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1.
Background and aimsCOVID-19 pandemic has challenged the physician-centered approach of diabetes care in India that is primarily based on routine clinic visits. We aim to review the various aspects of patient-centered care via diabetes self-management education based on available literature.MethodsThis is a narrative review using Pubmed, EMBASE and Google Scholar search till March 29, 2020. Search terms were “COVID-19”, “diabetes self-care”, “diabetes self-management education”, “DSME”, “diabetes self-management in India”, “diabetes self-care in India” and “DSME in India”.ResultsWe have discussed an educational plan on diabetes self-management that can be adopted for people with diabetes mellitus in our country amid the ongoing pandemic. We have also identified the barriers to diabetes self-management in the current scenario and suggested possible solutions to overcome those.ConclusionsWe have reemphasized the need for a simultaneous patient-centered approach in routine diabetes care that has to be coordinated by a multidisciplinary team amid the ongoing COVID-19 pandemic.  相似文献   

2.
Background and aimsThe novel coronavirus disease (COVID-19) pandemic and the resulting nationwide lockdowns have posed a major challenge to the management of pre-existing and newly diagnosed endocrine disorders. Herein, we have summarized the management approaches of common endocrine disorders amid the ongoing pandemic.MethodsWe have performed an extensive literature search for articles in PubMed, EMBASE and Google Scholar databases till 25 May 2020, with the following keywords: “COVID-19”, “diabetes mellitus”, “thyroid disorders”, “primary adrenal insufficiency”, “Cushing’s syndrome”, “pituitary tumors”, “vitamin D″", “osteoporosis”, “primary hyperparathyroidism”, “hypoparathyroidism”, “management”, “treatment” and “guidelines” with interposition of the Boolean operator “AND”.ResultsWe have summarized the most feasible strategies for the management of diabetes mellitus, thyroid disorders, primary adrenal insufficiency (including congenital adrenal hyperplasia), Cushing’s syndrome, pituitary tumors, osteoporosis, primary hyperparathyroidism and hypoparathyroidism amid the constraints laid down by the raging pandemic. In general, medical management should be encouraged and surgical interventions should be deferred whenever possible. Ongoing medications should be continued. Sick-day rules should be sincerely adhered to. Regular contact with physicians can be maintained through teleconsultations and virtual clinics.ConclusionsConsidering the burden of endocrine disorders in the general population, their management needs to be prioritized amid the ongoing COVID-19 pandemic.  相似文献   

3.
《Primary Care Diabetes》2021,15(6):918-922
BackgroundThe world is facing the current COVID-19 pandemic. The pandemic response is affecting routine health care provision all over the world. We aimed to review the relevant literature and highlight challenges in the provision of routine care for patients with diabetes during the COVID-19 outbreak.MethodsWe systematically searched PubMed, ScienceDirect, and Embase databases up till August 13, 2020 and retrieved relevant articles published on difficulties on routine diabetes management during the COVID-19 pandemic.ResultsThrough our reading of the recent literature discussing the difficulties of routine healthcare provision for patients with diabetes amid the COVID-19 pandemic, we have identified nine themes as follows: lockdown of standard outpatient clinics, decreased inpatient capacity, staff shortage, medicine shortage, unaffordable medicine, delayed care seeking, limited self-care practice, transport difficulties, and undiagnosed cases/events.ConclusionDiabetes management during lockdown is particularly challenging. This review specified a summary of difficulties of diabetes care during COVID-19 pandemic. Healthcare policy makers as well as healthcare providers could take advantage of the results of this review to mitigate the adverse effect of the crisis on provision of routine care for diabetes as well as other chronic conditions.  相似文献   

4.
Background and aimsDiabetes mellitus is associated with poor prognosis in patients with COVID-19. On the other hand, COVID-19 contributes to worsening of dysglycemia in people with diabetes mellitus over and above that contributed by stress hyperglycemia. Herein, we have reviewed the two-way interactions between COVID-19 and diabetes mellitus.MethodsWe have performed an extensive literature search for articles in PubMed, EMBASE and Google Scholar databases till April 25, 2020, with the following keywords: “COVID-19”, “SARS-CoV-2”, “diabetes”, “diabetes mellitus”, “SARS”, “infection” and “management of diabetes mellitus” with interposition of the Boolean operator “AND”.ResultsCompromised innate immunity, pro-inflammatory cytokine milieu, reduced expression of ACE2 and use of renin-angiotensin-aldosterone system antagonists in people with diabetes mellitus contribute to poor prognosis in COVID-19. On the contrary, direct β-cell damage, cytokine-induced insulin resistance, hypokalemia and drugs used in the treatment of COVID-19 (like corticosteroids, lopinavir/ritonavir) can contribute to worsening of glucose control in people with diabetes mellitus.ConclusionsThe two-way interaction between COVID-19 and diabetes mellitus sets up a vicious cycle wherein COVID-19 leads to worsening of dysglycemia and diabetes mellitus, in turn, exacerbates the severity of COVID-19. Thus, it is imperative that people with diabetes mellitus take all necessary precautions and ensure good glycemic control amid the ongoing pandemic.  相似文献   

5.
Background and aimsThe global pandemic of coronavirus (COVID-19) affects almost all countries in the world, which potentially alter diabetes management. Many diabetes patients are experiencing barrier of care due to the policy related to COVID-19. This article aims to review the current evidence on diabetes management and specific considerations during the COVID-19 pandemic for people living with diabetes.MethodsWe conducted a scoping review in PubMed, Science Direct, DOAJ and Microsoft Academics databases from January 1 to April 17, 2020. Searching terms included “COVID-19”, “severe acute respiratory syndrome coronavirus 2”, and “Diabetes Mellitus” were used. Only scientific articles discussing diabetes management and specific considerations were selected and extracted.ResultsA total of 7 articles was selected in the analysis. Most were published in diabetes journals (85.71%). All articles (100%) discussed diabetes management and 71.43% of them provided diabetes care in specific considerations. We discussed issue of diabetes management in glycemic control and monitoring, dietary intake, physical activity, medication, education and prevention of COVID-19 infection that applicable for diabetes patients. In addition, specific considerations explored caring for diabetes in children and adolescents, pregnancy, elderly, emergency or critical care, to offer certain concern for raising the awareness.ConclusionsThis review specifies a summary of diabetes management as well as the particular considerations to care people living with diabetes during COVID-19 pandemic. Patients, health care providers, and policy makers could take advantage of the review to assist diabetic people passing through COVID-19 pandemic session with optimum glycemic outcome.  相似文献   

6.
Background and aimsThe ongoing pandemic of coronavirus disease 2019 (COVID-19) is rapidly evolving, thereby posing a profound challenge to the global healthcare system. Cardiometabolic disorders are associated with poor clinical outcomes in persons with COVID-19. Healthcare challenges during the COVID-19 pandemic are linked to resource constraints including shortage of Personal Protective Equipment’s (PPE), laboratory tests and medication. In this context, a group of clinical experts discussed the endocrine and cardiology vigilance required in times of COVID-19. Further, the group proposed certain resource husbandry recommendations to be followed during the pandemic to overcome the constraints.MethodThe clinical experts discussed and provided their inputs virtually. The expert panel included clinical experts comprising endocrinologists, Consultant Physicians and cardiologists from India. The panel thoroughly reviewed existing literature on the subject and proposed expert opinion.ResultsThe expert panel put forward clinical practice-based opinion for the management of cardiometabolic conditions including diabetes mellitus and hypertension. As these conditions are associated with poor clinical outcomes, the expert panel recommends that these persons be extra-cautious and take necessary precautions during the ongoing pandemic. Further, experts also provided appropriate, affordable, available and accessible solution to the resource constraint situations in times of COVID-19 pandemic.ConclusionThe clinical expert opinion put forward in this article will serve as a reference for clinicians treating diabetes and cardiovascular disease during the COVID-19 pandemic.  相似文献   

7.
BackgroundDuring the first wave of the COVID-19 pandemic physicians worked on the front lines, immersed in uncertainty. Research into perspectives of frontline physicians has lagged behind clinical innovation throughout the pandemic.ObjectiveTo inform ongoing and future efforts in the COVID-19 pandemic, we conducted a qualitative exploration of physician perspectives of the effects of policies and procedures as well as lessons learned while caring for patients during the height of the first wave in the spring of 2020.DesignA confidential survey was emailed to a convenience sample. Survey questions included demographic data, participant role in the pandemic, and geographic location. Eleven open-ended questions explored their perspectives and advice they would give going forward. Broad areas covered included COVID-19-specific education, discharge planning, unintended consequences for patient care, mental health conditions to anticipate, and personal/institutional factors influencing workforce well-being amid the crisis.ParticipantsWe received fifty-five surveys from May through July 2020. Demographic data demonstrated sampling of frontline physicians working in various epicenters in the USA, and diversity in gender, race/ethnicity, and clinical specialty.ApproachInductive thematic analysis.Key ResultsFour themes emerged through data analysis: (1) Leadership can make or break morale; (2) Leadership should engage frontline workers throughout decision-making processes; (3) Novelty of COVID-19 led to unintended consequences in care delivery; and (4) Mental health sequelae will be profound and pervasive.ConclusionsOur participants demonstrated the benefit of engaging frontline physicians as important stakeholders in policy generation, evaluation, and revision; they highlighted challenges, successes, unintended consequences, and lessons learned from various epicenters in the first wave of the COVID-19 pandemic. There is much to be learned from the early COVID-19 pandemic crisis; our participants’ insights elucidate opportunities to examine institutional performance, effect policy change, and improve crisis management in order to better prepare for this and future pandemics.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-022-07792-y.KEY WORDS: COVID-19, stakeholder engagement, physician perspectives, healthcare system, crisis management  相似文献   

8.
BackgroundCOVID-19-related pleural effusions are frequently described during the ongoing pandemic.ObjectivesWe described the incidence, characteristics, and outcomes of COVID-19-related pleural effusions based on the current evidence available in the literature.MethodsWe searched MEDLINE, Pubmed, and Google Scholar databases using keywords of “coronavirus disease 2019 (COVID-19),” “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),” “pleural effusion,” “pleural fluid,” and “pleura” from January 1st, 2020 to January 31st, 2021.ResultsThe incidence of pleural effusions was low at 7.3% among the 47 observational studies. Pleural effusions were commonly observed in critically ill patients and had Multisystem Inflammatory Syndrome (MIS). COVID-19-related pleural effusions were identified 5–7 days and 11 days, after hospital admission and onset of COVD-19 symptoms. The characteristic findings of pleural fluid were exudative, lymphocytic or neutrophilic-predominant pleural fluid with markedly elevated lactate dehydrogenase (LDH) levels and pleural fluid to serum LDH ratio.ConclusionA well-designed study is required to assess the significance of COVID-19-related pleural effusions during this current pandemic.  相似文献   

9.
BackgroundThe ongoing coronavirus disease 2019 (COVID-19) calls for setting up of well-equipped and dedicated health facilities to manage sick patients while protecting healthcare workers and the environment. An ideal high-level isolation unit requires a high level of administrative commitment, availability of space, human resource and logistics.MethodThe experience of setting up COVID-19 care facilities on a noticeably short period in a tertiary TB and respiratory diseases institute in wake of the COVID-19 pandemic is being shared here.ResultAll the essential COVID-19 services were set up in record time of 8 days. A total of 115 COVID-19 patients were admitted. Out of these 89 patients were discharged in a satisfactory condition. There were 19 deaths, and 4 patients became critical and had to be referred to level 3 facility for ICU care.ConclusionThis experience will help other hospitals in planning out the strategies and solve the difficulties they may face while opening a COVID-19 care facility under limited resources on an urgent basis.  相似文献   

10.
11.
Background and aimsPeople with diabetes have multiple psychosocial issues related to diabetes and its complications and this may be exacerbated during the COVID-19 pandemic.MethodsWe reviewed the psychological adaptative difficulties in people with diabetes especially during natural disasters including the prevailing COVID-19 pandemic.ResultsThere are significant concerns regarding worsening of glycemic control, unavailability of appropriate medicines, inaccessibility to health care or acquiring SARS- CoV-2 infection and subsequent poorer outcomes during the COVID-19 pandemic. Although there are some guidance documents for managing diabetes and associated complications during COVID-19 pandemic but very few address the psychological issues in people with diabetes. We discuss the psychological adaptive difficulties and an approach to address the psychosocial concerns in people with diabetes during the COVID-19 pandemic.ConclusionsPeople with diabetes have significant diabetes distress and psychological adaptive difficulties that is aggravated by the COVID-19 pandemic. An integrated multidisciplinary approach is needed to manage the prevailing psychological issues amongst people with diabetes during the COVID-19 pandemic.  相似文献   

12.
《Primary Care Diabetes》2022,16(5):640-643
AimsTo understand the associations between sociodemographic factors, self-rated health, and COVID-19-related changes in physical activity and diet and the reported number of days per week participants engaged in physical activity and consumed fruits and vegetables for people with type 2 diabetes mellitus (T2DM).MethodsRespondents from Arkansas primary care clinics completed a survey between October 2020 and January 2021. Multivariable regression determined associations between sociodemographic factors, self-rated health, and COVID-19-related changes in physical activity and diet and the reported number of days per week participants engaged in physical activity and consumed fruits and vegetables.ResultsRespondents exercised for at least 30 min on a mean of 2.09 days and consumed five or more fruit and vegetable servings on a mean of 3.57 days. Males engaged in one additional day of physical activity compared to women. Respondents with a college degree or higher ate 5 or more fruit and vegetable servings on fewer days per week than those with a high school education or less.ConclusionsResults reaffirm a need for diabetes education programs and health care providers to provide information on the importance of maintaining physical activity and a healthy diet as part of a self-care plan for T2DM, especially during public health emergencies like the COVID-19 pandemic.  相似文献   

13.
AimsTo assess the awareness about COVID-19 and the problems being faced by young adults with T1DM amid nationwide lockdown in India.MethodsA cross-sectional telephone-based qualitative interview study was conducted in young adults (aged 18–30 years) with T1DM amid lockdown. Following verbal consent, participants were asked 8 open-ended questions, 5 on awareness about COVID-19 and 3 catering to problems being faced concerning diet, physical activity and treatment amid lockdown. On average, 3 interviews were conducted per day with each lasting for 15?20 min. Interviews were recorded, transcribed and analyzed by qualitative content analysis.ResultsThirty-two participants were interviewed; after exclusion of two poorly recorded interviews, 30 were finally analyzed. Mean age of participants was 22.4 ± 4.0 years (M:F = 8:7). Only 30%, 40% and 53% of participants were aware of modes of transmission (respiratory droplets and fomites), cardinal symptoms (fever, cough and breathing difficulty) and means of prevention (staying indoors, social distancing and regular hand washing), respectively. Majority of participants were unaware of additional risks associated with COVID-19 in diabetes mellitus. Most participants could continue with their routine diet and prescribed treatment regime, however, 90% reported a reduction in physical activity and 72% experienced worsening of glycemic control amid lockdown.ConclusionsYoung adults with T1DM lack adequate awareness about COVID-19. Increasing awareness and imparting diabetes self-management education via digital/print media is needed.  相似文献   

14.
BackgroundThe extent of the COVID-19 pandemic and the resulting response has varied globally. The European and African Hepato-Pancreato-Biliary Association (E-AHPBA), the premier representative body for practicing HPB surgeons in Europe and Africa, conducted this survey to assess the impact of COVID-19 on HPB surgery.MethodsAn online survey was disseminated to all E-AHPBA members to assess the effects of the pandemic on unit capacity, management of HPB cancers, use of COVID-19 screening and other aspects of service delivery.ResultsOverall, 145 (25%) members responded. Most units, particularly in COVID-high countries (>100,000 cases) reported insufficient critical care capacity and reduced HPB operating sessions compared to COVID-low countries. Delayed access to cancer surgery necessitated alternatives including increased neoadjuvant chemotherapy for pancreatic cancer and colorectal liver metastases, and locoregional treatments for hepatocellular carcinoma. Other aspects of service delivery including COVID-19 screening and personal protective equipment varied between units and countries.ConclusionThis study demonstrates that the COVID-19 pandemic has had a profound adverse impact on the delivery of HPB cancer care across the continents of Europe and Africa. The findings illustrate the need for safe resumption of cancer surgery in a “new” normal world with screening of patients and staff for COVID-19.  相似文献   

15.
BackgroundThe epidemiology of COVID-19 and its association with cardiometabolic disorders is poorly understood. This is a narrative review that investigates the effects of COVID-19 infection on insulin resistance in patients with diabetes.MethodsAn online search of all published literature was done via PubMed and Google Scholar using the MeSH terms “COVID-19,” “SARS-CoV-2,” “coronavirus,” “insulin resistance,” and “diabetes.” Only articles that were directly applicable to insulin resistance in COVID-19 and diabetes was reviewed.ResultsCurrent data shows an increased risk of mortality in patients with diabetes and COVID-19 compared to those without diabetes. COVID-19 triggers insulin resistance in patients, causing chronic metabolic disorders that were non-existent prior to infection.ConclusionPatients with diabetes are more susceptible to COVID-19 infection than those without diabetes. ACE2 expression decreases with infection, exaggerating Ang II activity with subsequent insulin resistance development, an exaggerated immune response and severe SARS-COV-2 infection.  相似文献   

16.
Background and aimThe current global challenge of COVID-19 pandemic has surpassed the provincial, radical, conceptual, spiritual, social, and pedagogical boundaries. Internet of Things (IoT) enabled healthcare system is useful for proper monitoring of COVID-19 patients, by employing an interconnected network. This technology helps to increase patient satisfaction and reduces readmission rate in the hospital.MethodsSearched the databases of Google Scholar, PubMed, SCOPUS and ResearchGate using the keywords “Internet of things” or “IoT” and “COVID-19”. Further inputs are also taken from blogs and relevant reports.ResultsIoT implementation impacts on reducing healthcare cost and improve treatment outcome of the infected patient. Therefore, this present study based research is attempted to explore, discuss, and highlight the overall applications of the well-proven IoT philosophy by offering a perspective roadmap to tackle the COVID-19 pandemic. Finally, twelve significant applications of IoT are identified and discussed. It has ultimately forced the researchers, academicians, and scientists to propose some productive solutions to overcome or confront this pandemic.ConclusionsIoT is helpful for an infected patient of COVID-19 to identify symptoms and provides better treatment rapidly. It is useful for patient, physician, surgeon and hospital management system.  相似文献   

17.
BackgroundThe novel coronavirus SARS-CoV-2 has taken the world by storm. Alongside COVID-19, diabetes is a long-standing global epidemic. The diabetes population has been reported to suffer adverse outcomes if infected by COVID-19. The aim was to summarise information and resources available on diabetes and COVID-19, highlighting special measures that individuals with diabetes need to follow.MethodsA search using keywords “COVID-19” and “Diabetes” was performed using different sources, including PubMed and World Health Organization.ResultsCOVID-19 may enhance complications in individuals with diabetes through an imbalance in angiotension-converting enzyme 2 (ACE2) activation pathways leading to an inflammatory response. ACE2 imbalance in the pancreas causes acute β-cell dysfunction and a resultant hyperglycemic state. These individuals may be prone to worsened COVID-19 complications including vasculopathy, coagulopathy as well as psychological stress. Apart from general preventive measures, remaining hydrated, monitoring blood glucose regularly and monitoring ketone bodies in urine if on insulin is essential. All this while concurrently maintaining physical activity and a healthy diet. Different supporting entities are being set up to help this population.ConclusionCOVID-19 is a top priority. It is important to remember that a substantial proportion of the world's population is affected by other co-morbidities such as diabetes. These require special attention during this pandemic to avoid adding on to the burden of countries' healthcare systems.  相似文献   

18.
Background and aimsThe COVID-19 pandemic affected the processes of routine care for chronic patients due to disrupted delivery care. The aim of the present study is to verify the COVID-19 pandemic effects on diabetes control and management.Methods and resultsThe study was designed as a retrospective observational study, performed on two cohorts of patients with diabetes in 2019 and 2020. Data used for the analyses were gathered from administrative and laboratory databases, which do not include any sensible information on COVID-19. The Tuscany Regional Health Agency is data controller for current administrative databases and has been working to produce available information for policy decision-making.In 2020, in comparison with 2019, a relevant reduction of the number of patients measuring HbA1c was observed during the March–April lockdown, and again during the second pandemic wave in Autumn. A similar pattern was observed for specialist visits for diabetes, for which the introduction of televisits only partly compensated for the reduction of traditional office visits. The number of patients receiving drugs for diabetes each week in 2020 was very similar to 2019. The mean HbA1c values and the proportion of HbA1c values > 8% for each week, were higher during the 2020 Spring and Autumn lockdown.ConclusionCOVID-19 pandemic negatively impacts diabetes management, reducing specialist visits and HbA1c determinations during the first and second pandemic wave. Despite a satisfactory continuity in pharmacological treatment, short-term impairment of average glycemic control was detected, particularly in Autumn.  相似文献   

19.
BackgroundAlong with its high infectivity and fatality rates, the 2019 Corona Virus Disease (COVID-19) has caused universal psychosocial impact by causing mass hysteria, economic burden and financial losses. Mass fear of COVID-19, termed as “coronaphobia”, has generated a plethora of psychiatric manifestations across the different strata of the society. So, this review has been undertaken to define psychosocial impact of COVID-19.MethodsPubmed and GoogleScholar are searched with the following key terms- “COVID-19”, “SARS-CoV2”, “Pandemic”, “Psychology”, “Psychosocial”, “Psychitry”, “marginalized”, “telemedicine”, “mental health”, “quarantine”, “infodemic”, “social media” and” “internet”. Few news paper reports related to COVID-19 and psychosocial impacts have also been added as per context.ResultsDisease itself multiplied by forced quarantine to combat COVID-19 applied by nationwide lockdowns can produce acute panic, anxiety, obsessive behaviors, hoarding, paranoia, and depression, and post-traumatic stress disorder (PTSD) in the long run. These have been fueled by an “infodemic” spread via different platforms of social media. Outbursts of racism, stigmatization, and xenophobia against particular communities are also being widely reported. Nevertheless, frontline healthcare workers are at higher-risk of contracting the disease as well as experiencing adverse psychological outcomes in form of burnout, anxiety, fear of transmitting infection, feeling of incompatibility, depression, increased substance-dependence, and PTSD. Community-based mitigation programs to combat COVID-19 will disrupt children’s usual lifestyle and may cause florid mental distress. The psychosocial aspects of older people, their caregivers, psychiatric patients and marginalized communities are affected by this pandemic in different ways and need special attention.ConclusionFor better dealing with these psychosocial issues of different strata of the society, psychosocial crisis prevention and intervention models should be urgently developed by the government, health care personnel and other stakeholders. Apt application of internet services, technology and social media to curb both pandemic and infodemic needs to be instigated. Psychosocial preparedness by setting up mental organizations specific for future pandemics is certainly necessary.  相似文献   

20.
Background and aimIn the age of advanced digital technology, smart healthcare based on the Internet of Things (IoT) is gaining importance to deal with the current COVID-19 pandemic. In this paper, the novel application of cognitive radio (CR) based IoT specific for the medical domain referred to as Cognitive Internet of Medical Things (CIoMT) is explored to tackle the global challenge. This concept of CIoT is best suited to this pandemic as every person is to be connected and monitored through a massive network that requires efficient spectrum management.MethodsAn extensive literature survey is conducted in the Google Scholar, Scopus, PubMed, Research Gate, and IEEE Xplore databases using the terms “COVID-19” and “Cognitive IoT” or “Corona virus” and “IoMT”. The latest data and inputs from official websites and reports are used for further investigation and analysis of the application areas.ResultsThis review encompasses different novel applications of CIoMT for fighting the ongoing COVID-19 health crisis. The CR based dynamic spectrum allocation technique is the solution for accommodating a massive number of devices and a wide number of applications. The CIoMT platform enables real-time tracking, remote health monitoring, rapid diagnosis of the cases, contact tracking, clustering, screening, and surveillance thus, reducing the workload on the medical industry for prevention and control of the infection. The challenges and future research directions are also identified.ConclusionsCIoMT is a promising technology for rapid diagnosis, dynamic monitoring and tracking, better treatment and control without spreading the virus to others.  相似文献   

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