Estimation of effects of nationwide lockdown for containing coronavirus infection on worsening of glycosylated haemoglobin and increase in diabetes-related complications: A simulation model using multivariate regression analysis
Identifieur interne : 000508 ( Main/Exploration ); précédent : 000507; suivant : 000509Estimation of effects of nationwide lockdown for containing coronavirus infection on worsening of glycosylated haemoglobin and increase in diabetes-related complications: A simulation model using multivariate regression analysis
Auteurs : Samit Ghosal [Inde] ; Binayak Sinha [Inde] ; Milan Majumder [Inde] ; Anoop Misra [Inde]Source :
- Diabetes & Metabolic Syndrome [ 1871-4021 ] ; 2020.
Abstract
and aims: To prevent the spread of coronavirus disease (COVID19) total lockdown is in place in India from March 24, 2020 for 21 days. In this study, we aim to assess the impact of the duration of the lockdown on glycaemic control and diabetes-related complications.
A systematic search was conducted using Cochrane library. A simulation model was created using glycemic data from previous disasters (taken as similar in impact to current lockdown) taking baseline HBA1c and diabetes-related complications data from India-specific database. A multivariate regression analysis was conducted to analyse the relationship between the duration of lockdown and glycaemic targets & diabetes-related complications.
The predictive model was extremely robust (R2 = 0.99) and predicted outcomes for period of lockdown up to 90 days. The predicted increment in HBA1c from baseline at the end of 30 days and 45 days lockdown was projected as 2.26% & 3.68% respectively. Similarly, the annual predicted percentage increase in complication rates at the end of 30-day lockdown was 2.8% for non-proliferative diabetic retinopathy, 2.9% for proliferative diabetic retinopathy, 1.5% for retinal photocoagulation, 9.3% for microalbuminuria, 14.2% for proteinuria, 2.9% for peripheral neuropathy, 10.5% for lower extremity amputation, 0.9% for myocardial infarction, 0.5% for stroke and 0.5% for infections.
The duration of lockdown is directly proportional to the worsening of glycaemic control and diabetes-related complications. Such increase in diabetes-related complications will put additional load on overburdened healthcare system, and also increase COVID19 infections in patients with such uncontrolled glycemia.
Url:
DOI: 10.1016/j.dsx.2020.03.014
PubMed: 32298984
PubMed Central: 7146694
Affiliations:
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wicri:level="1"><nlm:aff id="aff1">Nightingale Hospital, Kolkata, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Nightingale Hospital, Kolkata</wicri:regionArea><wicri:noRegion>Kolkata</wicri:noRegion></affiliation></author><author><name sortKey="Sinha, Binayak" sort="Sinha, Binayak" uniqKey="Sinha B" first="Binayak" last="Sinha">Binayak Sinha</name><affiliation wicri:level="1"><nlm:aff id="aff2">AMRI Hospitals, Kolkata, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>AMRI Hospitals, Kolkata</wicri:regionArea><wicri:noRegion>Kolkata</wicri:noRegion></affiliation></author><author><name sortKey="Majumder, Milan" sort="Majumder, Milan" uniqKey="Majumder M" first="Milan" last="Majumder">Milan Majumder</name><affiliation wicri:level="1"><nlm:aff id="aff3">Milan Majumder, Biostatistician, Pune, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Milan Majumder, Biostatistician, Pune</wicri:regionArea><wicri:noRegion>Pune</wicri:noRegion></affiliation></author><author><name sortKey="Misra, Anoop" sort="Misra, Anoop" uniqKey="Misra A" first="Anoop" last="Misra">Anoop Misra</name><affiliation wicri:level="1"><nlm:aff id="aff4">Fortis CDOC Hospital for Diabetes and Allied Sciences, New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Fortis CDOC Hospital for Diabetes and Allied Sciences, New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5">Diabetes Foundation (India), National Diabetes Obesity and Cholesterol Foundation (NDOC), New Delhi, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Diabetes Foundation (India), National Diabetes Obesity and Cholesterol Foundation (NDOC), New Delhi</wicri:regionArea><wicri:noRegion>New Delhi</wicri:noRegion></affiliation></author></analytic><series><title level="j">Diabetes & Metabolic Syndrome</title><idno type="ISSN">1871-4021</idno><idno type="eISSN">1878-0334</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>and aims: To prevent the spread of coronavirus disease (COVID19) total lockdown is in place in India from March 24, 2020 for 21 days. In this study, we aim to assess the impact of the duration of the lockdown on glycaemic control and diabetes-related complications.</p></sec><sec><title>Materials and methods</title><p>A systematic search was conducted using Cochrane library. A simulation model was created using glycemic data from previous disasters (taken as similar in impact to current lockdown) taking baseline HBA1c and diabetes-related complications data from India-specific database. A multivariate regression analysis was conducted to analyse the relationship between the duration of lockdown and glycaemic targets & diabetes-related complications.</p></sec><sec><title>Results</title><p>The predictive model was extremely robust (R2 = 0.99) and predicted outcomes for period of lockdown up to 90 days. The predicted increment in HBA1c from baseline at the end of 30 days and 45 days lockdown was projected as 2.26% & 3.68% respectively. Similarly, the annual predicted percentage increase in complication rates at the end of 30-day lockdown was 2.8% for non-proliferative diabetic retinopathy, 2.9% for proliferative diabetic retinopathy, 1.5% for retinal photocoagulation, 9.3% for microalbuminuria, 14.2% for proteinuria, 2.9% for peripheral neuropathy, 10.5% for lower extremity amputation, 0.9% for myocardial infarction, 0.5% for stroke and 0.5% for infections.</p></sec><sec><title>Conclusion</title><p>The duration of lockdown is directly proportional to the worsening of glycaemic control and diabetes-related complications. Such increase in diabetes-related complications will put additional load on overburdened healthcare system, and also increase COVID19 infections in patients with such uncontrolled glycemia.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Chen, Y" uniqKey="Chen Y">Y. Chen</name></author><author><name sortKey="Li, L" uniqKey="Li L">L. 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Jerums</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Ghosal, Samit" sort="Ghosal, Samit" uniqKey="Ghosal S" first="Samit" last="Ghosal">Samit Ghosal</name></noRegion><name sortKey="Majumder, Milan" sort="Majumder, Milan" uniqKey="Majumder M" first="Milan" last="Majumder">Milan Majumder</name><name sortKey="Misra, Anoop" sort="Misra, Anoop" uniqKey="Misra A" first="Anoop" last="Misra">Anoop Misra</name><name sortKey="Misra, Anoop" sort="Misra, Anoop" uniqKey="Misra A" first="Anoop" last="Misra">Anoop Misra</name><name sortKey="Sinha, Binayak" sort="Sinha, Binayak" uniqKey="Sinha B" first="Binayak" last="Sinha">Binayak Sinha</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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