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García-Lara RA, Suleiman-Martos S, Dominguez-Vías G, Romero-Béjar JL, Garcia-Morales V, Gómez-Urquiza JL, Suleiman-Martos N. Impact effects of COVID-19 pandemic on chronic disease patients: A longitudinal prospective study. J Clin Nurs 2024; 33:2226-2236. [PMID: 38476057 DOI: 10.1111/jocn.17104] [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: 01/14/2024] [Revised: 02/11/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024]
Abstract
AIMS To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. DESIGN A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. METHODS Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper. RESULTS A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened. CONCLUSIONS COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. IMPACT Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term.
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Affiliation(s)
- Rubén A García-Lara
- Íllora Health Center, Granada-Metropolitan Health District, Andalusian Health Service, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Spain
| | | | - Germán Dominguez-Vías
- Physiology Department, Ceuta Faculty of Health Sciences, University of Granada, Ceuta, Spain
| | | | - Victoria Garcia-Morales
- Biomedicine, Biotechnology and Public Health Department, Physiology Area, Faculty of Medicine, University of Cádiz, Cádiz, Spain
| | | | - Nora Suleiman-Martos
- Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
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King JK, Kieu A, El-Deyarbi M, Aljneibi N, Al-Shamsi S, Hashim MJ, Östlundh L, King KE, King RH, AB Khan M, Govender RD. Towards a better understanding between non-Muslim primary care clinicians and Muslim patients: A literature review intended to reduce health care inequities in Muslim patients. HEALTH POLICY OPEN 2023; 4:100092. [PMID: 37383881 PMCID: PMC10297732 DOI: 10.1016/j.hpopen.2023.100092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 03/14/2023] [Accepted: 03/19/2023] [Indexed: 04/03/2023] Open
Abstract
Although Muslims are a growing population within many non-Muslim countries, there are insufficient Muslim clinicians to care for them. Studies have shown that non-Muslim clinicians have limited knowledge and understanding of Islamic practices affecting health, which may lead to disparities in the quality of healthcare delivery and outcomes when caring for Muslim patients. Muslims come from many different cultures and ethnicities and have variations in their beliefs and practices. This literature review provides some insights which may strengthen therapeutic bonds between non-Muslim clinicians and their Muslim patients resulting in improved holistic, patient-centered care in the areas of cancer screening, mental health, nutrition, and pharmacotherapy. Additionally, this review informs clinicians about the Islamic perspective on childbirth, end of life issues, travel for Islamic pilgrimage, and fasting during the month of Ramadan. Literature was sourced by a comprehensive search in PubMed, Scopus, and CINAHL along with hand screening of citations. Title and abstract screening followed by full-text screening excluded studies including less than 30% Muslim participants, protocols, or reporting results deemed irrelevant to primary care. 115 papers were selected for inclusion in the literature review. These were grouped into the themes of general spirituality, which were discussed in the Introduction, and Islam and health, Social etiquette, Cancer screening, Diet, Medications and their alternatives, Ramadan, Hajj, Mental health, Organ donation and transplants, and End of life. Summarizing the findings of the review, we conclude that health inequities affecting Muslim patients can be addressed at least in part by improved cultural competency in non-Muslim clinicians, as well as further research into this area.
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Affiliation(s)
- Jeffrey K King
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
- Home Based Primary Care, Division of Extended Care and Geriatrics, Department of Veterans Affairs, Greater Los Angeles area, CA, USA
| | - Alexander Kieu
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
- Kanad Hospital, Al Ain, Abu Dhabi, United Arab Emirates
| | - Marwan El-Deyarbi
- Ambulatory Health Services, Abu Dhabi, United Arab Emirates
- Department of Pharmacology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Noof Aljneibi
- Emirates Center for Happiness Research, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Saif Al-Shamsi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Muhammad Jawad Hashim
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | | | | | - Renee Houjintang King
- Academic Family Medical Center, Ventura County Family Medicine Residency Program, 300 Hillmont Ave, Building 340, Suite 201, Ventura, CA, USA
| | - Moien AB Khan
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
- Primary Care, NHS North West London, London TW3 3EB, United Kingdom
| | - Romona Devi Govender
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
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Alamoudi RM, Aljohani NJ, Alfadhli EM, Alzaman N, Alfadhly AF, Kallash MA, Alshenqete AM, Batais MA, Alharbi M, Ekhzaimy AA, Sheshah E, Ahmedani MY, Buyukbese MA, Shaltout I, Hemaida K, Belkhadir J, Afandi B, Hafidh K, Hussein Z, Elbarbary NS, Hassanein M. Fasting Ramadan in patients with T1DM - Saudi Arabia versus other countries during the COVID-19 pandemic. Diabetes Metab Syndr 2023; 17:102676. [PMID: 36463695 DOI: 10.1016/j.dsx.2022.102676] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/28/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS To compare Saudi Arabia with other countries regarding patient attitudes towards fasting Ramadan and complications related to fasting during the COVID-19 pandemic. METHODS Data collected from Saudi Arabia and 12 other mostly Muslim majority countries, via physician administered questionnaire within post Ramadan 2020. RESULTS 1485 Type1 diabetes (T1DM) patients analyzed; 705 (47.5%) from Saudi Arabia vs. 780 (52.5%) from other countries. 1056 (71.1%) fasted Ramadan; 636 (90.2%) of Saudi patients vs. 420 (53.8%) of other countries. Experiencing Ramadan during the COVID-19 pandemic did not affect the Saudi T1DM patients' decision to fast while it significantly influenced their decision in other countries (1.4 vs 9.9%, P < 0.001). More Saudi patients needed to break the fast due to a diabetes related complication compared to other countries (67.4% vs. 46.8%, p=<0.001). The mean number of days fasted in Saudi and other countries was 24 ± 7 and 23 ± 8 days respectively. Hypoglycemic events were more common among Saudi patients during Ramadan compared to other countries 72% and 43.6% (p < 0.001) respectively. There was a significant difference in timing; the largest peak for Saudi Arabia patients was after dawn (35% vs 7%, p < 0.001), while it was pre-sunset for the other countries (23 vs 54%, p = 0.595). Day time-hyperglycemia was also more common among Saudi patients (48.6% vs. 39%, p < 0.001), however it was a less likely cause to break the fast (25.6% vs 38.3%, p < 0.001). CONCLUSION Observing the fast of Ramadan is extremely common among Saudi T1DM patients compared to other Muslim countries and was not affected by the COVID-19 pandemic. However, it was associated with higher frequency of hypoglycemic and hyperglycemic episodes.
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Affiliation(s)
- Reem M Alamoudi
- Department of Medicine, King Abdulaziz Medical City, King Abdullah International Research Centre, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guards Health Affairs, Jeddah, Saudi Arabia.
| | - Naji J Aljohani
- Obesity, Endocrine and Metabolic Center, King Fahad Medical City, King Abdulaziz Bin Saud University for Health Sciences, Riyadh, Saudi Arabia
| | - Eman M Alfadhli
- Department of Medicine, Medical College, Taibah University, AlMadinah, Saudi Arabia
| | - Naweed Alzaman
- Department of Medicine, Medical College, Taibah University, AlMadinah, Saudi Arabia
| | - Abdulaziz F Alfadhly
- Department of Family Medicine, Prince Mansour Military Hospital, Taif City, Saudi Arabia
| | - Majd-Aldeen Kallash
- Obesity, Endocrine and Metabolic Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Mohammed A Batais
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Aishah A Ekhzaimy
- Department of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Eman Sheshah
- Diabetes Care Center, King Salman Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Muhammad Yakoob Ahmedani
- Department of Medicine, Baqai Institute of Diabetology & Endocrinology, Baqai Medical University, Karachi, Pakistan
| | | | - Inass Shaltout
- Department of Internal Medicine and Diabetes, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Kamel Hemaida
- Glan Clwyd Hospital, Renal and Diabetes, Rhyl, Denbighshire, UK; Alexandria University, Faculty of Medicine, Medical Department, Alexandria, Egypt
| | - Jamal Belkhadir
- Moroccan League for the Fight Against Diabetes, IDF Middle East and North Africa, Morocco
| | | | - Khadija Hafidh
- Diabetes Unit, Rashid Hospital, Dubai Health Authority, Dubai Academic Health Cooperation, United Arab Emirates
| | - Zanariah Hussein
- Department of Internal Medicine, Hospital Putrajaya, Putrajaya, Malaysia
| | | | - Mohamed Hassanein
- Department of Endocrinology and Diabetes, Dubai Hospital, Dubai Academic Health Cooperation, United Arab Emirates
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Gameil MA, Marzouk RE, El-Sebaie AH, Eldeeb AAA. Influence of sodium-glucose Co-transporter 2 inhibitors on clinical and biochemical markers of dehydration during the Holy Ramadan. Diabetes Metab Syndr 2022; 16:102606. [PMID: 36063675 DOI: 10.1016/j.dsx.2022.102606] [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: 06/06/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Alteration of the hydration status with the use of sodium-glucose co-transporter- 2 inhibitors (SGLT2i) during the Holy Ramadan has not been studied in depth. Precisely, we aimed to detect the potential alteration of hydration status in adult Muslims with type 2 diabetes mellitus (T2D) who used SGLT2i during Ramadan. METHODS An observational non-interventional study included 245 patients with type 2 diabetes mellitus of matched age and sex. The study included 3 groups: empagliflozin group; 87 patients, dapagliflozin group; 85 patients and control group; 73 patients without the use of SGLT2i. Participants in each group were well-settled on their medications for more than 3 months before the onset of Ramadan. Clinical and biochemical parameters of hydration status were evaluated during the last week of Ramadan. RESULTS We noticed a higher prevalence of orthostatic dizziness and postural hypotension among SGLT2i users than non-SGLT2i users (p < 0.001). The mean arterial blood pressure was significantly lowered among users of empagliflozin and dapagliflozin than non-SGLT2i users; 93.7 ± 5.1 and 93.1 ± 6.9 versus 106.2 ± 4.3, p < 0.001, respectively. Moreover, patients who used empagliflozin or dapagliflozin exhibited significantly higher values of urine specific gravity; 1029.6 ± 1.5 and 1029.1 ± 1.6 versus 1016.9 ± 4.4, p < 0.001, serum osmolality; 300.7 ± 10.2 and 297.8 ± 8.9 versus 290.9 ± 6.7, p < 0.001, and BUN/creatinine ratio; 24.1 ± 4.1 and 23.2 ± 4.6 versus 16.3 ± 4.2, p < 0.001 than non-SGLT2i users. CONCLUSION Significant clinical and biochemical markers of dehydration were noticed among users of SGLT2i during the Holy Ramadan.
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Affiliation(s)
- Mohammed Ali Gameil
- Internal Medicine, Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
| | - Rehab Elsayed Marzouk
- Lecturer of Medical Biochemistry, Medical Biochemistry Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
| | - Ahmed Hassan El-Sebaie
- Clinical Pathology, Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
| | - Ahmed Ahmed Ahmed Eldeeb
- Internal Medicine, Nephrology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
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Hassanein M, Sahay R, Hasan MI, Hussain A, Mittal V, Mohammed R, Shaikh Z, Farishta F, Mohanasundaram S, Naqvi M, Nair A, Ali Z. A Real-World Observational Study of Gla-300 in Adults with Type 2 Diabetes Who Fast During Ramadan in the South Asia Region: A Subgroup Analysis of the ORION Study. Diabetes Ther 2022; 13:747-759. [PMID: 35286607 PMCID: PMC8991272 DOI: 10.1007/s13300-022-01234-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/14/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION In this ORION study subgroup analysis, the safety and effectiveness of insulin glargine 300 U/mL (Gla-300) was evaluated in people from the South Asia region with type 2 diabetes mellitus (T2DM) before, during, and after Ramadan, in a real-world setting. METHODS The ORION study was a real-world, prospective, observational, non-comparative study conducted across 11 countries. The current subgroup analysis included participants from the South Asia region (India and Pakistan) who fasted during Ramadan. The primary endpoint was the percentage of participants experiencing ≥ 1 event of severe and/or symptomatic documented hypoglycemia with self-monitored plasma glucose (SMPG) ≤ 70 mg/dL during Ramadan. Secondary endpoints analyzed were changes in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), SMPG, insulin dose, and adverse events (AEs). RESULTS This subgroup analysis included 106 participants from the South Asia region with mean (standard deviation) age of 51.3 (10.9) years and mean number of 29.8 (4.0) fasting days. The number of severe and/or symptomatic documented hypoglycemia events was low in the pre-Ramadan (SMPG ≤ 70 mg/dL: 1 event [0.9%]; SMPG < 54 mg/dL: 1 event [0.9%]) and Ramadan periods (SMPG ≤ 70 mg/dL: 1 event [0.9%]; SMPG < 54 mg/dL: 0 events), and none in the post-Ramadan period. One participant reported severe hypoglycemia (any time of the day: nocturnal or daytime) throughout the pre-Ramadan period. A reduction in HbA1c and FPG levels was seen during the pre- to post-Ramadan period; however, a slight increase in SMPG levels was reported during this same period. Gla-300 daily dose was reduced from 21.6 (9.6) U to 20.2 (8.9) U during the pre-Ramadan to Ramadan period. The incidence of AEs was 1.9%. CONCLUSIONS The real-world data from the ORION study indicate that Gla-300 is effective, with low risk of hypoglycemia, for the management of T2DM during Ramadan in the South Asian population. TRIAL REGISTRATION CTRI/2019/02/017636.
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Affiliation(s)
- Mohamed Hassanein
- Dubai Hospital, Dubai Health Authority, 222 Al Khaleej Road, Deira, 7272, Dubai, United Arab Emirates.
| | - Rakesh Sahay
- Osmania Medical College, Hyderabad, 500095, Telangana, India
| | - Mohammad I Hasan
- Diabetics Institute of Pakistan, Jail Road, Lahore, 54000, Pakistan
| | - Arshad Hussain
- North West General Hospital, Hayatabad, Peshawar, 25100, Pakistan
| | - Vinod Mittal
- Delhi Diabetes Care Centre, Sat Nagar, Karol Bagh, Delhi, 110005, India
| | - Riyaz Mohammed
- Esani Diabetes and Multispeciality Center, Surya Nagar Colony, Toli Chowki, Hyderabad, 500008, Telangana, India
| | - Zaman Shaikh
- Sir Syed Hospital, Qayyumabad, Karachi, 75640, Pakistan
| | - Faraz Farishta
- F S Endocrine Centre, Santosh Nagar, Hyderabad, 500059, Telangana, India
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Helal R, Ashraf T, Majeed M, Lessan N. The Effect of Coronavirus Disease-19 Pandemic Lockdown and the Overlapping Ramadan Fasting Period on Glucose Control in Insulin-Treated Patients With Diabetes: A Flash Glucose Monitoring Study. Front Nutr 2022; 9:843938. [PMID: 35433783 PMCID: PMC9008837 DOI: 10.3389/fnut.2022.843938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/11/2022] [Indexed: 12/23/2022] Open
Abstract
Background A strict lockdown was enforced during coronavirus disease (COVID-19) pandemic in many countries including the UAE. Lockdown period overlapped with Ramadan which is accompanied by its own drastic changes in lifestyle that include meal timings. Aims We report the impact of COVID-19 lockdown (between 22/3/2020 and 24/6/2020) on glucose control pre- and postlockdown and during Ramadan, in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D) on insulin therapy. Methods A number of twenty-four patients (19 men, 6 women) who were monitoring their glucose levels using flash glucose monitoring (FGM) and remotely connected to the diabetes clinic in Imperial College London Diabetes Centre (ICLDC), Abu Dhabi, UAE were included. Using the international consensus on the use of continuous glucose monitoring guidelines, analyses of data were performed on glucose management indicator (GMI), time in range (TIR), time in hyperglycemia, time in hypoglycemia, low blood glucose index (LBGI) and high blood glucose index (HBGI). Variables were calculated for each period: 30 days before lockdown 14/2/2020-14/3/2020, 30 days into lockdown and pre-Ramadan 20/3/2020-18/4/2020, and 30 days into lockdown and Ramadan 24/4/2020-23/5/2020, using cgmanalysis package in R-studio software. Results Mean average glucose (MAG) remained steady before and during lockdown, and no significant differences were observed in TIR, time in hypoglycemia, and LBGI between prelockdown and lockdown periods. However, there was a statistically significant difference in GMI and percentage of time in hyperglycemia (>10.0 mmol/L) between Ramadan and pre-Ramadan during the lockdown period in p = 0.007, 0.006, and 0.004, respectively. Percentage of TIR (3.9-10.0 mmol/L) was significantly lower in Ramadan as compared to pre-Ramadan (50.3% vs. 56.1%; p = 0.026). Mean absolute glucose (MAG) (182.0 mmol/L vs. 166.6 mmol/L, p = 0.007) and HBGI (10.2 (6.8, 14.8) vs. 11.9 (7.9, 17.8), p = 0.037) were significantly higher in Ramadan compared to pre-Ramadan period. There was no statistically significant difference in percentage of time in hypoglycemia (<3.9 mmol/L) and LBGI between Ramadan and pre-Ramadan periods. Conclusion The lockdown period had no significant effects in the markers of glycemic control in the population studied. However, Ramadan fasting period embedded within this time was associated with several changes that include increase in GMI, HBGI, and glycemic variability similar to what has been reported in other Ramadan studies.
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Affiliation(s)
| | | | | | - Nader Lessan
- Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates
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Kumari N, Prakash V, Roy SS, Kumar M, Mishra H, Dikshit H. Impact of SARS-CoV-2 Pandemic on Glycaemic Control, Metabolic Status, Treatment Adherence, Quality of Life in Diabetes Mellitus Patients in Tertiary Care Hospital of Eastern India. MAEDICA 2022; 17:88-96. [PMID: 35733731 PMCID: PMC9168569 DOI: 10.26574/maedica.2022.17.1.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction: Many medical and social challenges have been noticed during lockdowns and restrictions in the course of the COVID-19 pandemic. These restrictions had a profound impact on people's lifestyle and caused psychological distress. In the management of type 2 diabetes mellitus, lifestyle modifications, such as nutritional intervention and proper physical activity, are important aspects. Aims/objective:To study the effect of lockdown or self-imposed restrictions due to pandemic on glycaemic control in diabetes mellitus patients and the possible determinants, including diet, sleep, physical activity, psychological status and adherence to treatment. Materials and methods:A comparative analysis of the glycaemic status and metabolic parameters (such as random blood glucose, glycated haemoglobin, weight, hypoglycaemia and lipid profile), lifestyle and psychological changes and treatment adherence was done in 103 patients. Retrospective pre-lockdown data was collected from the clinical records and interviews (offline, online or by telephone). Prospective lockdown/restrictions data was questionnaire based. Chi-square test was used to analyse categorical data and ANOVA for continuous data. Results:The majority of patients were in the age group of 40-60 years. Most of them reported disturbance in their adherence to proper diet, physical activity, sleep and medication schedule. These differences of opinion were statistically significant (p <0.00001). There were more patients who reported stress and anxiety and this difference was statistically significant. Deterioration of glycaemic control and lipid profile was highly significant (p <0.00001). Mean body weight was increased by 6.67% at the end of the study and the difference was statistically significant. Conclusion:In patients with diabetes, pandemic-related restrictions had a profound impact on the glycaemic control, metabolic status, adherence to medication and quality of life. This highlights the need for a multidisciplinary approach in managing patients with diabetes, focusing on various issues, including prevalence of poor diet control, physical inactivity and psychological stress, via various awareness and counselling programs, preferably through online mode.
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Affiliation(s)
- Nidhi Kumari
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Ved Prakash
- Department of Endocrinology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Sukalyan Saha Roy
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Manish Kumar
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Hitesh Mishra
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Harihar Dikshit
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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N Ahmed W. Lockdown and diabetes–what actually happened? JOURNAL OF DIABETES, METABOLIC DISORDERS & CONTROL 2020. [DOI: 10.15406/jdmdc.2020.07.00211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Sankar P, Ahmed WN, Mariam Koshy V, Jacob R, Sasidharan S. Effects of COVID-19 lockdown on type 2 diabetes, lifestyle and psychosocial health: A hospital-based cross-sectional survey from South India. Diabetes Metab Syndr 2020; 14:1815-1819. [PMID: 32956926 PMCID: PMC7485570 DOI: 10.1016/j.dsx.2020.09.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Lockdown during the COVID-19 pandemic imposed many restrictions on the public. Loss of continuum of care along with improper lifestyle was expected to worsen glycemic control in people with type 2 diabetes (T2D). We aimed to identify the effects of lockdown on their glycemic status, lifestyle changes and psychosocial health. METHODS The pre- and post-lockdown data of 110 adults with T2D who were under regular follow up was collected by direct interview during their visit to the diabetes clinic. The variables analyzed included demographic data, HbA1c, body weight, lifestyle changes, psychosocial factors and use of technology. RESULT The overall physical activity and dietary adherence remained unchanged in more than 80% of the participants. There was increased consumption of vegetables (80.9%), fruits (42.7%), and decreased unhealthy snacking (63%). 90% of them had access to medications. No significant change was noted in the mean HbA1c and body weight before and after lockdown. Most of them (99%) watched television and 73.6% of them spent time with their family members. Those with mental stress and poor sleep had unhealthy dietary habits. Poor glycemic control was seen in those with less physical activity and an unhealthy diet. CONCLUSION Lockdown did not cause a major change in the overall glycemic control. Measures to promote healthy lifestyle practices along with ways to reduce psychosocial stress must be implemented for better T2D management during such restricted times.
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Affiliation(s)
| | - Waseem N Ahmed
- Department of Family and Internal Medicine, CRAFT Hospital and Research Centre, Kodungallur, Thrissur, Kerala, India.
| | | | - Rittin Jacob
- MGM Muthoot Hospitals, Pathanamthitta, Kerala, India.
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