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      Maintenance of Self-Care Activities During COVID-19 Lockdown in Patients with Type 2 Diabetes That Received a Comprehensive Care Program Training

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          Abstract

          Introduction

          In 2020, several countries established a global emergency state. Lockdowns restricted people’s lifestyles and daily activities to prevent coronavirus spread. These measures hindered diabetes mellitus control and lifestyle changes. This study aims to evaluate if attending a multidisciplinary program before the pandemic helped maintain a good metabolic state, lifestyle modifications, and mental health in patients with diabetes mellitus during the COVID-19 lockdown.

          Methods

          Patients included in this study attended a multidisciplinary program, with <5 years of diagnosis of type 2 diabetes, without disabling complications, between 18–70 years old. The complete lockdown occurred from February 27, 2020, to May 31, 2020. The first patient (non-COVID) to return to the center for face-to-face consultation was in March 2021. Consultations in 2019 were face-to-face and changed to a virtual modality during 2020. We analyzed metabolic, lifestyle, mental health, and diabetes education parameters.

          Results

          A total of 133 patients with type 2 diabetes mellitus were included with complete information in visits before and during the lockdown. Metabolic parameters and self-care measures (nutrition plan, foot evaluation, and self-glucose monitoring) evaluated on our patients had no change during the lockdown. We found a significant increase in the time patients spent sitting during the day (p<0.05). Barriers to exercise increased during lockdown, being joint pain (3.8% to 12.0%, p<0.01) and lack of time to exercise (4.5% to 7.5%, p=0.33) being the most common. There was no significant difference in symptoms of anxiety and depression, quality of life, and empowerment.

          Conclusion

          A multidisciplinary diabetes mellitus program, including diabetes education for self-care activities, positively impacts patients, maintaining good outcomes despite lockdown difficulties.

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          Most cited references15

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          The hospital anxiety and depression scale.

          A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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            The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity.

            The International Physical Activity Questionnaire (IPAQ) was developed to measure health-related physical activity (PA) in populations. The short version of the IPAQ has been tested extensively and is now used in many international studies. The present study aimed to explore the validity characteristics of the long-version IPAQ. Forty-six voluntary healthy male and female subjects (age, mean +/- standard deviation: 40.7 +/- 10.3 years) participated in the study. PA indicators derived from the long, self-administered IPAQ were compared with data from an activity monitor and a PA log book for concurrent validity, and with aerobic fitness, body mass index (BMI) and percentage body fat for construct validity. Strong positive relationships were observed between the activity monitor data and the IPAQ data for total PA (rho = 0.55, P < 0.001) and vigorous PA (rho = 0.71, P < 0.001), but a weaker relationship for moderate PA (rho = 0.21, P = 0.051). Calculated MET-h day(-1) from the PA log book was significantly correlated with MET-h day(-1) from the IPAQ (rho = 0.67, P < 0.001). A weak correlation was observed between IPAQ data for total PA and both aerobic fitness (rho = 0.21, P = 0.051) and BMI (rho = 0.25, P = 0.009). No significant correlation was observed between percentage body fat and IPAQ variables. Bland-Altman analysis suggested that the inability of activity monitors to detect certain types of activities might introduce a source of error in criterion validation studies. The long, self-administered IPAQ questionnaire has acceptable validity when assessing levels and patterns of PA in healthy adults.
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              COVID-19 Lockdown and Changes of the Dietary Pattern and Physical Activity Habits in a Cohort of Patients with Type 2 Diabetes Mellitus

              The COVID-19 lockdown clearly affected the lifestyle of the population and entailed changes in their daily habits, which involved potential health consequences, especially on patients with Type 2 Diabetes Mellitus (T2DM). We aimed to examine the impact of the lockdown caused by COVID-19 pandemic on both nutrition and exercise habits, as well as the psychological effects in patients with T2DM, compared to their usual diet and physical activity level previous to the complete home confinement. We also intended to analyse any potential variables that may have influenced these lifestyle modifications. A Food Frequency Questionnaire (FFQ), Physical Activity Questionnaire (IPAQ), Food Craving Questionnaire-State (FCQ-S) and Food Craving Questionnaire-Trait (FCQ-T) were used. Our results showed an increase in vegetable, sugary food and snack consumption. An association between levels of foods cravings and snack consumption was also found. Data also showed a high percentage of physical inactivity before the COVID-19 lockdown, which was exacerbated during the home confinement. These findings emphasise the great importance to do further research with larger study samples to analyse and explore dietary habits and to develop public health policies to promote a healthy lifestyle in terms of diet and physical activity in these patients, especially after this strict period of lockdown.
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                Author and article information

                Journal
                Diabetes Metab Syndr Obes
                Diabetes Metab Syndr Obes
                dmso
                Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
                Dove
                1178-7007
                19 September 2022
                2022
                : 15
                : 2857-2865
                Affiliations
                [1 ]Center of Comprehensive Care for the Patient with Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City, Mexico
                [2 ]Faculty of Health Sciences, Universidad Anáhuac México Norte , Huixquilucan, Mexico
                Author notes
                Correspondence: Sergio Hernández-Jiménez, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Centro de Atención Integral del Paciente con Diabetes , Vasco de Quiroga No. 15, Belisario Domínguez, Colonia Sección XVI, Tlalpan, Mexico City, 14080, Mexico, Tel +1 52 55 54870900 (5045); +1 52 55 55737378, Email sergio.hernandezj@incmnsz.mx
                Author information
                http://orcid.org/0000-0003-0653-4938
                http://orcid.org/0000-0001-6085-6757
                http://orcid.org/0000-0002-6963-0276
                http://orcid.org/0000-0002-0385-1973
                http://orcid.org/0000-0003-4363-3126
                http://orcid.org/0000-0001-6656-2901
                http://orcid.org/0000-0003-3080-8708
                Article
                379547
                10.2147/DMSO.S379547
                9504530
                36160467
                d7e0eb0d-f596-4df6-bd47-37a87784ba77
                © 2022 García Ulloa et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 12 July 2022
                : 07 September 2022
                Page count
                Figures: 1, Tables: 8, References: 21, Pages: 9
                Categories
                Original Research

                Endocrinology & Diabetes
                multidisciplinary care,lifestyle,self-care,mental health,type 2 diabetes,covid-19 pandemics

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