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COVID-19 hinterland: surveilling the self-reported impacts of the pandemic on diabetes management in the USA (cross-sectional results of the iNPHORM study)
- Source :
- BMJ Open, BMJ Open, Vol 11, Iss 9 (2021), Family Medicine Publications
- Publication Year :
- 2021
- Publisher :
- BMJ Publishing Group, 2021.
-
Abstract
- Main objectiveTo determine how and to what extent COVID-19 has affected real-world, self-reported glycaemic management in Americans with type 1 or type 2 diabetes taking insulin and/or secretagogues, with or without infection.DesignA cross-sectional substudy using data from the Investigating Novel Predictions of Hypoglycemia Occurrence using Real-world Models panel survey.SettingUSA.ParticipantsAmericans 18–90 years old with type 1 or 2 diabetes taking insulin and/or secretagogues were conveniently sampled from a probability-based internet panel.Primary outcome measureA structured, COVID-19-specific questionnaire was administered to assess the impact of the pandemic (irrespective of infection) on socioeconomic, behavioural/clinical and psychosocial aspects of glycaemic management.ResultsData from 667 respondents (type 1 diabetes: 18%; type 2 diabetes: 82%) were analysed. Almost 25% reported A1c values ≥8.1%. Rates of severe and non-severe hypoglycaemia were 0.68 (95% CI 0.5 to 0.96) and 2.75 (95% CI 2.4 to 3.1) events per person-month, respectively. Ten respondents reported a confirmed or probable COVID-19 diagnosis. Because of the pandemic, 24% of respondents experienced difficulties affording housing; 28% struggled to maintain sufficient food to avoid hypoglycaemia; and 19% and 17% reported challenges accessing diabetes therapies and testing strips, respectively. Over one-quarter reported issues retrieving antihyperglycaemics from the pharmacy and over one-third reported challenges consulting with diabetes providers. The pandemic contributed to therapeutic non-adherence (14%), drug rationing (17%) and reduced monitoring (16%). Many struggled to keep track, and in control, of hypoglycaemia (12%–15%) and lacked social support to help manage their risk (19%). Nearly half reported decreased physical activity. Few statistically significant differences were observed by diabetes type.ConclusionsCOVID-19 was found to cause substantial self-reported deficiencies in glycaemic management. Study results signal the need for decisive action to restabilise routine diabetes care in the USA.Trial registration numberNCT04219514.
- Subjects :
- Adult
medicine.medical_specialty
Adolescent
Cross-sectional study
diabetes & endocrinology
Type 2 diabetes
quality in health care
Social support
Young Adult
COVID-19 Testing
Diabetes management
Diabetes mellitus
Epidemiology
medicine
Humans
Hypoglycemic Agents
general endocrinology
Pandemics
Aged
Aged, 80 and over
Type 1 diabetes
business.industry
SARS-CoV-2
general diabetes
COVID-19
General Medicine
Middle Aged
medicine.disease
United States
Diabetes and Endocrinology
Cross-Sectional Studies
Diabetes Mellitus, Type 2
Emergency medicine
Medicine
epidemiology
Self Report
business
Psychosocial
Subjects
Details
- Language :
- English
- ISSN :
- 20446055
- Volume :
- 11
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- BMJ Open
- Accession number :
- edsair.doi.dedup.....5f2da14e13fb47b8d1f508066ad4c67c