Change in glucose‐lowering medication regimens in individuals with type 2 diabetes mellitus during the COVID‐19 pandemic in Germany

Jacob, Louis; Rickwood, Sarah; Rathmann, Wolfgang; Kostev, Karel

doi:10.1111/dom.14293

Cited by 16 publications

(14 citation statements)

References 25 publications

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“…There has been increased emphasis on the importance of self-care activities for people with diabetes to optimise their diabetes management; however, this has proven difficult because of restrictions due to lockdown and reduced face-to-face education on diabetes. 151 During the pandemic, we have learned how to optimise pharmacological management, including ICU treatment, for patients with diabetes with or without COVID-19. 12 , 113 The pandemic has also presented people with diabetes and their health-care teams with an opportunity to innovate and transition towards increasingly digitalised care, to continue supporting patients from their own homes.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and metabolic disease: mechanisms and clinical management

Steenblock

Schwarz

Ludwig

et al. 2021

The Lancet Diabetes & Endocrinology

165

133

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Up to 50% of the people who have died from COVID-19 had metabolic and vascular disorders. Notably, there are many direct links between COVID-19 and the metabolic and endocrine systems. Thus, not only are patients with metabolic dysfunction (eg, obesity, hypertension, non-alcoholic fatty liver disease, and diabetes) at an increased risk of developing severe COVID-19 but also infection with SARS-CoV-2 might lead to new-onset diabetes or aggravation of pre-existing metabolic disorders. In this Review, we provide an update on the mechanisms of how metabolic and endocrine disorders might predispose patients to develop severe COVID-19. Additionally, we update the practical recommendations and management of patients with COVID-19 and post-pandemic. Furthermore, we summarise new treatment options for patients with both COVID-19 and diabetes, and highlight current challenges in clinical management.

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Section: Discussionmentioning

confidence: 99%

COVID-19 and metabolic disease: mechanisms and clinical management

Steenblock

Schwarz

Ludwig

et al. 2021

The Lancet Diabetes & Endocrinology

165

133

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“…It has previously been found that the panel of practices included in the Disease Analyzer database is representative of general and specialized practices in Germany (8). Finally, this database has already been used for other studies investigating the impact of the Covid-19 pandemic on the healthcare system (9)(10)(11).…”

Section: Methodsmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Consultations and Diagnoses in Gastroenterology Practices in Germany

et al. 2021

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The COVID-19 pandemic has been a major burden for healthcare systems worldwide and has caused multiple changes and problems in outpatient care. The aim of this study was to investigate the impact of the COVID-19 pandemic on consultations and diagnoses in gastroenterology practices in Germany. To this end, we retrospectively analyzed data from the Disease Analyzer database (IQVIA) using the International Classification of Diseases, 10th revision (ICD-10). We included all patients aged ≥18 years with at least one visit to one of 48 gastroenterology practices in Germany between April and September 2019 and April and September 2020. A total of 63,914 patients in the 2nd quarter of 2019, 63,701 in the 3rd quarter of 2019, 55,769 in the 2nd quarter of 2020, and 60,446 in the 3rd quarter of 2020 were included. Overall, a clear downward trend in the number of visits to gastroenterologists was observed in the 2nd quarter of 2020 compared to 2019 (−13%, p = 0.228). The decrease in consultations was particularly pronounced in patients >70 years of age (−17%, p = 0.096). This trend was evident for all gastrointestinal diagnoses except for tumors. Most notably, rates of gastrointestinal infections (−19%) or ulcers (−43%) were significantly lower in this period than in the same quarter of 2019. Reflecting the course of the pandemic, the differences between the 3rd quarter of 2020 and that of 2019 were less pronounced (−5%, p = 0.560). Our data show that the pandemic changed patients' behavior with respect to the health care system. Using the example of German gastroenterology practices, we show that the number of consultations as well as the number and range of diagnoses have changed compared to the same period in 2019.

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“…Similar changes in glucose-lowering therapy were reported in patients with T2D in Germany between January and July 2019 (N = 79,268) and between January and July 2020 (N = 85,046). Compared with 2019, the number of persons with ≥1 change in medication fell in 2020, as follows: DPP4 inhibitors, -15%; sodium-glucose co-transporter 2 (SGLT2) inhibitors, -3%; glucagon-like peptide-1 (GLP1) receptor agonists, 0%; other oral hypoglycemic drugs, -6%; and insulin, -21% [35]. Another indirect consequence of the COVID-19 pandemic in T2D patients is the effect on diagnosis of DM, which requires specific diagnostic tests that must be performed in a clinical setting.…”

Section: Effects On Diabetes Of the Restrictions Arising From The Covid-19 Pandemicmentioning

confidence: 99%

COVID-19 and Diabetes

Bellido

Pérez

2021

JCM

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Diabetes mellitus (DM) is one of the most common comorbid conditions in persons with COVID-19 and a risk factor for poor prognosis. The reasons why COVID-19 is more severe in persons with DM are currently unknown although the scarce data available on patients with DM hospitalized because of COVID-19 show that glycemic control is inadequate. The fact that patients with COVID-19 are usually cared for by health professionals with limited experience in the management of diabetes and the need to prevent exposure to the virus may also be obstacles to glycemic control in patients with COVID-19. Effective clinical care should consider various aspects, including screening for the disease in at-risk persons, education, and monitoring of control and complications. We examine the effect of COVID-19 on DM in terms of glycemic control and the restrictions arising from the pandemic and assess management of diabetes and drug therapy in various scenarios, taking into account factors such as physical exercise, diet, blood glucose monitoring, and pharmacological treatment. Specific attention is given to patients who have been admitted to hospital and critically ill patients. Finally, we consider the role of telemedicine in the management of DM patients with COVID-19 during the pandemic and in the future.

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Change in glucose‐lowering medication regimens in individuals with type 2 diabetes mellitus during the COVID‐19 pandemic in Germany

Cited by 16 publications

References 25 publications

COVID-19 and metabolic disease: mechanisms and clinical management

COVID-19 and metabolic disease: mechanisms and clinical management

Impact of the COVID-19 Pandemic on Consultations and Diagnoses in Gastroenterology Practices in Germany

COVID-19 and Diabetes

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