Cardiorespiratory Physiotherapy, Critical Care and Rehabilitation
Cardiorespiratory Physiotherapy, Critical Care and Rehabilitation
Short Communication

Multi-level barriers faced and lessons learned to conduct a randomized controlled trial in patients with diabetes and prediabetes during the COVID-19 pandemic in Brazil

Lilian Pinto da Silva; Mariana Balbi Seixas; Ana Paula Delgado Bomtempo Batalha; Isabela Coelho Ponciano; Paul Oh; Gabriela Lima de Melo Ghisi

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Coronavirus disease 2019 (COVID-19) is a public health emergency of international concern. In March 2021, the number of confirmed cases worldwide reached 127,818,432, and Brazil ranked second among the countries with the highest number of confirmed cases (more than 12,573,615) and second in number of deaths worldwide . This pandemic is considered the most significant global health crisis of our time due to a high mortality rate associated with severe socioeconomic disruptions, educational institutions’ closures, shortages of medical supplies, and barriers for health systems and people, especially those living with chronic diseases such as diabetes .

Diabetes is considered a risk factor for COVID-19 progression and worse prognosis . People living with this health condition are warranted extra precautions, such as having at least a 30-day prescription supply and non-prescription medicines and having their healthcare provider’s phone number handy to connect if any concerns arise. Social distancing measures adopted as a strategy for the non-propagation and contamination of the virus caused difficulties for these patients to continue their treatments, which usually involve diabetes self-management education and support, dietary recommendations, and physical exercise . Therefore, these restrictions are leading to metabolic dysregulation and lack of control of coexisting cardiometabolic conditions in these patients.


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