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1.
Arch Osteoporos ; 18(1): 16, 2022 12 28.
Artigo em Inglês | MEDLINE | ID: covidwho-2238611

RESUMO

The aim of this study was to examine the feasibility and effectiveness of telemedicine care provided to osteoporotic patients in Saudi Arabia. Our results show that this service was effective and feasible, and patients had a good rate of satisfaction with it. PURPOSE: To investigate the efficacy and feasibility of telemedicine care in osteoporotic patients during the COVID-19 lockdown period in Saudi Arabia compared to in-person patients, as well as their satisfaction with this service. METHODS: This observational retrospective study was conducted between March 2021 and September 2021 in King Saud University Medical City, Saudi Arabia. A survey was used to compare patients attending telemedicine clinics with in-person patients in terms of access and adherence to medications, occurrence of new fractures, and overall satisfaction with this service. RESULTS: 195 patients attended the telemedicine clinic, while 63 attended the in-person clinic. Exercise frequency was similar in both groups, although exercise intensity was greater in the in-person group. 25(OH)D levels were stable in both groups. The availability and delay of supply of osteoporosis medications were not statistically different between both groups while adherence to treatment did not differ significantly between the two groups. The majority of patients in the telemedicine group were satisfied. CONCLUSIONS: Telemedicine care was feasible and effective in managing osteoporotic patients during the COVID-19 epidemic. Such service could be considered in the future for managing disabled patients and those living in remote areas.


Assuntos
COVID-19 , Telemedicina , Humanos , COVID-19/epidemiologia , Centros de Atenção Terciária , Arábia Saudita/epidemiologia , Pandemias , Estudos Retrospectivos , Controle de Doenças Transmissíveis
2.
Diabetes Metab Syndr ; 16(8): 102567, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: covidwho-1936311

RESUMO

OBJECTIVE: People with type 1 diabetes (T1D) are advised to have a "pre-Ramadan" visit to receive the assessment and education needed to safely fast during the holy month of Ramadan. The COVID-19 lockdown has interrupted this standard of care in Muslim-majority countries where telemedicine is not well-established. Here, we examined the impact of virtual"pre-Ramadan" visits, as an alternative option to the traditional (in-person) visits, on fasting experience and glycemic control during Ramadan in people with T1D. METHOD: 151 individuals with T1D were categorized into 3 groups according to the type of"pre-Ramadan" visit that they attended in 2020: virtual (n = 50), in-person (n = 56), and no visit (n = 45). Number of days fast was broken and CGM metrics were retrospectively compared across the groups. RESULT: Patients who had a virtual"pre-Ramadan" visit were more likely to use continuous glucose monitors (CGM) than those who had no visit (61.7% and 38.6%, respectively, p < 0.05). Attending a virtual"pre-Ramadan" visit was associated with the least number of days fast was broken compared to those who had no visit (p < 0.01) or in-person visit (p = 0.02). CGM time in range (TIR) during Ramadan was the highest in those who had virtual "Pre-Ramadan" visits compared to those who had no visit or in-person visits (59%, 44%, and 47%,respectively). After adjusting for age, gender, pre-Ramadan A1c, and CGM use, the odds of fasting most days of Ramadan were highest in the virtual group [OR (CI): 9.13 (1.43, 58.22)] followed by the in-person group [3.02 (0.54,16.68)] compared to the no visit group. CONCLUSION: Virtual"pre-Ramadan" visits are effective alternative to in-person visits when managing people with T1D who plan to fast during Ramadan.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 1 , Telemedicina , Glicemia , Controle de Doenças Transmissíveis , Jejum , Controle Glicêmico , Humanos , Islamismo , Estudos Retrospectivos
3.
Prim Care Diabetes ; 15(5): 793-798, 2021 10.
Artigo em Inglês | MEDLINE | ID: covidwho-1313366

RESUMO

AIM: To minimize the spread of COVID-19, the Kingdom of Saudi Arabia (KSA) enforced a nationwide lockdown. We aimed to explore whether the manner in which Saudi patients with type 1 diabetes (T1D) manage their disease has changed during this unparalleled lockdown. METHODS: An online survey exploring the effect of lockdown on T1D outcomes was distributed among T1D patients residing in KSA during lockdown. RESULTS: A total of 1010 patients responded to the survey. Around 40% reported communicating with their physicians during lockdown. Age, level of education, residence, previous visits to diabetes education clinics, last HbA1c value, and average monthly income were all significantly associated with communication with the treating physician (p = 0.008, p < 0.001, p < 0.001, p = 0.002, p < 0.001, and p < 0.001, respectively). Age, level of education, and average monthly income were significantly associated with experiencing severe hypoglycemia (p = 0.036, p = 0.03, and p < 0.001, respectively), while average monthly income and level of education were significantly associated with experiencing diabetic ketoacidosis (DKA) (p < 0.001 and p = 0.0039, respectively); during lockdown. Patients who communicated with their physicians reported lower rates of severe hypoglycemia compared to those who did not (25.2% vs 30.7%, respectively). CONCLUSION: Age and level of education were significantly associated with communication with the treating physician, and experiencing severe hypoglycemia and DKA; in patients with T1D during the lockdown period in Saudi Arabia. Keeping two-way virtual communication channels between physicians and their T1D patients should be encouraged.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 1 , Controle de Doenças Transmissíveis , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/epidemiologia , Humanos , SARS-CoV-2 , Arábia Saudita/epidemiologia
4.
Aging Clin Exp Res ; 33(5): 1415-1422, 2021 May.
Artigo em Inglês | MEDLINE | ID: covidwho-1158944

RESUMO

PURPOSE: As the world continues to cautiously navigate its way through the coronavirus disease 2019 (COVID-19) pandemic, several breakthroughs in therapies and vaccines are currently being developed and scrutinized. Consequently, alternative therapies for severe acute respiratory coronavirus 2 (SARS-CoV-2) prevention, such as vitamin D supplementation, while hypothetically promising, require substantial evidence from countries affected by COVID-19. The present retrospective case-control study aims to identify differences in vitamin D status and clinical characteristics of hospitalized patients screened for SARS-CoV-2, and determine associations of vitamin D levels with increased COVID-19 risk and mortality. METHODS: A total of 222 [SARS-CoV-2 (+) N = 150 (97 males; 53 females); SARS-CoV-2 (-) N = 72 (38 males, 34 females)] out of 550 hospitalized adult patients screened for SARS-CoV-2 and admitted at King Saud University Medical City-King Khalid University Hospital (KSUMC-KKUH) in Riyadh, Saudi Arabia from May-July 2020 were included. Clinical, radiologic and serologic data, including 25(OH)D levels were analyzed. RESULTS: Vitamin D deficiency (25(OH)D < 50 nmol/l) was present in 75% of all patients. Serum 25(OH)D levels were significantly lower among SARS-CoV-2 (+) than SARS-CoV-2 (-) patients after adjusting for age, sex and body mass index (BMI) (35.8 ± 1.5 nmol/l vs. 42.5 ± 3.0 nmol/l; p = 0.037). Multivariate regression analysis revealed that significant predictors for SARS-CoV-2 include age > 60 years and pre-existing conditions (p < 0.05). Statistically significant predictors for mortality adjusted for covariates include male sex [Odds ratio, OR 3.3 (95% confidence interval, CI 1.2-9.2); p = 0.02], chronic kidney disease [OR 3.5 (95% CI 1.4-8.7); p = 0.008] and severe 25(OH)D deficiency (< 12.5 nmol/l), but at borderline significance [OR 4.9 (95% CI (0.9-25.8); p = 0.06]. CONCLUSION: In hospital settings, 25(OH)D deficiency is not associated with SARS-CoV-2 infection, but may increase risk for mortality in severely deficient cases. Clinical trials are warranted to determine whether vitamin D status correction provides protective effects against worse COVID-19 outcomes.


Assuntos
COVID-19 , Deficiência de Vitamina D , Árabes , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Estudos Retrospectivos , SARS-CoV-2 , Arábia Saudita , Vitamina D
5.
Diabetes Res Clin Pract ; 173: 108682, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: covidwho-1062309

RESUMO

BACKGROUND: To minimize the spread of Coronavirus Disease-2019, Saudi Arabia imposed a nationwide lockdown for over 6 weeks. We examined the impact of lockdown on glycemic control in individuals with type 1 diabetes (T1D) using continuous glucose monitoring (CGM); and assessed whether changes in glycemic control differ between those who attended a telemedicine visit during lockdown versus those who did not. MATERIALS AND METHODS: Flash CGM data from 101 individuals with T1D were retrospectively evaluated. Participants were categorized into two groups: Attended a telemedicine visit during lockdown (n = 61) or did not attend (n = 40). Changes in CGM metrics from the last 2 weeks pre-lockdown period (Feb 25 - March 9, 2020) to the last 2 weeks of complete lockdown period (April 7-20, 2020) were examined in the two groups. RESULTS: Those who attended a telemedicine visit during the lockdown period had a significant improvement in the following CGM metrics by the end of lockdown: Average glucose (from 180 to 159 mg/dl, p < 0.01), glycemic management indicator (from 7.7 to 7.2%, p = 0.03), time in range (from 46 to 55%, p < 0.01), and time above range (from 48 to 35%, p < 0.01) without significant changes in time below range, number of daily scans or hypoglycemic events, and other indices. In contrast, there were no significant changes in any of the CGM metrics during lockdown in those who did not attend telemedicine. CONCLUSIONS: A six-week lockdown did not worsen, nor improve, glycemic control in individuals with T1D who did not attend a telemedicine visit. Whereas those who attended a telemedicine visit had a significant improvement in glycemic metrics; supporting the clinical effectiveness of telemedicine in diabetes care.


Assuntos
Glicemia/metabolismo , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Diabetes Mellitus Tipo 1/sangue , Controle Glicêmico , Telemedicina , Adolescente , Adulto , Automonitorização da Glicemia/métodos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/epidemiologia , Surtos de Doenças , Feminino , Controle Glicêmico/métodos , Controle Glicêmico/normas , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Avaliação de Programas e Projetos de Saúde , Quarentena/métodos , Quarentena/estatística & dados numéricos , Estudos Retrospectivos , SARS-CoV-2 , Arábia Saudita/epidemiologia , Telemedicina/organização & administração , Telemedicina/estatística & dados numéricos , Adulto Jovem
6.
J Diabetes Sci Technol ; 15(2): 329-338, 2021 03.
Artigo em Inglês | MEDLINE | ID: covidwho-695185

RESUMO

BACKGROUND: The importance of telemedicine in diabetes care became more evident during the coronavirus disease 2019 (COVID-19) pandemic as many people with diabetes, especially those in areas without well-established telemedicine, lost access to their health care providers (HCPs) during this pandemic. SUBJECTS AND METHODS: We describe a simplified protocol of a Diabetes Telemedicine Clinic that utilizes technological tools readily available to most people with diabetes and clinics around the world. We report the satisfaction of 145 patients and 14 HCPs who participated in the virtual clinic and 210 patients who attended the virtual educational sessions about "Diabetes and Ramadan." RESULTS: The majority of patients agreed or strongly agreed that the use of telemedicine was essential in maintaining a good glucose control during the pandemic (97%) and they would use the clinic again in the future (86%). A similar high satisfaction was reported by patients who attended the "Diabetes and Ramadan" virtual educational session and 88% of them recommended continuing this activity as a virtual session every year. Majority of the HCPs (93%) thought the clinic protocol was simple and did not require a dedicated orientation session prior to implementing. CONCLUSIONS: The simplicity of our Diabetes Telemedicine Clinic protocol and the high satisfaction reported by patients and HCPs make it a suitable model to be adopted by clinics, especially during pandemics or disasters in resource-limited settings. This clinic model can be quickly implemented and does not require technological tools other than those widely available to most people with diabetes, nowadays. We were able to successfully reduce the number of patients, HCPs, and staff physically present in the clinics during the COVID-19 pandemic without negatively impacting the patients' nor the HCPs' satisfaction with the visits.


Assuntos
Instituições de Assistência Ambulatorial/organização & administração , COVID-19/epidemiologia , Diabetes Mellitus/terapia , Endocrinologia/organização & administração , Telemedicina/organização & administração , Agendamento de Consultas , Registros Eletrônicos de Saúde , Humanos , Satisfação no Emprego , Pandemias , Satisfação do Paciente , Arábia Saudita/epidemiologia
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