Quality of care in patients with type 1 diabetes during the COVID-19 pandemic : a cohort study from Southern Brazil

• Main Author: Foppa, Luciana
• Publication Date: 2022
• Other Authors: Alessi, Janine, Nemetz, Betina, Matos, Rosimeri de, Teló, Gabriela Heiden, Schaan, Beatriz D'Agord
• Format: Article
• Language: eng
• Source: Repositório Institucional da UFRGS
• Download full: http://hdl.handle.net/10183/257174
• topic: Diabetes mellitus tipo 1; Indicadores de qualidade em assistência à saúde; COVID-19; Assistência ambulatorial; Diabetes mellitus, Type 1; Quality indicators, Health care; Ambulatory care

Background: Optimal glycemic control is the main goal for patients with diabetes. The results of type 1 diabetes patients’ neglected demands during the pandemic can determine a long-term negative clinical, social, and economic impact, and result in worse diabetes control and a higher incidence of chronic complications. Therefore, this study aims to evaluate the impact of the COVID-19 outbreak in the quality of care of patients with type 1 diabetes in Southern Brazil. Methods: Cohort study based on electronic medical records of patients with type 1 diabetes, with scheduled appointments between January 1st 2020, and November 6th 2020, at a university public hospital. The quality indicators used were: assessment of albuminuria and/or serum creatinine, lipid profile, thyroid-stimulating hormone, glycated hemoglobin, retinopathy, and neuropathy. McNemar test was used to analyze categorical variables and the Wilcoxon test for continuous variables. Results: Out of 289 patients, 49.5% were women aged 40 ± 12 years old. During the pandemic, 252 patients had at least one face-to-face appointment canceled. The quality of care indicators showed a significant worsening during the COVID-19 pandemic compared to the previous year (p < 0.001). In 2019, 23.2% of the participants had all the indicators evaluated, while in 2020, during the pandemic, only 3.5% had all of them evaluated. Conclusion: The COVID-19 pandemic hindered the offer of comprehensive and quality care to patients with type 1 diabetes.