COVID-19 大流行期间糖尿病护理和管理方法的变化。

Kushagra Vashist, Jennifer K Frediani, Mary Beth Weber, Mohammed K Ali, K M Venkat Narayan, Shivani A Patel
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摘要

背景我们研究了 COVID-19 大流行之前和期间糖尿病护理和管理方法的变化:我们通过行为风险因素监测系统从美国 19 个州和华盛顿特区的成年糖尿病患者中获得了有关四项糖尿病相关医疗保健参与度和四项自我管理指标的人群数据。利用逻辑回归法,我们估算了 2019 年(大流行前)和 2021 年(大流行期间)每个指标的总体流行率和各社会人口亚群流行率的变化:结果:2019 年至 2021 年期间,一年两次的 HbA1c 检测率下降了 2.6 个百分点(pp;95% 置信区间:-4.8,-0.4),从 75.4% 降至 73.1%;每年一次的眼科检查率下降了 4.0 个百分点(-6.2,-2.8),从 72.2% 降至 68.7%。参与医疗保健以控制糖尿病的综合指标下降了 3.5 个百分点(-5.9,-1.1),从 44.9% 降至 41.9%。在自我管理行为中,避免吸烟的比例增加了 2.0 个百分点(0.4,3.6),从 84.7% 上升到 87.1%:研究结果表明,在大流行期间,糖尿病控制所需的实验室服务和临床检查等循证预防性医疗服务的接受率有所下降。另一方面,吸烟率有所下降,这表明大流行可能对糖尿病患者的健康行为产生积极影响。
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Changes in diabetes care and management practices during the COVID-19 pandemic.

Background: We examined changes in diabetes care and management practices before and during the COVID-19 pandemic.

Methods: Population-based data regarding four diabetes-related healthcare engagement and four self-management indicators were obtained from adults with diabetes surveyed in 19 US States and Washington DC through the Behavioral Risk Factor Surveillance System. Using logistic regression, we estimated changes in the prevalence of each indicator, overall and by sociodemographic subgroups in 2019 (before the pandemic) and 2021 (during the pandemic).

Results: Between 2019 and 2021, the prevalence of biannual HbA1c tests reduced by 2.6 percentage points (pp; 95% confidence interval: -4.8, -0.4), from 75.4% to 73.1%, and prevalence of annual eye exams fell by 4.0 pp (-6.2, -2.8), from 72.2% to 68.7%. The composite indicator of engagement with healthcare for diabetes control fell by 3.5 pp (-5.9, -1.1), from 44.9% to 41.9%. Of self-management behaviors, avoidance of smoking increased by 2.0 pp (0.4, 3.6) from 84.7% to 87.1%.

Conclusions: The findings suggest a deterioration of the uptake of evidence-based, preventive health services requiring laboratory services and clinical examination for diabetes control during the pandemic. On the other hand, smoking rates decreased, suggesting potential positive impacts of the pandemic on health behaviors in people with diabetes.

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