Exhaustion and burnout in the healthcare system in Greece: A cross-sectional study among internists during the COVID-19 lockdown.

The COVID-19 pandemic has rapidly changed everyday life around the world. The situation created by the COVID-19 pandemic has been shown to be associated with severe mental health problems in frontline medical and nursing staff. The aim of this study was to investigate exhaustion, disengagement, secondary traumatic stress, compassion satisfaction, burnout, as well as depression, anxiety and stress among internists in Greece, during the second lockdown period. Internists were approached through the Internal Medicine Society of Greece and a total of 117 participated in the study (response rate: 15.3%). The participants responded through a Google form on the Depression, Anxiety and Stress Scale - 21, the Oldenburg Burnout Inventory (OLBI) and the Professional Quality of Life Scale version 5 (ProQOL-5). Exhaustion was found in the majority of the participants (88%), 65.8% met the criteria for at least moderate levels of compassion satisfaction and 71.8% presented moderate levels of burnout. Furthermore, about half of the participants met the criteria for moderate to extremely severe levels of depression, anxiety and stress. Finally, regression analyses showed that depression was associated with both the OLBI and ProQOL-5 scales. The majority of the internists, during the lockdown period in Greece, were evaluated as "exhausted", with high rates of negative psychological symptoms. The present study, despite the limitations, highlights the impact of the COVID-19 pandemic on internists, which triggered a shift in attention onto the treatment, and especially the prevention, of stressful situations for health professionals.

Is HbA1c an ideal biomarker of well-controlled diabetes?

HbA1c is a biomarker with a central role in the diagnosis and follow-up of patients with diabetes, although not a perfect one. Common comorbidities encountered in patients with diabetes mellitus, such as renal insufficiency, high output states (iron deficiency anaemia, haemolytic anaemia, haemoglobinopathies and pregnancy) and intake of specific drugs could compromise the sensitivity and specificity of the biomarker. COVID-19 pandemic poses a pressing challenge for the diabetic population, since maintaining optimal blood glucose control is key to reduce morbidity and mortality rates. Alternative methods for diabetes management, such as fructosamine, glycosylated albumin and device-based continuous glucose monitoring, are discussed.