Effect of COVID19 pandemic and national lockdown on persons with diabetes from rural areas availing care in a tertiary care center, southern India

Abstract

Background and aims COVID-19 pandemic and lockdown measures to contain it have affected health care services globally. This study aims to assess the effect and urban-rural differences of COVID19 pandemic on diabetes care. Methods This cross-sectional study was conducted among persons with diabetes (PWDs) registered for care at a diabetes clinic of a tertiary care center in Southern India. We collected following information by telephonic interviews: physician consultations, access to diabetes medications and blood sugar tests, use of telemedicine services, out of pocket expenditure and psychological morbidity. Results A total of 350 PWDs were interviewed. Majority were male (78%) and from rural areas (79%). One fourth (24%) met any physician for diabetes care at least once during lockdown. PWDs from rural areas mainly consulted a physician in a private clinic (55%) compared to urban areas (26%). Two third (65%) availed medications from private medical shops. Almost half (46%) got their blood sugar tested during and majority of them (81%) reported unsatisfactory glycemic control. Only few (5%) was aware and three utilized telemedicine services. Almost all (99%) spent money (US $ 8.3) for diabetes care. One third (33%) had moderate or high psychological distress. Conclusions Majority of PWDs did not consult a physician during lockdown. Cost of care was high. Measures to improve utilisation of telemedicine services and peripheral health facilities are needed.

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

“…22 Although previous studies have allowed a better understanding of the effects of the COVID-19 pandemic on the care of people with diabetes, they have at least two major limitations. First, the majority of the previous studies were conducted in Asia, [14][15][16][17]19,20 and the results may not be generalizable to other regions. Second, these studies frequently included fewer than 1000 participants, 10,12,[15][16][17][18][19][20] The aim of the present study therefore was to estimate the number of patients with T2DM with at least one medication regimen change in the periods January to July 2019 and January to July 2020.…”

“…The COVID‐19 pandemic has negatively impacted the healthcare of people with conditions such as cancer, 6,7 migraine 8 or gout 9 . The treatment and management of people with type 2 diabetes mellitus (T2DM) during the COVID‐19 pandemic has also been investigated 10–20 . For example, a study in individuals diagnosed with T2DM and followed in a tertiary care centre in India, showed that only 24% met a physician during the lockdown (23 March to 23 June 2020), and that the vast majority of patients undergoing blood glucose monitoring (81%) had insufficient glycaemic control 17 .…”

“…It is noteworthy that the prescription of SGLT2 inhibitors and GLP-1RAs prior to these prescription changes was more frequent in 2020 than in 2019. To the best of our knowledge, this is the first study to investigate the effects of the COVID-19 pandemic on glucoselowering prescription patterns in T2DM patients from Germany, and it is also one of the largest studies to date.The impact of the COVID-19 crisis on diabetes care has been the focus of several studies [10][11][12][13][14][15][16][17][18][19][20]. A telephone survey of individuals withF I G U R E 1 Number of patients with at least one medication regimen change in general practices in Germany in January to July 2019 and January to July 2020.…”

Critical Breaths in Transit: A Review of Non-invasive Ventilation (NIV) for Neonatal and Pediatric Patients During Transportation

“…However, data on the use of NIV for children in transportation settings are minimal, and even more limited in LMIC contexts. As COVID-19 exacerbates existing healthcare inequities and leads to more children falling ill and mothers giving birth at home, it is more crucial than ever to increase research and attention on the use of NIV for children during prehospital and interfacility transport (12)(13)(14).…”

Lockdown and diabetes–what actually happened?

“…A meager 5% of them were aware of the option of tele consultation unlike in cities like New Delhi which reported 69% awareness. 7,8 Hypoglycemic events have been reported secondary to increased household activities and delay in consuming food. 6 The supply of medicines to peripheral areas happens through major cities and towns.…”