医学
大流行
2019年冠状病毒病(COVID-19)
梅德林
糖尿病酮症酸中毒
糖尿病
流行病学
医疗保健
民族
重症监护医学
老年学
急诊医学
儿科
环境卫生
疾病
内科学
传染病(医学专业)
人类学
社会学
政治学
法学
经济
内分泌学
经济增长
作者
Jamie Hartmann‐Boyce,Patrick Highton,Karen Rees,Igho Onakpoya,Jana Suklan,Ffion Curtis,Lauren L. O’Mahoney,Elizabeth Morris,Laura Kudlek,James I. Morgan,Rosie Lynch,Sanjana Marpadga,Samuel Seidu,Kamlesh Khunti
标识
DOI:10.1016/s2213-8587(23)00351-0
摘要
Summary
The COVID-19 pandemic triggered disruptions to health care and lifestyles that could conceivably impact diabetes management. We set out to identify the impact of disruptions caused by COVID-19 on clinical outcomes in people with diabetes. We performed a systematic review of the available literature in the MEDLINE and OVID databases from Jan 1, 2020, to June 7, 2023, and included 138 studies (n>1 000 000 people). All but five studies were judged to be at some risk of bias. All studies compared prepandemic with pandemic periods. All-cause mortality (six studies) and diabetes-related mortality (13 studies) showed consistent increases, and most studies indicated increases in sight loss (six studies). In adult and mixed samples, data generally suggested no difference in diabetic ketoacidosis frequency or severity, whereas in children and adolescents most studies showed increases with some due to new-onset diabetes (69 studies). Data suggested decreases in hospital admissions in adults but increases in diabetes-related admissions to paediatric intensive care units (35 studies). Data were equivocal on diabetic foot ulcer presentations (nine studies), emergency department admissions (nine studies), and overall amputation rates (20 studies). No studies investigated renal failure. Where reported, the impact was most pronounced for females, younger people, and racial and ethnic minority groups. Further studies are needed to investigate the longer-term impact of the pandemic and the on potential differential impacts, which risk further exacerbating existing inequalities within people with diabetes.
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