https://orcid.org/0000-0003-0653-4938
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Abstract
Introduction
In 2020, several countries established a global emergency state. Lockdowns restricted people’s lifestyles and daily activities to prevent coronavirus spread. These measures hindered diabetes mellitus control and lifestyle changes. This study aims to evaluate if attending a multidisciplinary program before the pandemic helped maintain a good metabolic state, lifestyle modifications, and mental health in patients with diabetes mellitus during the COVID-19 lockdown.
Methods
Patients included in this study attended a multidisciplinary program, with <5 years of diagnosis of type 2 diabetes, without disabling complications, between 18–70 years old. The complete lockdown occurred from February 27, 2020, to May 31, 2020. The first patient (non-COVID) to return to the center for face-to-face consultation was in March 2021. Consultations in 2019 were face-to-face and changed to a virtual modality during 2020. We analyzed metabolic, lifestyle, mental health, and diabetes education parameters.
Results
A total of 133 patients with type 2 diabetes mellitus were included with complete information in visits before and during the lockdown. Metabolic parameters and self-care measures (nutrition plan, foot evaluation, and self-glucose monitoring) evaluated on our patients had no change during the lockdown. We found a significant increase in the time patients spent sitting during the day (p<0.05). Barriers to exercise increased during lockdown, being joint pain (3.8% to 12.0%, p<0.01) and lack of time to exercise (4.5% to 7.5%, p=0.33) being the most common. There was no significant difference in symptoms of anxiety and depression, quality of life, and empowerment.
Conclusion
A multidisciplinary diabetes mellitus program, including diabetes education for self-care activities, positively impacts patients, maintaining good outcomes despite lockdown difficulties.
Data Sharing Statement
Raw data were generated at the Center of Comprehensive Care for the Patient with Diabetes. Derived data supporting the findings of this study are available from the corresponding author [SHJ] on request and will be reviewed by the IRB Committee. De-identified individual participant data collected during the study will be shared with no end date. These data will be available to researchers who provide a proposal to achieve specific. Requesters will need to sign a data access agreement and to confirm that data will only be used for the agreed purpose for which access was granted”.
Ethics Approval and Informed Consent
The Institutional Ethics and Research Committees approved the comprehensive care protocol (INCMNSZ Research and Ethics Board - Reference 1198). It is also registered on ClinicalTrials.gov (NCT02836808). The procedures were conducted following the Declaration of Helsinki. All patients signed an informed consent form.
Acknowledgments
CAIPaDi Study Group: María Teresa Alcántara-Garcés, Denise Arcila-Martínez, Rodrigo Arizmendi-Rodríguez, Humberto Del Valle-Ramírez, Arturo Flores García, Fernanda Garnica-Carrillo, Eduardo González-Flores, Mariana Granados-Arcos, Héctor Infanzón-Talango, Arely Hernández Jasso, Claudia Lechuga-Fonseca, Angélica Palacios-Vargas, Liliana Pérez-Peralta, Sofía Ríos-Villavicencio, David Rivera de la Parra, Alejandra Rodríguez-Ramírez, Francis Rojas-Torres, Sandra Sainos-Muñoz, Alejandra Sierra-Esquivel, María Luisa Velasco-Pérez, Héctor Velázquez-Jurado, Andrea Villegas-Narváez, Luz Elena Urbina-Arronte, Verónica Zurita-Cortés, Carlos A Aguilar-Salinas, Francisco J Gómez-Pérez, David Kershenobich-Stalnikowitz.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; they took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The CAIPaDi program has received grants from Astra Zeneca, Fundación Conde de Valenciana, Novartis, Consejo Nacional de Ciencia y Tecnología (“Proyectos de Desarrollo Científico para Atender Problemas Nacionales 2013 project 214718), Nutrición Médica y Tecnología, NovoNordisk, Boehringer Ingelheim, Dirección General de Calidad y Educación en Salud, Eli Lilly, Merck Serono, MSD, Silanes, Chinoin and Carlos Slim Health Institute. The authors report no conflicts of interest in this work.