods: The PRISMA framework was the method used to conduct the systematic review and meta-analysis, and the search strategy was based on the population, intervention, control and outcome (PICO) model. The Health Sciences Research databases was accessed via EBSCO-host, and EMBASE were searched for relevant articles. Searches were conducted from inception of the databases until 17 September 2021. Results: The results identified three distinct areas: glycaemic control, lipid parameters and body mass index. It was found that COVID-19 lockdown led to a significant (p < 0.01) increase in the levels of glycated haemoglobin (%) compared with pre-COVID group (gp) with a mean difference of 0.34 (95% CI: 0.30, 0.38). Eleven studies contributed to the data for glycated haemoglobin analysis with a total of 16,895 participants (post-COVID-19 lockdown gp, n = 8417; pre-COVID gp, n = 8478). The meta-analysis of fasting plasma glucose (mg/dL) also showed a significant (p < 0.05) increase in levels of post-COVID-19 lockdown gp compared with pre-COVID gp, with a mean difference of 7.19 (95% CI: 5.28, 9.10). Six studies contributed to fasting plasma glucose analysis involving a total of 2327 participants (post-COVID-19 lockdown, n = 1159; pre-COVID gp, n = 1168). The body mass index (BMI) (kg/m2) analysis also demonstrated that post-COVID-19 lockdown gp had a significantly (p < 0.05) higher BMI than the pre-COVID gp with a mean difference of 1.13 (95% CI: 0.99; 1.28), involving six studies and a total of 2363 participants (post-COVID-19 lockdown gp, n = 1186; pre-COVID gp, n = 1177). There were significantly (p < 0.05) lower levels of total cholesterol (mmol/L), triglyceride (mmol/L) and LDL cholesterol (mmol/L), and higher levels of HDL cholesterol (mg/dL) in the post-COVID-19 lockdown gp compared with pre-COVID gp, although these results were not consistent following sensitivity analysis. Conclusion: The findings of the systematic review and meta-analysis have demonstrated that COVID-19 lockdown resulted in a significant increase (p < 0.05) in the levels of glycated haemoglobin, fasting glucose and body mass index in patients with type 2 diabetes. In contrast, the effect of the lockdown on lipid parameters, including total cholesterol, triglycerides, LDL and HDL cholesterol was not consistent.
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Affiliation(s)
- Omorogieva Ojo
- School of Health Sciences, Faculty of Education, Health and Human Sciences, Avery Hill Campus, University of Greenwich, Avery Hill Road, London SE9 2UG, UK;
- Correspondence:
| | - Xiao-Hua Wang
- The School of Nursing, Soochow University, Suzhou 215006, China; (X.-H.W.); (Q.-Q.F.)
| | - Osarhumwese Osaretin Ojo
- Smoking Cessation Department, University Hospital, South London and Maudsley NHS Foundation Trust, Lewisham High Street, London SE13 6LH, UK;
| | - Edith Orjih
- Diabetes and Endocrine Department, Darent Valley Hospital, Dartford & Gravesham NHS Trust, Dartford DA2 8DA, UK;
| | - Nivedita Pavithran
- Department of Clinical Nutrition, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, India;
| | - Amanda Rodrigues Amorim Adegboye
- Centre for Healthcare Research, School of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK;
| | - Qian-Qian Feng
- The School of Nursing, Soochow University, Suzhou 215006, China; (X.-H.W.); (Q.-Q.F.)
| | - Paul McCrone
- School of Health Sciences, Faculty of Education, Health and Human Sciences, Avery Hill Campus, University of Greenwich, Avery Hill Road, London SE9 2UG, UK;
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Carino M, Quill Z, Gabbs M, Sellers E, Hamilton J, Pinto T, Jetha M, Ho J, Alecio OG, Dart A, Wicklow B. The impact of the COVID-19 pandemic on adolescents and young adults living with type 2 diabetes. Can J Diabetes 2022; 46:404-410. [PMID: 35484051 PMCID: PMC8801385 DOI: 10.1016/j.jcjd.2022.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/16/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Abstract
Objectives The aim of this study was to assess the impacts of the COVID-19 pandemic on adolescents and young adults living with type 2 diabetes (T2D) involved in the national Improving Renal Complications in Adolescents with T2D through REsearch (iCARE) study. Methods The Environmental influences on Child Health Outcomes (ECHO) COVID-19 Questionnaire developed by the National Institutes of Health ECHO COVID-19 Task Force was administered to participants (n=85) from the iCARE study between June 2020 and October 2020. Children 12 years old (via parent report) and adolescents and young adults ≥13 years old (via self-report) participated. The questionnaire assessed the impact of the pandemic on health-care appointments, lifestyle, internet use, social connections and mental health. Results Participants were 17.0±3.1 (range, 12 to 27) years of age and predominantly female (61.3%). During the pandemic, 69.4% were able to attend their health-care appointments by telephone or virtual platforms, 31.7% ate more, 45.1% slept more and 29.3% spent less time on physical activities. There was an increase in internet use for both educational (42.0%) and noneducational purposes (54.9%). Participants felt less socially connected (64.6%). Participants also felt sometimes (59.2%), often (19.7%) and very often (6.7%) satisfied with their lives. Discussion Our study revealed that the COVID-19 pandemic has had various impacts on the daily lives of adolescents and young adults living with T2D. Future research should include longitudinal studies of the health burden of the COVID-19 pandemic on this population, with a more in-depth evaluation of mental health outcomes and clinical outcomes.
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Affiliation(s)
- Marylin Carino
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Zoe Quill
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Melissa Gabbs
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth Sellers
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jill Hamilton
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Teresa Pinto
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mary Jetha
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Josephine Ho
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Allison Dart
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Brandy Wicklow
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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Endo K, Miki T, Itoh T, Kubo H, Ito R, Ohno K, Hotta H, Kato N, Matsumoto T, Kitamura A, Tamayama M, Wataya T, Yamaya A, Ishikawa R, Ooiwa H. Impact of the COVID-19 Pandemic on Glycemic Control and Blood Pressure Control in Patients with Diabetes in Japan. Intern Med 2022; 61:37-48. [PMID: 34980759 PMCID: PMC8810256 DOI: 10.2169/internalmedicine.8041-21] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective In this study, we investigated whether and how the COVID-19 pandemic affected glycemic control and blood pressure (BP) control in patients with diabetes mellitus (DM). Methods DM patients whose HbA1c level was measured regularly before and after the declaration of a state of emergency were included in this study. Some patients were given questionnaires about changes in their lifestyle to determine the factors affecting glycemic control and BP control. Results The median HbA1c level of the 804 patients increased significantly from 6.8% before the state of emergency to 7.1% and 7.0% during and after the state of emergency, respectively. This was in contrast to the decrease one year earlier due to seasonal variations. In the 176 patients who responded to the questionnaire, the HbA1c level also increased significantly during and after the state of emergency. The worsening of glycemic control was more pronounced in the group that had achieved HbA1c of <7% before the state of emergency than in those with higher values. Unlike the rise in HbA1c, the BP did not rise during the state of emergency but did rise significantly afterwards. There was no marked decrease in HbA1c or BP after the state of emergency, even in patients who responded that they were much more careful with their diet, ate less, or exercised more. Conclusions The COVID-19 pandemic worsened glycemic control and BP control, even in patients who perceived no marked change in their diet or exercise, suggesting that more active lifestyle guidance is necessary for good treatment of DM patients.
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Affiliation(s)
- Keisuke Endo
- Department of Cardiology and Diabetes, Oji General Hospital, Japan
| | - Takayuki Miki
- Department of Cardiology and Diabetes, Oji General Hospital, Japan
| | - Takahito Itoh
- Department of Cardiology and Diabetes, Oji General Hospital, Japan
| | - Hirofumi Kubo
- Medical Record Administration Center, Oji General Hospital, Japan
| | - Ryosuke Ito
- Department of Cardiology and Diabetes, Oji General Hospital, Japan
| | - Kouhei Ohno
- Department of Cardiology and Diabetes, Oji General Hospital, Japan
| | - Hiroyuki Hotta
- Department of Cardiology and Diabetes, Oji General Hospital, Japan
| | - Nobuo Kato
- Department of Cardiology and Diabetes, Oji General Hospital, Japan
| | | | - Aya Kitamura
- Internal Medicine Outpatient Clinic, Oji General Hospital, Japan
| | - Mai Tamayama
- Internal Medicine Outpatient Clinic, Oji General Hospital, Japan
| | - Takako Wataya
- Internal Medicine Outpatient Clinic, Oji General Hospital, Japan
| | - Ayaka Yamaya
- Internal Medicine Outpatient Clinic, Oji General Hospital, Japan
| | - Rei Ishikawa
- Medical Record Administration Center, Oji General Hospital, Japan
| | - Hitoshi Ooiwa
- Department of Cardiology and Diabetes, Oji General Hospital, Japan
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41
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Hamaguchi M, Nojiri T, Okamura T, Hashimoto Y, Hanai A, Narisawa S, Ushigome E, Nakanishi N, Fukui M. Status of online diet management program users in Japan during the 2020 Coronavirus disease 2019 pandemic. J Clin Biochem Nutr 2021; 69:305-310. [PMID: 34857994 PMCID: PMC8611371 DOI: 10.3164/jcbn.21-31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/30/2021] [Indexed: 12/15/2022] Open
Abstract
The spread of coronavirus disease 2019 (COVID-19) has led to drastic changes in people’s lifestyles, including teleworking and restrictions on socializing. In the context of observing social distancing for preventing infection, the need to maintain fitness and health has attracted particular attention. We aimed to determine the relationship between the increase in the number of active users of online diet management applications and COVID-19 infection rates in Japan. A total of 1.5 million rows of log data was analyzed. The active number of users of online diet management applications increased with increase in the number of COVID-19 infections. The active user number in Kanagawa Prefecture, where the first cases of COVID-19 were reported in Japan, was particularly high. Moreover, there was a significant increase in the user number in prefectures under a state of emergency when compared to that in prefectures not under a state of emergency. The social anxiety caused by COVID-19 is expected to increase the demand for online health management applications further. The use of such programs can aid in achieving social distancing while enabling users to maintain healthy lifestyles.
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Affiliation(s)
- Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tetsuya Nojiri
- Oishi Kenko Incorporated, &WORK NINGYOCHO, 6-4 Nihonbashi Tomizawa-cho, Chuo-ku, Tokyo 103-0006, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Akiyoshi Hanai
- Oishi Kenko Incorporated, &WORK NINGYOCHO, 6-4 Nihonbashi Tomizawa-cho, Chuo-ku, Tokyo 103-0006, Japan
| | - Shota Narisawa
- Oishi Kenko Incorporated, &WORK NINGYOCHO, 6-4 Nihonbashi Tomizawa-cho, Chuo-ku, Tokyo 103-0006, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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42
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Silverii GA, Delli Poggi C, Dicembrini I, Monami M, Mannucci E. Glucose control in diabetes during home confinement for the first pandemic wave of COVID-19: a meta-analysis of observational studies. Acta Diabetol 2021; 58:1603-1611. [PMID: 34159476 PMCID: PMC8219181 DOI: 10.1007/s00592-021-01754-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 05/29/2021] [Indexed: 02/06/2023]
Abstract
AIM To assess the effect on glycaemic control of confinement due to lockdown measures, during COVID-19 pandemic, in people with type 1 (T1DM) and type 2 (T2DM) diabetes. METHODS Meta-analysis of observational studies reporting measures of glucose control and variability before and during and/or after periods of confinement caused by COVID-19 in 2020 and/or 2021. RESULTS We included 27 studies on T1DM. No significant change in Hba1c was observed after lockdown (WMD - 1.474 [- 3.26; 0.31] mmol/mol, I2 = 93.9). TIR significantly increased during and after lockdown (WMD: 2.73 1.47; 4.23 %, I2 = 81% and 3.73 [1.13; 5.33] %, I2 = 85%, respectively).We retrieved nine studies on T2DM patients. No significant variation in HbA1c was detected (WMD - 1.257 - 3.91; 1.39 mmol/mol, I2 = 98.3%). HbA1c had a more favourable trend in studies performed in Asia than in Europe (p = 0.022 between groups). CONCLUSION Lockdown showed no significant detrimental effect on HbA1c in either T1DM or T2DM. Conversely, home confinement led to a reduction in mean glucose and glucose variability in T1DM, although with a high heterogeneity of results.
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Affiliation(s)
- Giovanni Antonio Silverii
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
| | - Chiara Delli Poggi
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Ilaria Dicembrini
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Matteo Monami
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Edoardo Mannucci
- Diabetes Unit, Experimental and Clinical Biomedical Sciences "Mario Serio" Department, AOU Careggi Hospital, University of Florence, Largo Brambilla 3, 50134, Florence, Italy
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Knight RL, McNarry MA, Sheeran L, Runacres AW, Thatcher R, Shelley J, Mackintosh KA. Moving Forward: Understanding Correlates of Physical Activity and Sedentary Behaviour during COVID-19-An Integrative Review and Socioecological Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10910. [PMID: 34682653 PMCID: PMC8535281 DOI: 10.3390/ijerph182010910] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 12/13/2022]
Abstract
Population-level physical activity (PA) and sedentary time/behaviour estimates represent a significant public health issue exacerbated by restrictions enforced to control COVID-19. This integrative review interrogated available literature to explore the pandemic's impact on correlates of such behaviours in adults (≥18 years). Five electronic databases were systematically searched in January 2021. Data extracted from 64 articles were assessed for risk-of-bias using the Mixed Methods Assessment Tool, with correlates identified, coded, and themed via thematic analysis. A socioecological model of during-pandemic PA was conceptualized and mapped to the Capability, Opportunity, Motivation, and Behaviour (COM-B) model of behaviour change mechanisms, which illustrates influences over five levels: Individual (biological)-general health; Individual (psychological)-mental health, cognition, motivation, and behaviour; Social-domestic situation, sociodemographic factors, support, and lifestyle choices; Environmental-resources and area of residence; and Policy-COVID-19-related rules. For sedentary time/behaviour, individual level factors, namely general and mental health, may be important correlates. Neither age or sex were clearly correlated with either behaviour. As we transition into a new normal, understanding which behaviour mechanisms could effectively challenge physical inactivity is essential. Targeting capability on a psychological level may facilitate PA and limit sedentary time/behaviour, whereas, on a physical level, maximizing PA opportunities could be crucial.
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Affiliation(s)
- Rachel L. Knight
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea SA1 8EN, UK; (R.L.K.); (M.A.M.); (A.W.R.); (J.S.)
| | - Melitta A. McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea SA1 8EN, UK; (R.L.K.); (M.A.M.); (A.W.R.); (J.S.)
| | - Liba Sheeran
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff CF14 4EP, UK;
- Biomechanics and Bioengineering Research Centre Versus Arthritis, Cardiff University, Cardiff CF10 3AX, UK
| | - Adam W. Runacres
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea SA1 8EN, UK; (R.L.K.); (M.A.M.); (A.W.R.); (J.S.)
| | - Rhys Thatcher
- Institute of Biological Environmental and Rural Sciences, Aberystwyth University, Aberystwyth SY23 3FL, UK;
| | - James Shelley
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea SA1 8EN, UK; (R.L.K.); (M.A.M.); (A.W.R.); (J.S.)
| | - Kelly A. Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea SA1 8EN, UK; (R.L.K.); (M.A.M.); (A.W.R.); (J.S.)
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Lim S, Kong APS, Tuomilehto J. Influence of COVID-19 pandemic and related quarantine procedures on metabolic risk. Prim Care Diabetes 2021; 15:745-750. [PMID: 34312109 PMCID: PMC8286866 DOI: 10.1016/j.pcd.2021.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/11/2021] [Accepted: 07/15/2021] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has changed the lives of many people across the globe. In addition to the effect of the virus on the biological functions in those infected individuals, many countries have launched government policy with additional impact of these quarantine procedures on the metabolic health of many people worldwide. This mini-review aimed to highlight current evidence regarding the influence of metabolic health due to these quarantine procedures including decrease in physical activity, changes in unhealthy eating habits, increase in stress, and provide recommendations of healthy lifestyle during COVID-19 pandemic.
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Affiliation(s)
- Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Alice Pik-Shan Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
| | - Jaakko Tuomilehto
- Department of Public Health, University of Helsinki, Helsinki, Finland; Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
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45
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Shin SM, Oh TJ, Choi SH, Jang HC. Effects of Social Distancing on Diabetes Management in Older Adults during COVID-19 Pandemic. Diabetes Metab J 2021; 45:765-772. [PMID: 34461683 PMCID: PMC8497936 DOI: 10.4093/dmj.2021.0096] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/14/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND On March 22, 2020, intense social distancing (SD) was implemented in Korea to prevent the spread of coronavirus disease 19 (COVID-19). This study examined the impact of SD on diabetes control in older adults with diabetes. METHODS Adults aged 60 to 90 years with type 2 diabetes mellitus who were physically and mentally independent were recruited. Participants who had complete blood chemistry data from April to July 2019 (pre-SD era) and April to July 2020 (SD era) were enrolled. Data were obtained about physical activity, nutrition, sarcopenia, and psychological and mental health from questionnaires in April to July 2020. Calf circumference was measured. RESULTS In total, 246 people (100 men, 146 women; mean age, 73.8±5.7 years) participated in this study. The levels of glycated hemoglobin (HbA1c, 7.4%±1.0% vs. 7.1%±0.8%, P<0.001), fasting glucose (142.2±16.7 mg/dL vs. 132.0±27.7 mg/dL, P<0.001), and body weight (62.6±9.4 kg vs. 61.8±10.1 kg, P<0.01) were higher in the SD era than in the pre-SD era. Total physical activity was lower in the SD era (2,584.6±2,624.1 MET-min/week-1 vs. 1,987.3±2,295.0 MET-min/week-1, P<0.001). A larger increase in HbA1c level was associated with increased body weight and decreased physical activity. CONCLUSION SD had negative effects on diabetes management in older adults with diabetes. Fasting glucose and HbA1c levels and body weight increased during the SD era. Participants with reduced physical activity gained more weight and had higher blood glucose levels. Given that the COVID-19 pandemic is ongoing, health professionals and diabetes educators should monitor changes in lifestyle factors in older adults with diabetes.
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Affiliation(s)
- Soo Myoung Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Corresponding author: Hak Chul Jang https://orcid.org/0000-0002-4188-6536 Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea E-mail:
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Binhardi BA, de Souza Teixeira CR, de Almeida-Pititto B, Barbosa-Junior F, Franco LJ, de Melo KFS, Malerbi DAC, de Oliveira REM. Diabetes self-care practices and resilience in the Brazilian COVID-19 pandemic: results of a web survey: DIABETESvid. Diabetol Metab Syndr 2021; 13:87. [PMID: 34412660 PMCID: PMC8374417 DOI: 10.1186/s13098-021-00706-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/10/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The world guidance on the measures of social distancing for prevention of COVID-19 has changed the daily habits of great part of the population, and this could influence the care and resilience with diabetes during situations of adversity. This study aimed at assessing the characteristics of diabetic individuals and self-care practices and resilience with diabetes in the context of the COVID-19 pandemic in Brazil. METHODS This is a cross-sectional web survey study carried out among adults with diabetes, in which a structured 43-item questionnaire was conducted on the REDCap plataform, including the Diabetes Self-Care Activities Questionnaire and Connor-Davidson Resilience Scale, to measure socio-demographic and clinical characteristics. The web survey was disseminated through the main social media and data were collected from September 1st to October 19th, 2020. Data analysis was performed according to type of diabetes mellitus (DM) and at a significance level of 5% (p < 0.05). RESULTS Of the 1633 participants, 67.5% were women, 43.2% aged between 35 and 59 years old, 68.0% lived in the south-eastern region of Brazil, 57.1% had a high education level, 49% reported to have DM1 and 140 participants reported to have had COVID-19. Diabetes care mostly involved the use of medications (93%), whereas the least used ones were physical activity (24.6%) and examination of the shoes (35.7%). About 40% of the participants reported to be followed up by telemedicine, 61.5% monitored the glycaemic levels, 61.2% followed a healthy diet and 43.4% left home only to go to the supermarket and drugstore. The mean resilience was 25.4 (SD = 7.7). CONCLUSIONS In Brazil, individuals with diabetes followed social distancing and maintained their medication treatment for DM. However, practice of physical activity and foot examination was little followed by the participants, who also had a low level of resilience. These findings showed the importance of patient follow-up in the healthcare services, meaning that telemedicine should be improved and support provided for adaptation in view of the therapeutic setbacks.
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Affiliation(s)
- Bárbara Aparecida Binhardi
- University of São Paulo, Ribeirão Preto College of Nursing, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14040-902 Brazil
| | - Carla Regina de Souza Teixeira
- University of São Paulo, Ribeirão Preto College of Nursing, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14040-902 Brazil
| | - Bianca de Almeida-Pititto
- Department of Preventive Medicine, Paulista School of Medicine, Universidade Federal de São Paulo, Rua Botucatu, No. 740, Vila Clementino, São Paulo, SP CEP: 04023-062 Brazil
- Brazilian Diabetes Society (SBD), Rua Afonso Braz, 579, Salas 72/74, Vila Nova Conceição, São Paulo, SP CEP: 04511-011 Brazil
| | - Francisco Barbosa-Junior
- Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14049-900 Brazil
| | - Laercio Joel Franco
- Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14049-900 Brazil
| | - Karla Fabiana Santana de Melo
- Brazilian Diabetes Society (SBD), Rua Afonso Braz, 579, Salas 72/74, Vila Nova Conceição, São Paulo, SP CEP: 04511-011 Brazil
- Faculty of Medicine Clinics Hospital, University of São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 255, Cerqueira César, São Paulo, 05403-000 Brazil
| | | | - Rinaldo Eduardo Machado de Oliveira
- Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14049-900 Brazil
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de Boer DR, Hoekstra F, Huetink KIM, Hoekstra T, Krops LA, Hettinga FJ. Physical Activity, Sedentary Behavior and Well-Being of Adults with Physical Disabilities and/or Chronic Diseases during the First Wave of the COVID-19 Pandemic: A Rapid Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6342. [PMID: 34208156 PMCID: PMC8296179 DOI: 10.3390/ijerph18126342] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022]
Abstract
Background: People with physical disabilities and/or chronic diseases report lower levels of physical activity and well-being than the general population, which potentially is exacerbated through the COVID-19 pandemic. This study explored the international literature on physical activity, sedentary behavior and well-being in adults with physical disabilities and/or chronic diseases during the first wave of the pandemic. Method: In a rapid review, we included studies reporting on physical activity, sedentary behavior and/or well-being in adults with physical disabilities and/or chronic diseases. Four databases (Pubmed, CINAHL, PsycInfo, Embase) were searched for studies published until 30 September 2020. Results: We included twenty-nine studies involving eleven different types of disabilities or health conditions from twenty-one different countries. Twenty-six studies reported on physical activity, of which one reported an increase during the COVID-19 pandemic, four studies reported no difference, and twenty-one studies reported a decrease. Thirteen studies reported a decline in well-being. Only one study measured sedentary behavior, reporting an increase. Conclusion: Despite the variety in methods used, almost all studies reported negative impacts on physical activity and well-being in people with physical disabilities and/or chronic disease during the first wave of the pandemic. These findings highlight the importance of supporting this population, especially in times of crisis.
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Affiliation(s)
- Diederik R. de Boer
- Centre for Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands; (D.R.d.B.); (F.H.); (K.I.M.H.)
| | - Femke Hoekstra
- Centre for Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands; (D.R.d.B.); (F.H.); (K.I.M.H.)
- Faculty of Health and Social Development, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Kimberley I. M. Huetink
- Centre for Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands; (D.R.d.B.); (F.H.); (K.I.M.H.)
| | - Trynke Hoekstra
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Leonie A. Krops
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands;
| | - Florentina J. Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle NE1 8ST, UK
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The effect of COVID-19 pandemic on the lifestyle and glycemic control in patients with type 1 diabetes: a retrospective cohort study. Diabetol Int 2021; 13:85-90. [PMID: 33898153 PMCID: PMC8054854 DOI: 10.1007/s13340-021-00507-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/08/2021] [Indexed: 12/30/2022]
Abstract
Background To investigate the acute effects of coronavirus disease (COVID-19) on lifestyle and metabolic parameters in patients with type 1 diabetes (T1D). Methods This retrospective cohort study included 34 patients who were admitted to our hospital from April 16 to May 1, 2020. Data on stress levels, sleep duration, exercise, total diet, snacks, and prepared food intake were obtained from the questionnaires. Changes in the values of hemoglobin A1c (HbA1c) and body weight from 3 months before the administration of the questionnaire to the time the study questionnaire was administered (pandemic year), and those from 15 months before to 12 months before the administration of the questionnaire (pre-pandemic year) were evaluated. Results Increased stress levels and decreased exercise volumes were observed in approximately 60% and 50% of participants during the COVID-19 pandemic, respectively. Decreased sleep duration was associated with changes in the body weight for 3 months during pandemic year (r = − 0.40, p = 0.043). Furthermore, compared with changes in HbA1c for 3 months during pre-pandemic year, changes in HbA1c during the pandemic year were worse (0.12% [0.33] % during pandemic year vs. − 0.09 [0.39] % during pre-pandemic year, p = 0.027). Conclusions Many patients experienced stress and exercised less due to the COVID-19 pandemic. Glycemic control in patients with T1D was worse than that in the previous year. Since the pandemic is currently ongoing, more attention should be paid to stress and lifestyle factor management in patients with T1D. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-021-00507-4.
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Hasegawa Y, Takahashi F, Hashimoto Y, Munekawa C, Hosomi Y, Okamura T, Okada H, Senmaru T, Nakanishi N, Majima S, Ushigome E, Hamaguchi M, Yamazaki M, Fukui M. Effect of COVID-19 Pandemic on the Change in Skeletal Muscle Mass in Older Patients with Type 2 Diabetes: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084188. [PMID: 33920957 PMCID: PMC8071268 DOI: 10.3390/ijerph18084188] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023]
Abstract
Background: The aim of this study was to investigate the effect of the coronavirus disease (COVID-19) pandemic restrictions on the change in muscle mass in older patients with type 2 diabetes (T2D), who were not infected with COVID-19. Methods: In this retrospective cohort study, data were obtained from outpatients who underwent bioelectrical impedance analysis at least twice before April 2020 and at least once thereafter. Skeletal muscle mass index (SMI, kg/m2) was calculated as appendicular muscle mass (kg) divided by height squared (m2). Change in SMI (kg/m2/year) was calculated as (follow-up SMI-baseline SMI/follow-up period). The differences between the changes in SMI before and after the start of the COVID-19 pandemic were evaluated using paired t test. Results: This study recruited 56 patients, with a mean (SD) age of 75.2 (7.1) years. SMI changed from 6.7 (0.9) to 6.8 (0.9) kg/m2 before the COVID-19 pandemic, whereas SMI changed from 6.8 (0.9) to 6.6 (0.9) kg/m2 after the start of the COVID-19 pandemic. SMI decreased after the start of the COVID-19 pandemic compared with before the pandemic (-0.117 (0.240) vs. 0.005 (0.289) kg/m2/year, p = 0.049). This decrease was observed in men (-0.159 (0.257) vs. 0.031 (0.325) kg/m2/year, p = 0.038), patients with poor glycemic control (-0.170 (0.264) vs. 0.031 (0.285) kg/m2/year, p = 0.042), and those with a long diabetes duration (-0.153 (0.229) vs. 0.082 (0.291) kg/m2, p = 0.049). Conclusions: The COVID-19 pandemic restrictions caused muscle mass loss in older patents with T2D. Actions, including recommendation of exercise and adequate diet intake, are needed to prevent loss of muscle mass.
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Salinas Martínez AM, Gómez Campusano RI, Cordero Franco HF, Chávez Barrón KA, Gutiérrez Sauceda CJ, Guzmán de la Garza FJ, Núñez Rocha GM. Multiple Unhealthy Behaviors Share Equivalent Profiles of Readiness for Change in Patients with Type 2 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073631. [PMID: 33807339 PMCID: PMC8037007 DOI: 10.3390/ijerph18073631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022]
Abstract
Few studies have considered more than one behavior, despite the tendency towards multiple behaviors, and there are none that have focused on a Latino population. We determined the concurrence of four unhealthy behaviors related to glycemic control and identified common cognitive factors at advanced stages of readiness for change in patients with type 2 diabetes treated in primary care. A cross-sectional study was carried out during August–December 2018 in northeastern Mexico. We consecutively included patients between 20 and 70 years who were without medical contraindication, physical impediment against exercise, pregnancy and edentulism, among other selection criteria (n = 407). Stages of behavior were measured according to the Transtheoretical Model. Pros, cons, self-efficacy, susceptibility, and severity data were collected by interview. Statistical analysis consisted of descriptive statistics and multiple logistic regression. A total of 36.7% exhibited more than one unhealthy behavior in precontemplation or contemplation (no interest or some interest in changing consumption of refined sugars and saturated fats, exercise, or oral hygiene behavior). Cons (p < 0.05) and self-efficacy (p < 0.001) were common to all four unhealthy behaviors, independent of potential confounders. Studies like ours facilitate the recognition of individuals with multiple unhealthy behaviors who share equivalent profiles of readiness for change before implementing public health programs.
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Affiliation(s)
- Ana María Salinas Martínez
- School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey 64460, Mexico; (R.I.G.C.); (G.M.N.R.)
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Monterrey 64360, Mexico; (H.F.C.F.); (K.A.C.B.); (C.J.G.S.); (F.J.G.d.l.G.)
- Correspondence: ; Tel.: +52-811098-3303
| | - Ruth Isabel Gómez Campusano
- School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey 64460, Mexico; (R.I.G.C.); (G.M.N.R.)
- School of Dentistry, Faculty of Health Sciences, Universidad Nacional Pedro Henríquez Ureña, Santo Domingo 1423, Dominican Republic
| | - Hid Felizardo Cordero Franco
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Monterrey 64360, Mexico; (H.F.C.F.); (K.A.C.B.); (C.J.G.S.); (F.J.G.d.l.G.)
| | - Karen Abigail Chávez Barrón
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Monterrey 64360, Mexico; (H.F.C.F.); (K.A.C.B.); (C.J.G.S.); (F.J.G.d.l.G.)
| | - Cecilia Janeth Gutiérrez Sauceda
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Monterrey 64360, Mexico; (H.F.C.F.); (K.A.C.B.); (C.J.G.S.); (F.J.G.d.l.G.)
| | - Francisco Javier Guzmán de la Garza
- Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Monterrey 64360, Mexico; (H.F.C.F.); (K.A.C.B.); (C.J.G.S.); (F.J.G.d.l.G.)
- School of Medicine, Autonomous University of Nuevo Leon, Monterrey 64460, Mexico
| | - Georgina Mayela Núñez Rocha
- School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey 64460, Mexico; (R.I.G.C.); (G.M.N.R.)
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