Self-isolation negatively impacts self-management of diabetes during the coronavirus (COVID-19) pandemic
Tóm tắt
People with diabetes are at a greater risk of serious complications from Coronavirus disease (COVID-19). Self-management of diabetes is therefore of paramount importance. The purpose of this study is to compare self-management of diabetes pre-COVID-19 and during the COVID-19 pandemic. 679 participants with diabetes completed an online structured questionnaire survey. Various exposure variables (demographics, duration, treatment and complications of diabetes, self-isolation, etc.) were analysed to examine associations with the following outcome variables: (i) fluctuation of blood glucose levels, (ii) access to diabetes medicine, (iii) access to healthy diet, (iv) physical activity. Adjusted multiple regression analysis ascertained significant associations for each outcome variable against exposure variables. Multiple regression analysis showed that self-isolation was significantly associated with greater fluctuation in blood glucose levels (OR = 1.8, 95% CI = 1.2–2.6, p = 0.005), reduced access to diabetes medicine (OR = 1.9, 95% CI = 1.1–3.1, p = 0.02) and reduced access to healthy diet (OR = 3.0, 95% CI = 2.0–4.6, p < 0.001). Fluctuation in blood glucose level was also significantly associated with having at least one complication of diabetes (OR = 2.2, 95% CI = 1.2–3.9, p = 0.008) and reduced access to diabetes medicine was significantly higher in people who were on insulin (OR = 2.1, 95% CI = 1.3–3.3, p = 0.001). Self-isolation was shown to impact almost all factors that influence self-management of diabetes. A targeted approach to improved access to diabetes medicine, healthy diet for people who needed to self-isolate is vital in order to ensure that they are able to self-manage their diabetes effectively.
Tài liệu tham khảo
World Health Organisation Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.intAccessed 1 Jun 2021.
Fisher L, Polonsky W, Asuni A, Jolly Y, Hessler D. The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study. J Diabetes Complications. 2020;34(12):107748.
Asif M. The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern. J Educ Health Promot. 2014;3:1.
Franz MJ, Bantle JP, Beebe CA, Brunzell JD, Chiasson J, Garg A, et al. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care. 2002;25(1):148–98.
Campbell HM, Khan N, Cone C, Raisch DW. Relationship between diet, exercise habits, and health status among patients with diabetes. Res Social Adm Pharm. 2011;7(2):151–61.
Muliyil DE, Vellaiputhiyavan K, Alex R, Mohan VR. Compliance to treatment among type 2 diabetics receiving care at peripheral mobile clinics in a rural block of Vellore District, Southern India. J Family Med Prim Care. 2017;6(2):330–5.
Karter AJ, Parker MM, Moffet HH, Ahmed AT, Ferrara A, Liu JY, et al. Missed appointments and poor glycemic control: an opportunity to identify high-risk diabetic patients. Med Care. 2004;42(2):110–5.
Sapkota R, Chen Z, Zheng D, Pardhan S. The profile of sight-threatening diabetic retinopathy in patients attending a specialist eye clinic in Hangzhou, China. BMJ Open Ophthalmol. 2019;4(1):e000236.
Sapkota RP, Upadhyaya T, Gurung G, Parker M, Raman R, Pardhan S. Need to improve awareness and treatment compliance in high-risk patients for diabetic complications in Nepal. BMJ Open Diabetes Res Care. 2018;6(1):e000525.
Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis Diabetes Metab Syndr. 2020;14(4):535–45.
Barriers and facilitators for type-2 diabetes management in south asians: a systematic review. PLoS One 2015;10 (9):e0136202.
Gaede P, Vedel P, Parving HH, Pedersen O. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the Steno type 2 randomised study. Lancet. 1999;353(9153):617–22.
Macisaac RJ, Jerums G. Intensive glucose control and cardiovascular outcomes in type 2 diabetes. Heart Lung Circ. 2011;20(10):647–54.
Diabetes UK. Improving supported self-management for people with diabetes. 2009. https://www.diabetes.org.uk/resources-s3/2017-09/Supported_self-management.pdf. Accessed 1 June 2021
Ghosh A, Arora B, Gupta R, Anoop S, Misra A. Effects of nationwide lockdown during COVID-19 epidemic on lifestyle and other medical issues of patients with type 2 diabetes in north India. Diabetes Metab Syndr. 2020;14(5):917–20.
Ruiz-Roso MB, Knott-Torcal C, Matilla-Escalante DC, Garcimartín A, Sampedro-Nuñez MA, Dávalos A, et al. COVID-19 lockdown and changes of the dietary pattern and physical activity habits in a cohort of patients with type 2 diabetes mellitus. Nutrients. 2020. https://doi.org/10.3390/nu12082327.
Marçal IR, Fernandes B, Viana AA, Ciolac EG. The urgent need for recommending physical activity for the management of diabetes during and beyond COVID-19 outbreak. Front Endocrinol (Lausanne). 2020;11:584642.
Assaloni R, Pellino VC, Puci MV, Ferraro OE, Lovecchio N, Girelli A, et al. Coronavirus disease (Covid-19): How does the exercise practice in active people with type 1 diabetes change? A preliminary survey. Diabetes Res Clin Pract. 2020;166:108297.
Alessi J, De Oliveira GB, Franco DW, Do Amaral BB, Becker AS, Knijnik CP, et al. Mental health in the era of COVID-19: prevalence of psychiatric disorders in a cohort of patients with type 1 and type 2 diabetes during the social distancing. Diabetol Metab Syndr. 2020. https://doi.org/10.1186/s13098-020-00584-6.
Xue T, Li Q, Zhang Q, Lin W, Wen J, Li L, et al. Blood glucose levels in elderly subjects with type 2 diabetes during COVID-19 outbreak: a retrospective study in a single center 2020. Endocrinology. 2020. https://doi.org/10.1101/2020.03.31.20048579.
Ghosal S, Sinha B, Majumder M, Misra A. Estimation of effects of nationwide lockdown for containing coronavirus infection on worsening of glycosylated haemoglobin and increase in diabetes-related complications: a simulation model using multivariate regression analysis. Diabetes Metab Syndr. 2020;14(4):319–23.
Ghosh A, Anjana RM, Shanthi Rani CS, Jeba Rani S, Gupta R, Jha A, et al. Glycemic parameters in patients with new-onset diabetes during COVID-19 pandemic are more severe than in patients with new-onset diabetes before the pandemic: NOD COVID India Study. Diabetes Metab Syndr. 2021. https://doi.org/10.1016/j.dsx.2020.12.033.
Grabia M, Markiewicz-Żukowska R, Puścion-Jakubik A, Bielecka J, Nowakowski P, Gromkowska-Kępka K, et al. The nutritional and health effects of the COVID-19 pandemic on patients with diabetes mellitus. Nutrients. 2020. https://doi.org/10.3390/nu12103013.
Bonora BM, Boscari F, Avogaro A, Bruttomesso D, Fadini GP. Glycaemic control among people with type 1 diabetes during lockdown for the SARS-CoV-2 outbreak in Italy. Diabetes Ther. 2020;11:1–11.
Shi C, Zhu H, Liu J, Zhou J, Tang W. Barriers to self-management of type 2 diabetes during COVID-19 medical isolation: a qualitative study. Diabetes Metab Syndr Obes. 2020;13:3713–25.
Khare J, Jindal S. Observational study on effect of lock down due to COVID 19 on glycemic control in patients with diabetes: experience from central india. Diabetes Metab Syndr. 2020;14(6):1571–4.
Kishimoto M, Ishikawa T, Odawara M. Behavioral changes in patients with diabetes during the COVID-19 pandemic. Diabetol Int. 2020;12(2):1–5.
Potier L, Hansel B, Larger E, Gautier JF, Carreira D, Assemien R, et al. Stay-at-home orders during the COVID-19 pandemic, an opportunity to improve glucose control through behavioral changes in type 1 diabetes. Diabetes Care. 2021;44(3):839–43.
Schmitt A, Gahr A, Hermanns N, Kulzer B, Huber J, Haak T. The Diabetes Self-Management Questionnaire (DSMQ): development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control. Health Qual Life Outcomes. 2013;11:138.
Pardhan S, Nakafero G, Raman R, Sapkota R. Barriers to diabetes awareness and self-help are influenced by people’s demographics: perspectives of South Asians with type 2 diabetes. Ethn Health. 2020;25:843–61.
Saquib N, Saquib J, Ahmed T, Khanam MA, Cullen MR. Cardiovascular diseases and type 2 diabetes in Bangladesh: a systematic review and meta-analysis of studies between 1995 and 2010. BMC Public Health. 2012;12:434.
Kelley K, Clark B, Brown V, Sitzia J. Good practice in the conduct and reporting of survey research. Int J Qual Health Care. 2003;15:261–6.
American Association of Diabetes Educators. An effective model of diabetes care and education: revising the AADE7 self-care behaviors. Diabetes Educ. 2020;46(2):139–60.
Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531–8.
Hu Y, Sun J, Dai Z, Deng H, Li X, Huang Q, et al. Prevalence and severity of corona virus disease 2019 (COVID-19): a systematic review and meta-analysis. J Clin Virol. 2020;127:104371.
Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, et al. Clinical, laboratory and imaging features of COVID-19: a systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623.
Khader MA, Jabeen T, Namoju R. A cross sectional study reveals severe disruption in glycemic control in people with diabetes during and after lockdown in India. Diabetes Metab Syndr. 2020;14(6):1579–84.
Fadini GP, Morieri ML, Longato E, Avogaro A. Prevalence and impact of diabetes among people infected with SARS-CoV-2. J Endocrinol Invest. 2020;43(6):867–9.
Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia–a systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020;14(4):395–403.
Docherty AB, Harrison EM, Green CA, Hardwick H, Pius R, Norman L, et al. Features of 16,749 hospitalised UK patients with COVID-19 using the ISARIC WHO clinical characterisation protocol. medRxiv preprint. 2020. https://doi.org/10.1101/2020.04.23.20076042.
Pal R, Yadav U, Verma A, Bhadada SK. Awareness regarding COVID-19 and problems being faced by young adults with type 1 diabetes mellitus amid nationwide lockdown in India: A qualitative interview study. Prim Care Diabetes. 2021;15(1):10–5.
Kaur H, Singh T, Arya YK, Mittal S. Physical fitness and exercise during the COVID-19 pandemic: a qualitative enquiry. Front Psychol. 2020;11:590172.