Med. infant; 29 (1), 2022
Publication year: 2022
Introducción:
La diabetes en pacientes con COVID-19 se asocia
a mayor morbilidad y mortalidad. El aislamiento social podría
dificultar el acceso a la atención e insumos médicos. Nuestro
objetivo fue describir el control glucémico durante la pandemia
y los recursos médicos y tecnológicos disponibles. Métodos:
Estudio retrospectivo, descriptivo, analítico y transversal. Se
analizaron los resultados de una encuesta realizada a pacientes
diabéticos del Hospital de Pediatría Juan P. Garrahan. Se
indagó infección por coronavirus, proximidad geográfica, control
metabólico, cobertura, insumos y conectividad. Resultados:
No
se informaron casos de COVID-19. El 52,9% vivía a más de dos
horas de viaje. El 95,7% realizó 4 o más glucemias diarias, el
12,8% estuvo en el rango glucémico ideal de 70-140 mg%, el
75,2% entre 140-250 mg% y el 12% por encima de 250 mg%. El
6,8% presentó cetosis y el 3,4% hipoglucemia severa. El 17,9%
refirió dificultades para conseguir insumos. Todos poseían
internet, 12% con limitaciones. El 10% que vivía a 2 o más horas
del hospital estuvo en rango ideal vs. 28% de los que vivían
más cerca (p=0,02). El 96,4% de los que retiraron insumos de
su cobertura social o provincial alcanzaron un control metabólico
aceptable (70-250 mg%) vs. 79,5% de los que lo hicieron en
el hospital. (p=0,0002). Conclusiones:
La mayoría presentó un
control metabólico aceptable. La distancia y las dificultades de
disponibilidad de insumos, se asociaron a peor control glucémico.
La conectividad y recursos tecnológicos son limitados (AU)
Introduction:
In patients with diabetes who are infected with COVID-19, the latter is associated with increased morbidity and mortality. Social isolation may complicate access to care and medical supplies. Our aim was to describe glycemic control during the
pandemic and the medical and technological resources available.
Methods:
Retrospective, descriptive, analytical, and cross-sectional study. The results of a survey conducted in patients with diabetes seen at Hospital de Pediatría Juan P. Garrahan were analyzed. Coronavirus infection, geographic proximity to the hospital,
metabolic control, healthcare coverage, supplies, and connectivity
were investigated. Results:
No cases of COVID-19 were reported.
Overall, 52.9% lived more than two hours travel from the hospital;
95.7% performed four or more daily capillary blood glucose measurements; in 12.8% blood glucose was within the target range of
70-140 mg%, in 75.2% it was between 140-250 mg%, and in 12%
above 250 mg%; 6.8% had ketosis and 3.4% severe hypoglycemia. Overall, 17.9% reported difficulties in obtaining medical supplies. All had internet access, although 12% with limitations. Ten
percent of the patients who lived 2 or more hours from the hospital
had blood glucose levels within the target range vs. 28% of those
who lived closer (p=0.02); 96.4% of those who received diabetes
supplies from their social or provincial insurance achieved acceptable metabolic control (70-250 mg%) vs. 79.5% of those who did
so from the hospital (p=0,0002). Conclusions:
The majority of patients had acceptable metabolic control. Distance and difficulties
in the availability of supplies were associated with worse glycemic
control. Connectivity and technological resources are limited (AU)