The covid-19 pandemic led 59.5% of people with diabetes to reduce physical activity, while 59.4% had a change in blood glucose and 38.4% postponed medical appointments and routine exams, reveals a survey conducted in the first half of the year past, at the beginning of the health crisis. In the survey, 1 out, heard 1,700 Brazilians with the disease. The survey was led by and specialist in Diabetes Education of the Brazilian Society of Diabetes (SBD), Mark Barone.
Even in the initial phase of the pandemic, impacts on the lives of patients were already observed, such as changes in blood glucose in almost 60% of them, due to changes in routine, said specialist in diabetes education at the Brazilian Society of Diabetes (SBD), Mark Barone, coordinator of the Intersectoral Forum for Combating CNCDs (non-communicable chronic diseases), who coordinated the research.
“People with chronic diseases, such as diabetes, need physical activity, they need to go to medical appointments. This had an immediate impact, which worried us a lot, and it was the beginning [da pandemia]. Imagine the entire extended period,” said Barone. Added to this is the fact that many people no longer have contact with the health teams, who were transferred to other types of service. “It became more difficult to have this contact to make therapeutic adjustments, to the new routine that people had, and which would be fundamental”, he said.
Chronic non-communicable diseases (NCDs) are the cause of more than 75% of deaths in the country. “Nowadays, it is known that deaths caused in Brazil by CNCDs, such as diabetes, are already above 75%. This is one of the main causes of death, in addition to heart disease, cancers (neoplasms) and respiratory diseases. They are the ones that worry the most and cause the greatest number of deaths and premature deaths”, said the expert.
After this initial survey, the CNCDs Forum followed some groups that carried out new surveys, such as the one from the Federal University of Minas Gerais (UFMG), which found that people were also getting worse in terms of food, beverage consumption, cigarette use and sedentary lifestyle, through the so-called “screen time”, which measures the time a person spends in front of the computer or television. “Therefore, he is having a sedentary behavior, which is not healthy.”
After the research, the researchers made a stratification and found that people with chronic diseases had even worse. “This is worrisome,” said Barone. According to him, people with CNCDs who have worsening indicators of healthy habits are at greater risk of suffering a heart attack, stroke (CVA) or developing chronic kidney disease.
As founder and coordinator of the CNCDs Forum, Mark Barone is always in contact with the Ministry of Health, with the Pan American Health Organization (PAHO) and with state and municipal health secretariats. as soon as possible and prepare viable alternatives, and he mentioned the case of telemedicine, which was much advertised at the beginning of the pandemic, but which not all people knew how to access. “People who depend on the public system often heard about it, but they did not have access to this type of care, in general.”
Barone said he hopes that the Unified Health System (SUS) adjusts to this new reality and that, now, the system is very attentive to the potential consequences of the population’s worsening health, because the large number of people who were trapped, without going to the system, it will return at once and with a greater number of diseases. “It will overload. It will not be easy. The health system has to prepare itself, it has to anticipate and also make use of prevention policies, so that this accelerated risk of chronic diseases and their complications does not continue in this way.”
Some projects have taken shape in the country and generated positive results, said Barone, citing the primary health care program in Porto Alegre, organized in partnership with PAHO and the Ministry of Health. Through primary care, this program aims to give better care for people with diabetes and hypertension. There are also programs of this type, adjusting primary care, in the city of São Paulo, which is the program Caring for Your Heart, and in Vitória da Conquista, in Bahia, and Teófilo Otoni, in Minas Gerais. These are programs organized based on a specific model, through partnerships with the federal universities of Bahia and Minas Gerais.
For Barone, this is the way. “We have encouraged investment in primary care, because it is essential that people are not waited on in hospitals, because it is a very high risk.” The specialist said that, in case a person with a chronic disease is not located to go to the health unit closest to their home, the family health teams must identify them and look for them to undergo the necessary tests and medication adjustments. “This is very important for the system to resist the impoundment that took place during the pandemic,” he said.