Quality outcome of diabetes care during COVID-19 pandemic: a primary care cohort study

Aim: Management of diabetes care can be affected by COVID-19 pandemic control measures. This study aimed to determine the impact of the pandemic, during 17.03.2020-16.03.2021, on quality outcomes of diabetes care in general practice in Switzerland. Methods: In this retrospective cohort study, diabetes mellitus patients (≥ 18 years) with at least one consultation at a general practitioner, during 17.03.2018-16.03.2019 (cohort 1) and 17.03.2019-16.03.2020 (cohort 2) were included and followed-up for two years. Quality indicators and outcomes of diabetes care, at patient and practitioner level, were compared before and during the pandemic. Logistic regression was performed to identify patient's risk factors for dropout from follow-up. Results: Data from 191 practices, 23,903 patients, cohort 1 and 25,092 patients, cohort 2, were analyzed. The fraction of patients lost to follow-up, attributable to the pandemic, was 28% (95% confidence interval: 25%, 30%). During the pandemic, compared to the previous year, regular measurement of weight, HbA1c, blood pressure and serum creatinine were less frequent and less patients per practitioner reached HbA1c and blood pressure target outcomes. Factors associated with continuity of care during the pandemic were: patient age 41-80 years, longer diabetes duration, diagnosis of hypertension or dyslipidemia, influenza vaccination during the last year. Risk factors for dropout were age > 80 and receiving only insulin as anti-diabetic medication. Conclusion: A considerable quality reduction in diabetes mellitus care could be observed during the pandemic. Though the most vulnerable patients were not the most affected by the pandemic, key factors that might reduce dropout from follow-up were identified. Keywords: COVID-19 pandemic; Diabetes mellitus; Diabetes outcomes; Primary care; Quality indicators

Mosca-minadora (Liriomyza trifolii) na cultura da batata (Solanum tuberosum): observações de campo e respostas fotossintéticas da planta à injúria

Moscas-minadoras, Liriomyza spp. (Diptera: Agromyzidae), são pragas polífagas distribuídas por todo o mundo, que se alimentam de diferentes culturas, incluindo a da batata. Recentemente, a mosca-minadora (Liriomyza trifolii) tem tornado-se uma praga importante na cultura da batata. As larvas comem o mesófilo foliar, deixando longas minas no interior das folhas. O efeito na fotossíntese do tecido foliar remanescente das minas é desconhecido. em 2003, as respostas fisiológicas das plantas de batata à mosca-minadora L. trifolii foram avaliadas no condato de Kearney, Nebraska, EUA. As avaliações de área foliar danificada, fotossíntese e fluorescência foram feitas aos 7 e 14 dias após a infestação. A moscas-minadoras causaram até 13% de área foliar danificada, com nenhuma redução na capacidade fotossintética da área remanescente dos folíolos, tendo, portanto, efeitos semelhantes aos do grupo dos insetos desfolhadores. Entretanto, os resultados de fluorescência revelaram mudanças na eficiência fotossintética e, dependendo do tipo de injúria, esta pode levar a uma senescência precoce da folha. Monitoramentos de campo mostraram que o abamectin é eficiente no controle da mosca-minadora, L. trifolii, com um baixo impacto aos parasitóides da família Eulophidae, podendo ser uma boa opção de controle químico.Serpentine leafminers, Liriomyza spp. (Diptera: Agromyzidae), are polyphagous insects that feed on numerous crops worldwide including potato. Recently, leafminer larvae (Liriomyza trifolii) have become an economically important pest of potato. The larvae eat the mesophyll of leaflets leaving long winding tunnels inside the leaflets. The photosynthetic effects of larval tunneling on the remaining leaf tissue are unknown. In 2003, physiological responses of potato to leafminer, L. trifolii were evaluated in Kearney, Nebraska, USA. The leaflets were examined 7 and 14 days post infestation for leaf area injury, photosynthetic rates and fluorescence. Leafminers caused up to 13% leaf area loss due to leafminer injury with no effect on the photosynthetic rates of the remaining leaf tissue thus having similar effects as other gross tissue removers. However, fluorescence measures revealed changes in the photosynthetic efficiency and depend of the type of injury, it may lead to early leaf senescence. Field monitoring of L. trifolii infestations showed that treatments with abamectin were effective in reducing leafminer numbers and had no immediate effect on beneficial parasitoid from Eulophidae family suggesting that abamectin is a good option for chemical control