Comparative Study of the Control of Type 2 Diabetic Patients Before and After the Confinement Caused by the COVID-19 Pandemic
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v2i2.2027
Abstract
Objective: To assess the impact of the alterations of continuity of care on diabetic patients in our health department during the confinement that caused the pandemic. To check whether or not confinement entailed an alteration in the degree of control of our type 2 diabetic patients. To know whether our diabetic patients were adequately controlled before the pandemic began. To know if the pandemic has led to a deterioration in its degree of control. Subject and method: Retrospective study between the years 2019 and 2020 of type 2 diabetic patients in our health area. Through the "Alumbra" application of our health area, a random sample of our patients diagnosed with type 2 diabetes from 18 to 100 years of age was obtained. The patients were informed if they wanted to enter the study, and after express consent, the patients were asked about their lifestyle, habits and a review of the medical history was carried out with the data recorded before the confinement (year 2019) and during the months of confinement of 2020. Results: There were 882 patients (88.28%) with HbA1c determinations in 2019 with a mean of 708. There were 800 patients (88.98%) with HbA1c determinations in 2020 with a mean of 702. There was a reduction in alcohol, tobacco and soft drink consumption habits, but there was also a reduction in physical exercise (33% to 22%) and is following a diabetic diet (34% to 24%). In the sample analyzed, there was a reduction in a alcohol consumption from the data obtained in 2019 to those obtained in 2020 (22% to 13%). There was an increase in obesity, which goes from 77.7% to 90.4% in 2020. It is observed that there is no change in the percentages in pathologies such as dyslipidemia, atrial fibrillation, osteoarthritis, and stroke. Conclusion: The consequences associated with the pandemic on health are worrying, the decrease in acute consultation, preventive activities and the delay in controls of chronic patients will have a profound impact on the psychological and socioeconomic well being of populations. The holistic view of the Primary Care (PC) and the need to strengthen and rethink the system to increase its efficiency are of particular importance.
Keywords
primary care; type 2 diabetes control; confinement; teleconsultation
Funding
Funded by the II Call 2020 grants R & D & i in primary care Fisabio UGP-21-138.
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[7] Bernal DS, Tabasco MM, Riera MH, Pedrola MS. Etiología y manejo de la neuropatía diabética dolorosa. Rev Soc Esp Dolor. 2010;17(6):286-96.
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[9] Lim S, Bae JH, Kwon HS, Nauck MA. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol. 2021;17(1):11-30. https:// doi.org/10.1038/s41574-020-00435-4.
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[11] Paz-Ibarra J. Manejo de la diabetes mellitus en tiempos de COVID-19. Acta Méd Peruana. 2020;37(2):176-85.
[12] Orozco-Beltrán D, Pomares-Gómez F, Ortega-Ruiz P, Molina Ribera J, Iranzo-García N. Trabajando sin pacientes: una nueva estrategia para mejorar el control glucémico en pacientes con diabetes mellitus tipo 2 evitando la inercia terapéutica [Working without patients: a new strategy to improve the glycemic control in patients with type 2 diabetes Avoiding therapeutic inertia]. Rev Esp Salud Publica. 2021;95 e202110133.
[13] Martinez-Ferran M, de la Guía-Galipienso F, Sanchis-Gomar F, Pareja-Galeano H. Metabolic impacts of confinement during the COVID-19 pandemic due to modified diet and physical activity habits. Nutrients. 2020;12(6):1549.
[14] Orueta Sánchez R, Rodríguez de Cossío Á, Carmona de la Morena J, Moreno Álvarez Vijande A, García Lópeza A, Pintor Córdoba C. Anciano frágil y calidad de vida. Rev Clín Med Fam. 2008;2(3):101-5.
[15] Khunti K, Valabhji J, Misra S. Diabetes and the COVID-19 pandemic. Diabetologia. 2023 Feb;66(2):255-66. https://doi.org/10.1007/s00125-022-05833-z
[16] Christensen DH, Nicolaisen SK, Berencsi K, et al. Danish centre for strategic research in type 2 diabetes (DD2) project cohort of newly diagnosed patients with type 2 diabetes: a cohort profile. BMJ Open. 2018;8(4):e017273. https://doi.org/10.1136/ bmjopen-2017-017273.
[17] Gomez-Peralta F, Escalada San Martín FJ, Menéndez Torre E, Mata Cases M, Ferrer García JC, Ezkurra Loiola P, et al. Spanish Diabetes Society (SED) recommendations for the pharmacologic treatment of hyperglycemia in type 2 diabetes: 2018 Update. Endocrinol Diabetes Nutr (Engl Ed). 2018;65(10):611-24. https://doi.org/10.1016/j. endinu.2018.08.004
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