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LBSUN151 The Impact Of The COVID-19 Pandemic On Diabetes & Weight Management

 : COVID-19 was declared a pandemic on 03/11/2020 by the WHO and the State of Minnesota issued a stay-at-home mandate on 03/27/2020. While individuals with diabetes mellitus (DM) and severe obesity were identified as more likely to be infected and at higher risk of complications from COVID-19, acces...

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Autores principales: Hashmi, Hiba Z, Malham, Sarah Bou, Alameddine, Hind
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9624884/
http://dx.doi.org/10.1210/jendso/bvac150.577
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author Hashmi, Hiba Z
Malham, Sarah Bou
Alameddine, Hind
author_facet Hashmi, Hiba Z
Malham, Sarah Bou
Alameddine, Hind
author_sort Hashmi, Hiba Z
collection PubMed
description  : COVID-19 was declared a pandemic on 03/11/2020 by the WHO and the State of Minnesota issued a stay-at-home mandate on 03/27/2020. While individuals with diabetes mellitus (DM) and severe obesity were identified as more likely to be infected and at higher risk of complications from COVID-19, access to outpatient clinics was limited during this time, with a shift towards telemedicine. In June 2020, the WHO reported that in 49% of 155 surveyed countries, diabetes treatment was disrupted. However, the impact on diabetes care in the US was poorly characterized, particularly among underserved groups. AIM: To study the impact of the pandemic and telemedicine on medical treatment of patients with DM at Hennepin County Medical Center (HCMC), a teaching hospital in Minneapolis, Minnesota serving a diverse inner-city population. METHODS: Retrospective cohort study design with 710 participants. We compared A1C and weight changes before and after the pandemic. The study group (n=344) included patients, 18 years of age or older, with DM Type 1 or Type 2 who presented for an HCMC diabetes clinic visit between 12/2019-02/2020 and a follow up visit between 6/2020 -10/2020. The control group (n=366) included patients with DM who presented for an HCMC diabetes clinic visit between 12/2018 - 02/2019 and a follow up visit between 6/2019 - 10/2019. RESULTS: There was a significantly lower A1C reduction in the cases as compared to the control group (-0.34 [CI -0.59, -0. 09] p value 0. 007), adjusted for inpatient admission, continuous glucose monitor use, diabetes type 1, insurance status, insulin use, GLP-1 agonist use, smoking status and hypertension. Weight reduction during the pandemic was lower as compared to the control but did not achieve statistical significance (-0.96 [CI -3. 02, 1. 09] p value 0.36). Telemedicine use among the study group resulted in an insignificant A1c reduction of -0.24 (p value 0.23). There was statistically significant weight gain of 0.42 among the group who used telemedicine, while nonusers had weight loss of -3.24 (p value 0. 04). Telemedicine users had higher insulin utilization (92.6% vs 83.3%, p value 0. 017) and lower self-pay and Medicaid enrollment (1.7% vs 5.9% and 33.8% vs 40.6% respectively, p value 0. 011) as compared to nonusers. CONCLUSION: The COVID-19 pandemic led to a significant deterioration of glycemic control but had no effect on weight. Telemedicine use led to A1c reduction but did not reach statistical significance potentially due to the small sample size and short duration of follow up. Significant weight gain was observed in telemedicine users influenced by greater insulin use and insurance coverage as compared to weight loss amongst nonusers which may be attributed to socioeconomic barriers such as food scarcity among those without the means to access telemedicine. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
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spelling pubmed-96248842022-11-14 LBSUN151 The Impact Of The COVID-19 Pandemic On Diabetes & Weight Management Hashmi, Hiba Z Malham, Sarah Bou Alameddine, Hind J Endocr Soc Diabetes & Glucose Metabolism  : COVID-19 was declared a pandemic on 03/11/2020 by the WHO and the State of Minnesota issued a stay-at-home mandate on 03/27/2020. While individuals with diabetes mellitus (DM) and severe obesity were identified as more likely to be infected and at higher risk of complications from COVID-19, access to outpatient clinics was limited during this time, with a shift towards telemedicine. In June 2020, the WHO reported that in 49% of 155 surveyed countries, diabetes treatment was disrupted. However, the impact on diabetes care in the US was poorly characterized, particularly among underserved groups. AIM: To study the impact of the pandemic and telemedicine on medical treatment of patients with DM at Hennepin County Medical Center (HCMC), a teaching hospital in Minneapolis, Minnesota serving a diverse inner-city population. METHODS: Retrospective cohort study design with 710 participants. We compared A1C and weight changes before and after the pandemic. The study group (n=344) included patients, 18 years of age or older, with DM Type 1 or Type 2 who presented for an HCMC diabetes clinic visit between 12/2019-02/2020 and a follow up visit between 6/2020 -10/2020. The control group (n=366) included patients with DM who presented for an HCMC diabetes clinic visit between 12/2018 - 02/2019 and a follow up visit between 6/2019 - 10/2019. RESULTS: There was a significantly lower A1C reduction in the cases as compared to the control group (-0.34 [CI -0.59, -0. 09] p value 0. 007), adjusted for inpatient admission, continuous glucose monitor use, diabetes type 1, insurance status, insulin use, GLP-1 agonist use, smoking status and hypertension. Weight reduction during the pandemic was lower as compared to the control but did not achieve statistical significance (-0.96 [CI -3. 02, 1. 09] p value 0.36). Telemedicine use among the study group resulted in an insignificant A1c reduction of -0.24 (p value 0.23). There was statistically significant weight gain of 0.42 among the group who used telemedicine, while nonusers had weight loss of -3.24 (p value 0. 04). Telemedicine users had higher insulin utilization (92.6% vs 83.3%, p value 0. 017) and lower self-pay and Medicaid enrollment (1.7% vs 5.9% and 33.8% vs 40.6% respectively, p value 0. 011) as compared to nonusers. CONCLUSION: The COVID-19 pandemic led to a significant deterioration of glycemic control but had no effect on weight. Telemedicine use led to A1c reduction but did not reach statistical significance potentially due to the small sample size and short duration of follow up. Significant weight gain was observed in telemedicine users influenced by greater insulin use and insurance coverage as compared to weight loss amongst nonusers which may be attributed to socioeconomic barriers such as food scarcity among those without the means to access telemedicine. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m. Oxford University Press 2022-11-01 /pmc/articles/PMC9624884/ http://dx.doi.org/10.1210/jendso/bvac150.577 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Diabetes & Glucose Metabolism
Hashmi, Hiba Z
Malham, Sarah Bou
Alameddine, Hind
LBSUN151 The Impact Of The COVID-19 Pandemic On Diabetes & Weight Management
title LBSUN151 The Impact Of The COVID-19 Pandemic On Diabetes & Weight Management
title_full LBSUN151 The Impact Of The COVID-19 Pandemic On Diabetes & Weight Management
title_fullStr LBSUN151 The Impact Of The COVID-19 Pandemic On Diabetes & Weight Management
title_full_unstemmed LBSUN151 The Impact Of The COVID-19 Pandemic On Diabetes & Weight Management
title_short LBSUN151 The Impact Of The COVID-19 Pandemic On Diabetes & Weight Management
title_sort lbsun151 the impact of the covid-19 pandemic on diabetes & weight management
topic Diabetes & Glucose Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9624884/
http://dx.doi.org/10.1210/jendso/bvac150.577
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