Hypoglycemia at the time of Covid-19 pandemic.
Identifieur interne : 000693 ( Main/Exploration ); précédent : 000692; suivant : 000694Hypoglycemia at the time of Covid-19 pandemic.
Auteurs : Kiran Shah [Inde] ; Mangesh Tiwaskar [Inde] ; Purvi Chawla [Inde] ; Mayura Kale [Inde] ; Rajesh Deshmane [Inde] ; Alpana Sowani [Inde]Source :
- Diabetes & metabolic syndrome [ 1878-0334 ]
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Betacoronavirus (isolement et purification), Diabète de type 2 (physiopathologie), Femelle (MeSH), Glycémie (analyse), Humains (MeSH), Hypoglycémie (virologie), Hypoglycémie (épidémiologie), Hémoglobine A glycosylée (analyse), Incidence (MeSH), Inde (épidémiologie), Infections à coronavirus (complications), Infections à coronavirus (transmission), Infections à coronavirus (virologie), Marqueurs biologiques (analyse), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (complications), Pneumopathie virale (transmission), Pneumopathie virale (virologie), Pronostic (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Études de suivi (MeSH), Études rétrospectives (MeSH).
- MESH :
- analyse : Glycémie, Hémoglobine A glycosylée, Marqueurs biologiques.
- isolement et purification : Betacoronavirus.
- physiopathologie : Diabète de type 2.
- virologie : Hypoglycémie, Infections à coronavirus, Pneumopathie virale.
- épidémiologie : Hypoglycémie, Inde, Infections à coronavirus, Pneumopathie virale.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Incidence, Mâle, Pandémies, Pronostic, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de suivi, Études rétrospectives.
- Wicri :
- geographic : Inde.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (isolation & purification), Biomarkers (analysis), Blood Glucose (analysis), COVID-19 (MeSH), Coronavirus Infections (complications), Coronavirus Infections (transmission), Coronavirus Infections (virology), Diabetes Mellitus, Type 2 (physiopathology), Female (MeSH), Follow-Up Studies (MeSH), Glycated Hemoglobin A (analysis), Humans (MeSH), Hypoglycemia (epidemiology), Hypoglycemia (virology), Incidence (MeSH), India (epidemiology), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (transmission), Pneumonia, Viral (virology), Prognosis (MeSH), Retrospective Studies (MeSH), SARS-CoV-2 (MeSH).
- MESH :
- chemical , analysis : Biomarkers, Blood Glucose, Glycated Hemoglobin A.
- geographic , epidemiology : India.
- complications : Coronavirus Infections, Pneumonia, Viral.
- epidemiology : Hypoglycemia.
- isolation & purification : Betacoronavirus.
- physiopathology : Diabetes Mellitus, Type 2.
- transmission : Coronavirus Infections, Pneumonia, Viral.
- virology : Coronavirus Infections, Hypoglycemia, Pneumonia, Viral.
- Adult, Aged, Aged, 80 and over, COVID-19, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Pandemics, Prognosis, Retrospective Studies, SARS-CoV-2.
Abstract
BACKGROUND
Hypoglycemia is the limiting factor in the glycemic management of diabetes, which need to be addressed critically to avoid complications. Lockdown because of new coronavirus strain (COVID-19) pandemic has further complicated the issue of hypoglycemia due to limitations in access to food, outpatient clinics, pathological services and medicines.
AIM
To assess the factors associated with the risk of hypoglycemia during April-May 2020 lockdown in people with type 2 diabetes mellitus.
METHODOLOGY
We analyzed the data retrospectively from 146 patients of type 2 diabetes mellitus (T2DM) reporting to the emergency department (ED) during lockdown period with symptoms suggestive of hypoglycemia.
RESULTS
The majority of patients were male (90/146) with a mean age of 59.88 ± 10.09 years and a mean random blood glucose level of 57.67 ± 9.00 mg/dL. Two-third of patients (70.83%) had level 1 hypoglycemia, while level 2 hypoglycemia was reported in 29.16% of patients. A combination of Metformin and Sulfonylureas (SU) was most commonly associated with the risk of hypoglycemia (65.75%) followed by insulin (33.56%). Subjects who received insulin reported a lower blood glucose value (50.75 ± 8.20 mg/dL) as compared to those receiving a combination of metformin and SU (60.95 ± 7.10 mg/dl). 330.56% of patients who had received prophylaxis hydroxychloroquine (HCQ) 400 mg twice a day along with the routine anti-hyperglycemic agents without their dose adjustment reported hypoglycemia. Patients with hypertension, micro-vascular, macro-vascular complications, and coexistent with each other had a higher propensity to the risk of hypoglycemia (46.58%, 33.56%, 23.29%, and 32.88%) respectively.
CONCLUSION
The COVID-19 lockdown has shown to influence the risk of hypoglycemia in patients with T2DM, especially those receiving SU, insulin, HCQ especially in patients with associated co-morbidities. Patient education, support, and telemedicine plays a pivotal role to prevent hypoglycemia.
DOI: 10.1016/j.dsx.2020.07.003
PubMed: 32668399
PubMed Central: PMC7347476
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Electronic address: drkiranshh@gmail.com.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Diabetes & Thyroid Care Center</wicri:regionArea></affiliation></author><author><name sortKey="Tiwaskar, Mangesh" sort="Tiwaskar, Mangesh" uniqKey="Tiwaskar M" first="Mangesh" last="Tiwaskar">Mangesh Tiwaskar</name><affiliation wicri:level="1"><nlm:affiliation>Shilpa Medical Research Centre, India. Electronic address: tiwaskar@gmail.com.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Shilpa Medical Research Centre</wicri:regionArea></affiliation></author><author><name sortKey="Chawla, Purvi" sort="Chawla, Purvi" uniqKey="Chawla P" first="Purvi" last="Chawla">Purvi Chawla</name><affiliation wicri:level="1"><nlm:affiliation>Lina Diabetes Care and Mumbai Diabetes Research Centre, India. 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(epidemiology)</term><term>Hypoglycemia (virology)</term><term>Incidence (MeSH)</term><term>India (epidemiology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (transmission)</term><term>Pneumonia, Viral (virology)</term><term>Prognosis (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Betacoronavirus (isolement et purification)</term><term>Diabète de type 2 (physiopathologie)</term><term>Femelle (MeSH)</term><term>Glycémie (analyse)</term><term>Humains (MeSH)</term><term>Hypoglycémie (virologie)</term><term>Hypoglycémie (épidémiologie)</term><term>Hémoglobine A glycosylée (analyse)</term><term>Incidence (MeSH)</term><term>Inde (épidémiologie)</term><term>Infections à coronavirus (complications)</term><term>Infections à coronavirus (transmission)</term><term>Infections à coronavirus (virologie)</term><term>Marqueurs biologiques (analyse)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (complications)</term><term>Pneumopathie virale (transmission)</term><term>Pneumopathie virale (virologie)</term><term>Pronostic (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Études de suivi (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analysis" xml:lang="en"><term>Biomarkers</term><term>Blood Glucose</term><term>Glycated Hemoglobin A</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>India</term></keywords><keywords scheme="MESH" qualifier="analyse" xml:lang="fr"><term>Glycémie</term><term>Hémoglobine A glycosylée</term><term>Marqueurs biologiques</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Hypoglycemia</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Diabète de type 2</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Diabetes Mellitus, Type 2</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Hypoglycémie</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="virology" 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rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Inde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Hypoglycemia is the limiting factor in the glycemic management of diabetes, which need to be addressed critically to avoid complications. Lockdown because of new coronavirus strain (COVID-19) pandemic has further complicated the issue of hypoglycemia due to limitations in access to food, outpatient clinics, pathological services and medicines.</p></div><div type="abstract" xml:lang="en"><p><b>AIM</b></p><p>To assess the factors associated with the risk of hypoglycemia during April-May 2020 lockdown in people with type 2 diabetes mellitus.</p></div><div type="abstract" xml:lang="en"><p><b>METHODOLOGY</b></p><p>We analyzed the data retrospectively from 146 patients of type 2 diabetes mellitus (T2DM) reporting to the emergency department (ED) during lockdown period with symptoms suggestive of hypoglycemia.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The majority of patients were male (90/146) with a mean age of 59.88 ± 10.09 years and a mean random blood glucose level of 57.67 ± 9.00 mg/dL. Two-third of patients (70.83%) had level 1 hypoglycemia, while level 2 hypoglycemia was reported in 29.16% of patients. A combination of Metformin and Sulfonylureas (SU) was most commonly associated with the risk of hypoglycemia (65.75%) followed by insulin (33.56%). Subjects who received insulin reported a lower blood glucose value (50.75 ± 8.20 mg/dL) as compared to those receiving a combination of metformin and SU (60.95 ± 7.10 mg/dl). 330.56% of patients who had received prophylaxis hydroxychloroquine (HCQ) 400 mg twice a day along with the routine anti-hyperglycemic agents without their dose adjustment reported hypoglycemia. Patients with hypertension, micro-vascular, macro-vascular complications, and coexistent with each other had a higher propensity to the risk of hypoglycemia (46.58%, 33.56%, 23.29%, and 32.88%) respectively.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The COVID-19 lockdown has shown to influence the risk of hypoglycemia in patients with T2DM, especially those receiving SU, insulin, HCQ especially in patients with associated co-morbidities. Patient education, support, and telemedicine plays a pivotal role to prevent hypoglycemia.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32668399</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>28</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-0334</ISSN><JournalIssue CitedMedium="Internet"><Volume>14</Volume><Issue>5</Issue><PubDate><MedlineDate>2020 Sep - Oct</MedlineDate></PubDate></JournalIssue><Title>Diabetes & metabolic syndrome</Title><ISOAbbreviation>Diabetes Metab Syndr</ISOAbbreviation></Journal><ArticleTitle>Hypoglycemia at the time of Covid-19 pandemic.</ArticleTitle><Pagination><MedlinePgn>1143-1146</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1871-4021(20)30249-6</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.dsx.2020.07.003</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Hypoglycemia is the limiting factor in the glycemic management of diabetes, which need to be addressed critically to avoid complications. Lockdown because of new coronavirus strain (COVID-19) pandemic has further complicated the issue of hypoglycemia due to limitations in access to food, outpatient clinics, pathological services and medicines.</AbstractText><AbstractText Label="AIM" NlmCategory="OBJECTIVE">To assess the factors associated with the risk of hypoglycemia during April-May 2020 lockdown in people with type 2 diabetes mellitus.</AbstractText><AbstractText Label="METHODOLOGY" NlmCategory="METHODS">We analyzed the data retrospectively from 146 patients of type 2 diabetes mellitus (T2DM) reporting to the emergency department (ED) during lockdown period with symptoms suggestive of hypoglycemia.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The majority of patients were male (90/146) with a mean age of 59.88 ± 10.09 years and a mean random blood glucose level of 57.67 ± 9.00 mg/dL. Two-third of patients (70.83%) had level 1 hypoglycemia, while level 2 hypoglycemia was reported in 29.16% of patients. A combination of Metformin and Sulfonylureas (SU) was most commonly associated with the risk of hypoglycemia (65.75%) followed by insulin (33.56%). Subjects who received insulin reported a lower blood glucose value (50.75 ± 8.20 mg/dL) as compared to those receiving a combination of metformin and SU (60.95 ± 7.10 mg/dl). 330.56% of patients who had received prophylaxis hydroxychloroquine (HCQ) 400 mg twice a day along with the routine anti-hyperglycemic agents without their dose adjustment reported hypoglycemia. Patients with hypertension, micro-vascular, macro-vascular complications, and coexistent with each other had a higher propensity to the risk of hypoglycemia (46.58%, 33.56%, 23.29%, and 32.88%) respectively.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The COVID-19 lockdown has shown to influence the risk of hypoglycemia in patients with T2DM, especially those receiving SU, insulin, HCQ especially in patients with associated co-morbidities. Patient education, support, and telemedicine plays a pivotal role to prevent hypoglycemia.</AbstractText><CopyrightInformation>Copyright © 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Shah</LastName><ForeName>Kiran</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Diabetes & Thyroid Care Center, India. Electronic address: drkiranshh@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tiwaskar</LastName><ForeName>Mangesh</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Shilpa Medical Research Centre, India. Electronic address: tiwaskar@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chawla</LastName><ForeName>Purvi</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Lina Diabetes Care and Mumbai Diabetes Research Centre, India. Electronic address: purvi_chawla@yahoo.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kale</LastName><ForeName>Mayura</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Dr Kale's Diabetes and Psychiatry Clinic, India. Electronic address: kalediabetesclinic@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Deshmane</LastName><ForeName>Rajesh</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Shree Mahalaxmi Diabetic Care Centre, India. Electronic address: smdcc_kolhapur@yahoo.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sowani</LastName><ForeName>Alpana</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Diabetes Specialty Centre, India. Electronic address: alpanasowani@gmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>07</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Diabetes Metab Syndr</MedlineTA><NlmUniqueID>101462250</NlmUniqueID><ISSNLinking>1871-4021</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D015415">Biomarkers</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D001786">Blood Glucose</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D006442">Glycated Hemoglobin A</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C517652">hemoglobin A1c protein, human</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="Y">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015415" MajorTopicYN="N">Biomarkers</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="N">analysis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001786" MajorTopicYN="N">Blood Glucose</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="N">analysis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000635" MajorTopicYN="N">transmission</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003924" MajorTopicYN="N">Diabetes Mellitus, Type 2</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006442" MajorTopicYN="N">Glycated Hemoglobin A</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="N">analysis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007003" MajorTopicYN="N">Hypoglycemia</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007194" MajorTopicYN="N" Type="Geographic">India</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000635" MajorTopicYN="N">transmission</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Anti-diabetic agents</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Comorbidities</Keyword><Keyword MajorTopicYN="N">Hypoglycemia</Keyword></KeywordList><CoiStatement>Declaration of competing interest None, Declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate 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