O impacto da pandemia da COVID-19 no perfil clínico dos pacientes diabéticos atendidos no Centro de Especialidades Médicas do Cesupa no ambulatório de hiperdia durante o período de 2019 a 2021

Abstract

Diabetes Mellitus type 2 is a chronic disease resulting from a state of hyperglycemia and peripheral insulin resistance, which gained notoriety during the COVID-19 pandemic because it is a comorbidity of risk for the development of this infection, as well as other chronic diseases. Consequently, the control of glycemic levels of diabetic patients faced obstacles embedded by the chaotic scenario that developed in the pandemic period, such as: social isolation, decreased supply of basic health services, difficulty in accessing consultations and elective procedures. Therefore, it is important to conduct a study that analyzes the change in the clinical profile of diabetic patients during the pandemic period. To leverage data that translates the change in the clinical profile of diabetic patients followed at the Hiperdia outpatient clinic of the Center for Medical Specialties of CESUPA (CEMEC) in the period of 2019 to 2021. This is a descriptive cross-sectional analytical study conducted by collecting data from medical records provided by the Center for Medical Specialties of CESUPA (CEMEC). Regarding the epidemiological profile, the majority are female (63.9%) aged 60 to 89 years (57.4%). Regarding the anthropometric variables analyzed, weight and BMI, no significant changes were found, both in BMI (p=0.124), or weight (p=0.244), between 2019 and 2020; between 2020 and 2021, there were also not many changes. In the present study, when comparing the number of drugs between 2019 and 2020, there was an increase (Mean ± SD:1.5 ± 0.7 vs 1.7 ± 0.8; P=0.050). Regarding the number of tablets, there was also an increase between 2019 and 2020 (Mean ± SD: 3.5 ± 1.7 vs 3.9 ± 1.7; P<0.001). Between 2020 and 2021, the number of medicines did not differ significantly (p=0.881) nor the number of tablets (p=0.814). It was possible to observe that the daily dose of metformin between 2019 and 2020 showed an increase (Mean ± SD: 1607.5 mg ± 686.5 mg vs 1761.3 mg ± 673.8 mg; P=0.019). Regarding laboratory tests, between 2019 and 2020 there was low difference between fasting blood glucose values (Mean ± SD: 134.4 ± 37.4 vs 144.2 ± 59.3; P=0.348), postprandial glycemia (Mean ± SD: 177.0 ± 76.7 vs 154.8 ± 40.3; P=0.384) and glycated hemoglobin (Mean ± SD: 7.0 ± 1.3 vs 6.9 ± 2.4; P=0.315). Before these results, it is possible to conclude that during the pandemic there was an adjustment in the therapeutic plan of the followed-up patients, with an increase in the number of medications and tablets. In addition, most patients improved glycemic levels by fasting glycemia, postprandial glycemia and glycated hemoglobin. Thus, it is ensured that this work is of great value, because it is found that despite the obstacles faced by patients during the pandemic, diabetes control was achieved.