COVID-19 and type 1 diabetes: Challenges and actions
| العنوان: | COVID-19 and type 1 diabetes: Challenges and actions |
|---|---|
| المؤلفون: | Emma Louise Klatman, Graham D. Ogle, Stéphane Besançon, Silver Bahendeka, Mary T Mayige |
| المصدر: | Diabetes Research and Clinical Practice |
| بيانات النشر: | Elsevier B.V., 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Coronavirus disease 2019 (COVID-19), Adolescent, Endocrinology, Diabetes and Metabolism, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.medical_treatment, Pneumonia, Viral, Article, Diabetes Complications, Betacoronavirus, Endocrinology, Diabetes mellitus, Pandemic, Internal Medicine, medicine, Insulin, Humans, Child Care, Mortality, Child, Pandemics, Developing Countries, Poverty, Type 1 diabetes, biology, SARS-CoV-2, business.industry, Diabetes, COVID-19, General Medicine, Supply chain, medicine.disease, biology.organism_classification, Self-Care Units, Virology, Diabetes Mellitus, Type 1, Adolescent Health Services, Health Resources, Comprehensive Health Care, Coronavirus Infections, business, Intermediate Care Facilities, COVID 19 |
| الوصف: | Optimal care for children and adolescents with type 1 diabetes is well described in guidelines, such as those of the International Society for Pediatric and Adolescent Diabetes. High-income countries can usually provide this, but the cost of this care is generally prohibitive for lower-income countries. Indeed, in most of these countries, very little care is provided by government health systems, resulting in high mortality, and high complications rates in those who do survive. As lower-income countries work toward establishing guidelines-based care, it is helpful to describe the levels of care that are potentially affordable, cost-effective, and result in substantially improved clinical outcomes. We have developed a levels of care concept with three tiers: "minimal care," "intermediate care," and "comprehensive (guidelines-based) care." Each tier contains levels, which describe insulin and blood glucose monitoring regimens, requirements for hemoglobin A1c (HbA1c) testing, complications screening, diabetes education, and multidisciplinary care. The literature provides various examples at each tier, including from countries where the life for a child and the changing diabetes in children programs have assisted local diabetes centres to introduce intermediate care. Intra-clinic mean HbA1c levels range from 12.0% to 14.0% (108-130 mmol/mol) for the most basic level of minimal care, 8.0% to 9.5% (64-80 mmol/mol) for intermediate care, and 6.9% to 8.5% (52-69 mmol/mol) for comprehensive care. Countries with sufficient resources should provide comprehensive care, working to ensure that it is accessible by all in need, and that resulting HbA1c levels correspond with international recommendations. All other countries should provide Intermediate care, while working toward the provision of comprehensive care. |
| اللغة: | English |
| تدمد: | 1872-8227 0168-8227 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5003717f001805c76b32b3bb92fb40c0Test http://europepmc.org/articles/PMC7311352Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....5003717f001805c76b32b3bb92fb40c0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18728227 01688227 |
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