The effect of COVID-19 pandemic on diabetes care indices in Southern Iran: an interrupted time series analysis.

BACKGROUND: Type 2 diabetes mellitus (T2DM) requires a continues bulk of cares. It is very probable COVID-19 pandemic is affected its healthcare coverage. METHODS: The interrupted time series analysis is used to model the trend of diabetes healthcare indices, such as the health worker visits, physician visits, body mass index (MBI), fasting blood sugar (FBS), and hemoglobin A1c (HbA1c), before and after the start of COVID-19 pandemic. The reference of data was the totals of all T2DM patients living in Fars Province, Southern Iran, areas covered by Shiraz University of Medical Science (SUMS), from 2019 to 2020. RESULTS: A significant decrease for visits by the health workers, and physicians was observed by starting COVID-19 pandemic (ß2 = -0.808, P < 0.001, ß2 = -0.560, P < 0.001); Nevertheless, the coverage of these services statistically increased by next months (ß3 = 0.112, P < 0.001, ß3 = 0.053, P < 0.001). A same pattern was observed for the number of BMI, FBS and HbA1c assessments, and number of refer to hospital emergency wards (ß3 = 0.105, P < 0.001; ß3 = 0.076, P < 0.001; ß3 = 0.022, P < 0.001; ß3 = 0.106, P < 0.001). The proportion of T2DM patients with HbA1C < 7%, and controlled hypertension during study period was statistically unchanged. CONCLUSIONS: When the COVID-19 pandemic was announced, T2DM healthcare coverage drastically decreased, but it quickly began to rebound. The health monitoring system could not have any noticeable effects on diabetes outcomes.

Prevalence and predictive factors of transient and permanent congenital hypothyroidism in Fars province, Iran.

INTRODUCTION: There is no data on the number as well as the prevalence of congenital hypothyroidism (CH) in the Fars province. Hence, we designed this study to analyze the latest data and the possible predictive factors on transient and permanent CH in this province. METHOD: This cross sectional study is based on the Fars province screening data from 2013 to 2016. A total of 294,214 newborns were screened with 938 confirmed cases of CH, which were included in this study. After recall and completion of the missing data, follow-up data for 642 CH cases with thyroid stimulating hormone (TSH) concentrations and levothyroxine doses for ten outpatient visits and final transient vs. permanent CH diagnosis were included. RESULTS: The incidence rate was 1:313.66, and out of the 642 CH cases, 66.04 % had permanent CH, while 33.96 % had transient CH. TSH level trend during the outpatient visits were not statistically different between the two groups (P = 0.312). A cutoff point of > 2.25 levothyroxine µg/kg (sensitivity: 76.11 %, specificity: 58.52 %) at the third year and a TSH concentration of > 43.35 mIU/L at the venous sampling (initial TSH) (sensitivity: 31.66 %, specificity: 90.32 %) were the predictive factors for permanent CH. CONCLUSION: Fars province has one of the highest incidence rate of CH in Iran. Levothyroxine dose at the 3rd year and the 1st venous TSH sample are the predictive factors for permanent CH in the Iranian population; however, TSH concentrations during follow ups are unreliable predictors.