Related Experiment Video
Updated: Dec 5, 2025
Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health
Published on: December 1, 2023
Decentralized COVID-19 measures in Brazil were ineffective to protect people with diabetes
Mark Thomaz Ugliara Barone1, Simone Bega Harnik2, Matheus Chaluppe3
1International Diabetes Federation (IDF), 166 Chaussée de La Hulpe B-1170 Brussels, Belgium; ADJ Diabetes Brasil (ADJ). Rua Padre Antônio Tomás, 213, Zip code, 05003-010, Água Branca, São Paulo, SP, Brazil; Fórum Intersetorial para Combate às DCNTs no Brasil (ForumDCNTs), Rua Padre Antônio Tomás, 213, 05003-010, Água Branca, São Paulo, SP, Brazil; Sociedade Brasileira de Diabetes (SBD), Rua Afonso Braz 579, Salas 72/74, Vila Nova, Conceição, 04511-011, São Paulo SP, Brazil.
Insights
COVID-19 care for people with diabetes in Brazil was inadequate. Many individuals with diabetes faced challenges accessing medications and experienced worsened blood glucose control due to decentralized pandemic measures.
Area of Science:
- Endocrinology and Metabolism
- Public Health
- Infectious Diseases
Background:
- Individuals with diabetes face elevated COVID-19 severity and mortality risks.
- Global and Brazilian recommendations for diabetes management during the pandemic emphasized glycemic control and home confinement.
- The effectiveness of these measures in Brazil required assessment.
Purpose of the Study:
- To evaluate the impact of pandemic-related diabetes management strategies in Brazil.
- To assess whether recommended measures achieved their objectives of maintaining glycemic control and safety for people with diabetes.
Main Methods:
- An anonymous, untraceable online survey was conducted from April 22nd to May 4th.
- Data from 26 Brazilian states were analyzed, with states requiring over 30 respondents included.
- Fisher's exact test was used for association analysis (p < 0.05 significance).
Main Results:
- 1562 responses from 10 states and the Federal District were analyzed.
- Most respondents (across 7 states) reported increased glycemia or glycemic variability during the pandemic.
- Significant postponement of medical consultations and lab exams occurred in major states (Minas Gerais, Rio de Janeiro, São Paulo); Goiás, with better medication access, showed lower glycemic deterioration.
Conclusions:
- Decentralized pandemic measures in Brazil left many people with diabetes unprotected.
- Forced monthly excursions for medical supplies led to reported increases in glycemic levels and variability.
- The study highlights the need for robust, centralized support systems for chronic disease management during health crises.
Background And Aims:
COVID-19 severity and mortality are elevated in individuals with diabetes. During the pandemic, interventions recommended globally for people with diabetes were to keep blood glucose on target whilst staying at home to curb the spread of the virus. In Brazil, similar measures were proposed. The aim of our observational study was to assess whether these measures achieved their objectives.
Methods:
An anonymous and untraceable survey was shared from April 22nd to May 4th. States with more than 30 respondents were included in the analysis and Fisher's exact test was performed to identify associations, with p < 0.05 considered significant.
Results:
Type 1 diabetes and female participants were prevalent, 60.76% and 76.12% respectively. 10 out of 26 states were included, in addition to the Federal District (1562 responses). Only in three states (Bahia, Goiás and Pernambuco) less than 50% of the respondents experienced higher glycemia or higher variability during the pandemic. Goiás state, where almost half of the respondents (49.12%) have private insurance, presented the highest percentage of individuals receiving medicines for three months (35.48%) and one of the lowest percentages of blood glucose deterioration (47.17%). In the large states of Minas Gerais, Rio de Janeiro and São Paulo, consultations and/or lab exams were postponed by 37.14%, 34.33% and 40.88%, respectively.
Conclusions:
The decentralized measures implemented by states in Brazil left most people with diabetes unprotected. Many were forced to venture outside to collect or to purchase their medical supplies monthly and reported increased glycemic levels and/or variability.
Related Concept Videos
01:15Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:22Diabetes Mellitus: Type 2 and Gestational
01:36Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...