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1.
J Korean Med Sci ; 37(22): e176, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1879452

ABSTRACT

BACKGROUND: Hospital visitation has become challenging during the coronavirus disease 2019 pandemic because of quarantine measures and fear of infection. Consequently, newly diagnosed patients may present with more severe diseases during the pandemic. The present study analyzed the differences in the initial clinical presentations of newly diagnosed patients with type 1 diabetes (T1D) and type 2 diabetes (T2D), comparing pre-pandemic and pandemic periods. METHODS: Newly diagnosed patients with T1D or T2D and aged < 18 years during 2018-2020 were included in the study. Data were collected retrospectively from four academic centers in Gyeonggi-do, South Korea. Initial clinical data were compared between the pre-pandemic (2018-2019) and pandemic (2020) periods. RESULTS: In the pre-pandemic and pandemic periods, 99 patients (41 T1D and 58 T2D patients) and 84 patients (51 T1D and 33 T2D patients) were identified, respectively. During the pandemic, the proportion of diabetic ketoacidosis (DKA) cases increased compared to the pre-pandemic period (21.2% during 2018-2019 vs. 38.1% in 2020; P = 0.012). In the pre-pandemic and pandemic periods, initial pH was 7.32 ± 0.14 and 7.27 ± 0.15, respectively (P = 0.040), and HbA1c values were 11.18 ± 2.46% and 12.42 ± 2.87%, respectively (P = 0.002). During the pandemic, there was an increased risk of DKA in patients with T1D (odds ratio, 2.42; 95% confidence interval, 1.04-5.62; P = 0.040). CONCLUSION: During the pandemic, the proportion of DKA in newly diagnosed patients with T1D increased and clinical parameters showed a deteriorating pattern. Increased awareness of pediatric diabetes, especially DKA, could facilitate visit to the hospital for an early diagnosis; thus, reducing the number of DKA cases during the pandemic era.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 2 , Diabetic Ketoacidosis , COVID-19/epidemiology , Child , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Diabetic Ketoacidosis/diagnosis , Diabetic Ketoacidosis/epidemiology , Humans , Pandemics , Retrospective Studies
2.
Stud Health Technol Inform ; 290: 304-308, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1879404

ABSTRACT

We present an automated knowledge synthesis and discovery framework to analyze published literature to identify and represent underlying mechanistic associations that aggravate chronic conditions due to COVID-19. Our literature-based discovery approach integrates text mining, knowledge graphs and medical ontologies to discover hidden and previously unknown pathophysiologic relations, dispersed across multiple public literature databases, between COVID-19 and chronic disease mechanisms. We applied our approach to discover mechanistic associations between COVID-19 and chronic conditions-i.e. diabetes mellitus and chronic kidney disease-to understand the long-term impact of COVID-19 on patients with chronic diseases. We found several gene-disease associations that could help identify mechanisms driving poor outcomes for COVID-19 patients with underlying conditions.


Subject(s)
COVID-19 , Diabetes Mellitus , Renal Insufficiency, Chronic , Chronic Disease , Diabetes Mellitus/epidemiology , Humans , Pattern Recognition, Automated , Renal Insufficiency, Chronic/epidemiology
3.
4th International Conference on Communications and Cyber-Physical Engineering, ICCCE 2021 ; 828:355-363, 2022.
Article in English | Scopus | ID: covidwho-1877775

ABSTRACT

This paper is proposed to find the diabetes types using machine learning model classification and classifier accuracy using Support Vector Machine (SVM) for classification of whether patient have diabetes or not and classifier accuracy implemented using random forest algorithm as well as for best result XGboost algorithm. Diabetes Mellitus patient may suffer with comorbidity of either kidney, heart stroke or retinopathy or Covid-19 then how the diabetes will effect on more and how much dangerous cases in this pandemic situation. The dataset is collected from standard open source Kaggle this dataset is benchmark. Patient have multiple chronic conditions, screening, conscious and treatment need to take care far exceed time available cases how effect will increase in the various ages. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

4.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-338077

ABSTRACT

Purpose: In young adults (18 to 49 years old), investigation of the acute respiratory distress syndrome (ARDS) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been limited. We evaluated the risk factors and outcomes of ARDS following infection with SARS-CoV-2 in a young adult population. Methods: A retrospective cohort study was conducted between January 1st, 2020 and February 28th, 2021 using patient-level electronic health records (EHR), across 241 United States hospitals and 43 European hospitals participating in the Consortium for Clinical Characterization of COVID-19 by EHR (4CE). To identify the risk factors associated with ARDS, we compared young patients with and without ARDS through a federated analysis. We further compared the outcomes between young and old patients with ARDS. Results: Among the 75,377 hospitalized patients with positive SARS-CoV-2 PCR, 1001 young adults presented with ARDS (7.8% of young hospitalized adults). Their mortality rate at 90 days was 16.2% and they presented with a similar complication rate for infection than older adults with ARDS. Peptic ulcer disease, paralysis, obesity, congestive heart failure, valvular disease, diabetes, chronic pulmonary disease and liver disease were associated with a higher risk of ARDS. We described a high prevalence of obesity (53%), hypertension (38%- although not significantly associated with ARDS), and diabetes (32%). Conclusion: Trough an innovative method, a large international cohort study of young adults developing ARDS after SARS-CoV-2 infection has been gather. It demonstrated the poor outcomes of this population and associated risk factor.

5.
American Journal of Public Health ; 112(6):853-858, 2022.
Article in English | ProQuest Central | ID: covidwho-1877218

ABSTRACT

The coronavirus pandemic reveals an urgent need: the marketing of ultra-processed "junk" food must be stopped. [...]the food industry has gotten away with pushing consumption of high-calorie, highly processed products-as often and in as many places as possible, and in increasingly large amounts-all in the name of profit.1 In this business-first food environment, obesity and its associated type 2 diabetes, coronary heart disease, and, these days, severe outcomes from COVID-19, are collateral damage.2 Because poor health more strongly affects the most vulnerable members of society,3 public health advocates ought to be demanding immediate, forceful government action to discourage food industry production and marketing of unhealthful products. Obesity prevalence rose in parallel with increasing portion sizes.12 The low prices of ultra-processed foods also encourage overconsumption. Since 1980, the prices of all foods have risen with inflation, but those of soft drinks and snacks rose much less than average, whereas fruits and vegetables became relatively more expensive.13 Low food prices democratize eating in fast-food and other restaurants where portions are large and more calories are consumed. [...]in 2000, Michael Jacobson and I, recognizing the food industry's role in weight gain, recommended measures such as taxes and advertising restrictions that would improve the environment of food choice.18 In 2001, the Surgeon General called for obesity policies to reduce racial, ethnic, gender, and age disparities and stigma;to encourage food companies to provide foods and beverages in reasonable portion sizes;and examine its marketing practices (my emphasis).19 Federal Dietary Guidelines for Americans explicitly target personal choice: they advise individuals to reduce consumption of sugar, salt, and saturated fat. The 2020 objectives include modest goals for increasing the proportion of schools that exclude sugar-sweetened beverages and for increasing the number of states that provide incentives to retail outlets selling foods consistent with dietary guidelines.21 Current guidelines and health objectives not only ignore ultra-processed foods but also ignore three valiant but unsuccessful attempts to address the food industry's role in childhood obesity (an easier target than in adults).

6.
Rozhl Chir ; 101(4): 163-167, 2022.
Article in English | MEDLINE | ID: covidwho-1876530

ABSTRACT

INTRODUCTION: Bariatric-metabolic surgery is an effective tool in the treatment of severe obesity and related diseases. Its importance has increased even more in the era of the type II diabetes mellitus and COVID 19 pandemics. The aim of our study is to present the initial results of a new operation that minimizes surgical trauma. METHODS: In the prospective study, laparoscopic side-to-side anisoperistaltic jejunocolic anastomosis was constructed in order to derive part of the chyme by the anastomosis. Patients were operated in the period of IV/2018VII/2019; their mean age was 48.43±10.36 years, mean weight 112.3±16.6 kg and mean BMI 41.9±5.2. Patients were examined one month before surgery and then followed at 3, 6 and 12 months after surgery. We evaluated weight loss and changes in carbohydrate metabolism. RESULTS: We did not record any perioperative or postoperative surgical complications. There was a statistically significant weight loss during the study period. There was a significant decrease in absolute weight in kilograms (p.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Adult , Anastomosis, Surgical/methods , Humans , Middle Aged , Pilot Projects , Postoperative Complications , Prospective Studies , Weight Loss
7.
Endocrinol Metab (Seoul) ; 2022 Jun 03.
Article in English | MEDLINE | ID: covidwho-1875844

ABSTRACT

Vitamin D has received considerable optimistic attention as a potentially important factor in many pathological states over the past few decades. However, the proportion of the active form of vitamin D metabolites responsible for biological activity is highly questionable in disease states due to flexible alterations in the enzymes responsible for their metabolism. For instance, CYP3A4 plays a crucial role in the biotransformation of vitamin D and other drug substances. Food-drug and/or drug-drug interactions, the disease state, genetic polymorphism, age, sex, diet, and environmental factors all influence CYP3A4 activity. Genetic polymorphisms in CYP450-encoding genes have received considerable attention in the past few decades due to their extensive impact on the pharmacokinetic and dynamic properties of drugs and endogenous substances. In this review, we focused on CYP3A4 polymorphisms and their interplay with vitamin D metabolism and summarized the role of vitamin D in calcium homeostasis, bone diseases, diabetes, cancer, other diseases, and drug substances. We also reviewed clinical observations pertaining to CYP3A4 polymorphisms among the aforementioned disease conditions. In addition, we highlighted the future perspectives of studying the pharmacogenetics of CYP3A4, which may have potential clinical significance for developing novel diagnostic genetic markers that will ascertain disease risk and progression.

8.
BJGP Open ; 2022 May 31.
Article in English | MEDLINE | ID: covidwho-1875831

ABSTRACT

BACKGROUND: The Australian government introduced temporary government-subsidised telehealth service items (phone and video-conference) in mid-March 2020 in response to the COVID-19 pandemic. The uptake of telehealth by patients with type 2 diabetes (T2DM) for consulting with GPs is unknown. AIM: To evaluate the uptake of telehealth consultations and associated patient characteristics in Australian general practice, including the frequency of haemoglobin A1c (HbA1c) tests and change in HbA1c levels by telehealth use, compared with guideline recommendations. DESIGN & SETTING: This exploratory study used electronic patient data from approximately 800 general practices in Victoria and New South Wales (NSW), Australia. A pre-COVID-19 period from March 2019-February 2020 was compared with a pandemic period from March 2020-February 2021. Patients diagnosed with T2DM before March 2018 were included. METHOD: Telehealth uptake patterns were examined overall and by patient characteristics. Generalised estimating equation models were used to examine patient probability of 6-monthly HbA1c testing and change in HbA1c levels, comparing between patients who did and patients who did not use telehealth. RESULTS: Of 57 916 patients, 80.8% had telehealth consultations during the pandemic period. Telehealth consultations were positively associated with patients with T2DM who were older, female, had chronic kidney disease (CKD), prescribed antidiabetic medications, and living in remote areas. No significant difference was found in 6-monthly HbA1c testing and HbA1c levels between telehealth users and patients who had face-to-face consultations only. CONCLUSION: Telehealth GP consultations were well utilised by patients with T2DM. Diabetes monitoring care via telehealth is as effective as face-to-face consultations.

9.
Medicina (Kaunas) ; 58(5)2022 May 06.
Article in English | MEDLINE | ID: covidwho-1875699

ABSTRACT

Given the current state of COVID-19, it is crucial to reveal its evolving relationship with and effect on different body organ systems and their diseases. The severity and outcome of COVID-19 have a very complex relationship, especially to the vital organs including the kidney, either in their state of health or disease. Additionally, it is well known that diabetes affects the kidney, leading to diabetic nephropathy. The kidney is also affected by different pathological and immunopathological reactions with COVID-19 infection, leading to acute kidney injury. Therefore, this review intended to extract the recent advances, updates, and discoveries about the effects of COVID-19 on diabetic patients and the relationship between COVID-19 invasion and the diabetic kidney and to discuss the current state of knowledge that has not yet been proved or disproved, leading to numerous controversial issues in looking for the effect of COVID-19 associated with diabetes mellitus on the human kidney.


Subject(s)
Acute Kidney Injury , COVID-19 , Diabetes Mellitus , Diabetic Nephropathies , Acute Kidney Injury/pathology , COVID-19/complications , Diabetes Mellitus/epidemiology , Diabetes Mellitus/pathology , Diabetic Nephropathies/complications , Humans , Kidney
10.
Life (Basel) ; 12(5)2022 Apr 29.
Article in English | MEDLINE | ID: covidwho-1875685

ABSTRACT

Apart from ATP generation, mitochondria are involved in a wide range of functions, making them one of the most prominent organelles of the human cell. Mitochondrial dysfunction is involved in the pathophysiology of several diseases, such as cancer, neurodegenerative diseases, cardiovascular diseases, and metabolic disorders. This makes it a target for a variety of therapeutics for the diagnosis and treatment of these diseases. The use of nanoparticles to target mitochondria has significant importance in modern times because they provide promising ways to deliver drug payloads to the mitochondria by overcoming challenges, such as low solubility and poor bioavailability, and also resolve the issues of the poor biodistribution of drugs and pharmacokinetics with increased specificity. This review assesses nanoparticle-based drug-delivery systems, such as liposomes, DQAsome, MITO-Porters, micelles, polymeric and metal nanocarriers, as well as quantum dots, as mitochondria-targeted strategies and discusses them as a treatment for mitochondrial disorders.

11.
Iranian Red Crescent Medical Journal ; 24(4), 2022.
Article in English | CAB Abstracts | ID: covidwho-1876520

ABSTRACT

Introduction: Rectus sheath hematoma (RSH) is an uncommon cause of acute abdominal pain that is often misinterpreted. Only about 2% of patients who present with acute abdominal pain display this condition. Damage to the superior or inferior epigastric arteries or their branches, as well as direct rupture of the rectus abdominis muscle, causes bleeding into the rectus sheath. In hospitalized COVID-19 patients, anticoagulant prophylaxis with heparin has become a standard part of medical care. This method may raise the risk of bleeding in older people with comorbidities. Case presentation: The patient was a 60-year-old woman with a history of asthma and diabetes mellitus who was referred to the emergency department with shortness of breath and cough. Chest X-Ray demonstrated Covid-19 pneumonia. On the second day of hospitalization, after the exacerbation of tachypnea, computed tomography (CT) angiography was performed, and the results confirmed pulmonary embolism;therefore, the therapeutic dose of heparin was initiated. On the 21st day of hospitalization, the patient experienced abdominal pain and was visited by a general surgeon. A large ecchymosis was observed in the periumbilical;nonetheless, there was no significant tenderness in the abdominal exam. The patient's hemoglobin dropped to 7.9 mg/dl at this time. An abdominal and pelvic CT scan showed a 45 mm hematoma in the left rectus muscle.

12.
Quantitative Biology ; 9(1):23-46, 2021.
Article in English | ProQuest Central | ID: covidwho-1876231

ABSTRACT

COVID-19 is now rapidly spreading worldwide. While the majority of COVID-19 patients show only mild or moderate symptoms, some could deteriorate quickly and may succumb to a sudden death. It is therefore important to identify who will be more likely to develop severe outcomes and be treated with particular or preventive care. Here in this literature survey, we collected epidemiologic and clinical data from 36 articles on 51,270 patients with different severity of COVID-19, aiming to characterize the population that are prone to severe condition and bad outcomes. These data reveal that old males and those with high BMI or underlying diseases, especially cardiovascular disease, hypertension and diabetes, are overrepresented among severe cases. High leukocyte and lymphopenia are common features in severe and critical patients. Upon deterioration of the disease, both CD4 and CD8 T cells are decreased, while almost all serum cytokines, especially pro-inflammatory cytokines, increased.

13.
Bioinformation ; 18(4):402, 2022.
Article in English | ProQuest Central | ID: covidwho-1876088

ABSTRACT

It is of interest to assess the immediate and antecedent causes of mortality amongst adult COVID-19 infected patients with or without comorbidities admitted in an exclusive COVID-19 hospital was conducted the between August 2020 to May 2021. The immediate and antecedent causes were collected from the medical certificate of cause of death (MCCD). Remaining data was extracted from the hospital's record. ICMR protocol was used to grade severity of illness at admission into mild, moderate and severe categories. Clinical status during hospitalisation and most recent radiographic and laboratory data were used to assess disease progression and outcome. This study includes data from 571 people, who died at our centre between August 2020 and May 2021. Patients registered without any co-morbidity were 146 with mean age of 57.53 years;(33/146) were females and (110/46) males. Hypertension (274, 47.99%) was found in a moderately large number of patients followed by diabetes (225, 39.4%) and anaemia (199, 34.6%). Increase in risk of mortality of COVID-19 was found maximum in patients with acute respiratory distress syndrome (72.33%), followed by secondary infections (6.83%). Mortality recorded in this study was mainly in males of older age (50 years and above) with at least one co-morbidity. Anaemia was also prevalent amongst these patients and considered as an independent factor for mortality. Hence, recording of comorbidities and haemoglobin levels may help as a guideline to develop risk stratification and management of patients with COVID-19 to reduce overall mortality.

14.
Journal of Pharmacy and Bioallied Sciences ; 14(1):46-51, 2022.
Article in English | ProQuest Central | ID: covidwho-1875948

ABSTRACT

Background: There was a global surge in cases of mucormycosis in COVID-19 patients during the second wave of the pandemic in 2021, reported especially from India. Various predisposing factors such as diabetes mellitus, rampant use of corticosteroids, and COVID-19 per se may be responsible for this spike. Some public health experts have postulated that the epidemiological link between the Delta variant of SARS-CoV-2 and mucormycosis should be explored. Material and Methods: A retrospective exploratory study was conducted, in which data of 15 laboratory-confirmed cases of COVID-19 with mucormycosis and/or aspergillosis co-infections were collected after obtaining approval from the institute's ethics committee. These patients were admitted to the Mucor wards of our hospital. The positive COVID-19 status of these patients was confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR). The residual SARS-CoV-2 RNA containing elutes of these patients were stored at −80°C in deep freezers and subjected to whole-genome sequencing in June 2021 at the National Centre for Disease Control (NCDC), New Delhi, India as part of the Indian SARS-CoV-2 Genomic Consortia (INSACOG) program. Concomitant fungal infections in these patients were diagnosed by KOH wet mount and fungal culture as per standard guidelines. Descriptive statistics in the form of percentages and median were used to report the findings. Results: Periorbital swelling and ocular pain (14/15;93.33%), followed by facial swelling (11/15;73.33%) and nasal obstruction (9/15;60%), were the most common clinical features observed in these patients. Rhizopus arrhizus was the most common causative fungal agent (12/15;80%). The majority of the patients (9/13;69.23%) were infected with the Delta variant of SARS-CoV-2. Conclusion: COVID-associated mucormycosis seems to be multifactorial in origin. Although there may be a possible association between mucormycosis and the Delta variant, more studies should be conducted to explore this seemingly reasonable proposition.

15.
Journal of Family Medicine and Primary Care ; 11(5):1834-1841, 2022.
Article in English | GIM | ID: covidwho-1875940

ABSTRACT

Background: About 10% of patients with type 2 diabetes mellitus at the time of diagnosis have more than one risk factor for developing foot ulceration, and it increases to 15% in a lifetime. The risk of development of Diabetic foot ulcers/gangrene can be prevented by the patient's self-foot care practice at home. The present study aimed to determine the prevalence of awareness of self-foot care practice among diabetic patients in a rural setting. The study also aimed to identify the factors preventing dry or wet diabetic gangrene development and subsequent amputation.

16.
Journal of Family Medicine and Primary Care ; 11(5):1664-1671, 2022.
Article in English | CAB Abstracts | ID: covidwho-1875930

ABSTRACT

Upsurge in mucormycosis cases in the second wave of SARS CoV2 infection in India has been reported. Uncontrolled diabetes is the major predisposing risk factor for these cases. The early diagnosis and surgical intervention with medical treatment may result in good clinical outcomes. The glycaemic control in diabetic patients also favours better treatment outcome in patients suffering from mucormycosis.

17.
1st International Conference on Technologies for Smart Green Connected Society 2021, ICTSGS 2021 ; 107:16431-16440, 2022.
Article in English | Scopus | ID: covidwho-1874868

ABSTRACT

BACKGROUND: COVID-19 (corona virus) is a recently acknowledged disease. Corona is spreading quickly in the whole world At least 185 countries. Many cases from china. Covid-19 causes many death and abnormalities. mortality rate in covid-19 patient is low(1.4-2.3) but in diabetic patients have poor immune system and this a severe co-morbidity so mortality rate is high in Diabetic patients with covid-19. Diabetes mellitus refer as risk factor that arises with mortality and severity of covid-19 there's no absolute article and journals to direct the actual connection between diabetes mellitus and covid-19. So the aim of this study to sum up the confirmation About covid-19 and diabetes mellitus breakout all over a meta-analysis and systematic review. METHODS: A writing analysis was applied within detail of SCOPUS PUBMED, DIRECT SCIENCE, & SCIENCE related network. Monitoring analysis, studies of case- series and case reports on the diabetes mellitus in covid-19, were involved. RESULT: Some studies recommended such there are no notable differences in symptoms between diabetes mellitus with covid-19 and non-diabetic corona patients. In this patient acute Respiratory distress syndrome prognosis is poor. Death chances increase with age and seriousness of disease. Those people survive ARS. Some recover completely, while other Encounter lasting Damage of Lungs. Serious Manifestations and rate of death is higher between patients of diabetes mellitus and covid-19. In short this recommended the patient who suffering from diabetes or will be treated with H C Q antibiotics, anti- viral drugs. CONCLUSION: The analysis and the data of this study Convey such determinant condition of diabetes mellitus, which shows the high rate of mortality and severity among the patient who are suffering from covid-19 this article also provide us guidelines and criteria regarding diagnosis that can be convenient in the treatment and prevention of medical condition of the patient who is suffering from diabetes mellitus and covid-19. © The Electrochemical Society

18.
J Investig Med ; 2022 Jun 02.
Article in English | MEDLINE | ID: covidwho-1874631

ABSTRACT

COVID-19 infection is known to increase mortality in patients with diabetes. We aim to demonstrate the differences in disease course and clinical outcomes of patients with COVID-19 regarding the presence of impaired fasting glucose, pre-existing diabetes mellitus (DM) or new-onset DM. 236 patients with positive reverse transcription-PCR tests for SARS-CoV-2 were included in this single-center, retrospective observational study between March 2020 and May 2021. Laboratory results, comorbidities, medications and imaging findings were noted. Logistic regression was used to estimate associated factors for admission to the intensive care unit (ICU). 43 patients with normal glucose, 53 with impaired fasting glucose, 60 with newly diagnosed DM, and 80 with pre-existing DM were classified. Patients with pre-existing DM had higher fasting glucose and glycated hemoglobin than the other groups (p<0.001 for all). Patients with newly diagnosed DM were more likely to need dexamethasone 6 mg (p=0.001). In both newly diagnosed diabetes and impaired fasting glucose groups, 250 mg methylprednisolone was needed at higher rates (p=0.002). Newly diagnosed DM had higher rates of intubation (21.6%) and more mortality (20.0%) (p=0.045 and p=0.028, respectively). Mortality and hospitalization in the ICU were lower in the group receiving antidiabetic treatment. The risk of ICU attendance was higher in patients with impaired fasting glucose (HR=1.71, 95% CI: 0.48 to 6.08) and newly diagnosed DM (HR=1.88, 95% CI: 0.57 to 6.17), compared with pre-existing DM and non-diabetics. Newly diagnosed DM and impaired fasting glucose are associated with increased mortality and intubation in inpatients with COVID-19.

19.
JMIR Diabetes ; 7(2), 2022.
Article in English | ProQuest Central | ID: covidwho-1871420

ABSTRACT

Background: The use of digital technology to assess patients remotely can reduce clinical study costs. In the European Union, the 2D matrix code on prescription drug packaging serves as a unique identifier of a given package of medication, and thus, also of the patient receiving that medication. Scanning of the 2D matrix code may therefore allow remote patient authentication in clinical studies. Objective: The aim of the DePRO study was to assess the feasibility of a fully digital data-capture workflow, the authentication of participants via drug packaging 2D matrix codes, in patients with type 2 diabetes mellitus (T2DM) who use metformin. The primary objective was to describe the self-care activities of these patients. Secondary objectives were to evaluate (1) the self-reported health status of these patients, (2) the association of self-care activities with demographics and disease characteristics, and (3) the usability of the my ePRO app. Methods: DePRO was an observational, multicenter, cross-sectional, digital, and patient-driven study conducted in Germany from June to December 2020. Adult patients prescribed metformin were invited to participate via their pharmacist or a medication tracker app. Participants downloaded the my ePRO app onto their own mobile device, scanned the 2D matrix code on their metformin package for registration and authentication, and provided informed consent via an electronic form. They were then able to complete a study-specific questionnaire on demographics and clinical characteristics, the German version of the Summary of Diabetes Self-Care Activities measure (SDSCA-G), the Diabetes Treatment Satisfaction Questionnaire (DTSQ), and the EQ-5D-5L. The patients conducted the study without support from a health care professional. Statistical analyses were exploratory and descriptive. Results: In total, 3219 patients were invited to participate. The proportion of patients giving consent was greater among those invited by pharmacists (19/217, 8.8%) than among those invited via the medication tracker app (13/3002, 0.4%). Of the 29 patients eligible for analysis, 28 (97%) completed all study questionnaires. Most of the patients (23/29, 79%) were aged <60 years, and 59% (17/29) were male. The patients spent a mean total of 3.5 (SD 1.3) days out of 7 days on self-care activities (SDSCA-G). Most patients (24/29, 83%) were satisfied to extremely satisfied with their current treatment (DTSQ). Events of perceived hyperglycemia or hypoglycemia were reported by 20 of 29 (69%) patients. The best possible health status (EQ-5D-5L) was reported by 18 of 28 (64%) patients. Age was positively correlated with time spent on general and specific diet (Spearman coefficient 0.390 and 0.434, respectively). Conclusions: The DePRO study demonstrates the feasibility of fully digital authentication (via 2D matrix codes on drug packaging) and data capture in patients with T2DM. Personal invitations yielded higher recruitment rates than remote invitations via the medication tracker app. A high questionnaire completion rate was realized, based on completion by 28 out of 29 patients. Trial Registration: ClinicalTrials.gov NCT04383041;https://clinicaltrials.gov/ct2/show/NCT04383041 International Registered Report Identifier (IRRID): RR2-10.2196/21727

20.
International Journal of Environmental Research and Public Health ; 19(10):6315, 2022.
Article in English | ProQuest Central | ID: covidwho-1871415

ABSTRACT

This paper qualitatively explores how technologies and physical activity are experienced by adolescents with type 1 diabetes. Type 1 diabetes is a life-threatening autoimmune condition, which is highly prevalent in young children. Physical activity is underutilised as part of treatment goals due to multifactorial challenges and lack of education in both the family setting and across society as a whole. Using photovoice methodology, 29 participants (parents and adolescents), individually or as dyads, shared and described in reflective journal format examples of technology and physical activity in their lives. In total, 120 personal photographs with accompanying narratives were provided. The data were thematically coded by the researcher and then collaboratively with participants. Four key themes (and 12 subthemes) were generated including: (i) benefits of technology;(ii) complexity and difficulty;(iii) emotional impact;(iv) reliance and risk. Findings demonstrate that current technology does not address the complex needs of adolescents with type 1 diabetes to enable participation in physical activity without life risk. We conclude from our findings that future technologies for supporting engagement in physical activity as part of diabetes management need to be: more interoperable, personalised and integrated better with ongoing education and support.

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