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Background: The covid-19 pandemic made self-management difficult for people with type 2 diabetes mellitus (T2DM). Some health services provided remote care to people with chronic illnesses., Objective: To compare the modalities of care, in-person (AP) versus virtual (AV), during the covid-19 pandemic on clinical and mental health variables., Material and Methods: Prospective cohort study of 75 patients with a diagnosis of DM2 (age Me = 49 years) treated between June 2020 and December 2021. A total of 40 (53%) received VA and 35 (47%) AP. The Chi square and Mann-Whitney U statistical tests were used to show homogeneity between groups and the Friedman test to compare the pre- and post-test change, considering each attention group as a comparison factor., Results: In both groups the values ​​of HbA1c, triglycerides and Non-HDL cholesterol decreased. Both groups improved in quality of life and emotional exhaustion. A Cox regression model showed that the perception of a good quality of life and triglyceride control at two months increase the HR of HbA1c control, after adjusting the model for age and sex., Conclusions: Both care modalities generate a similar benefit in the management of T2DM. The virtual consultation was a useful and safe alternative., (Licencia CC 4.0 (BY-NC-ND) © 2024 Revista Médica del Instituto Mexicano del Seguro Social.)

Introduction: Diabetic peripheral neuropathy (DPN) causes morbidity and affects the quality of life. Before diabetes diagnosis, neuropathic damage may be present. Sudoscan provides accurate measurement of the sudomotor function. This study aimed to assess the abnormalities detected by Sudoscan, offered estimates of DPN prevalence, and investigated the relationship between metabolic and clinical parameters. Additionally, we evaluated the diagnostic accuracy of the Sudoscan compared with monofilament and tuning fork tests for detecting DPN., Research Design and Methods: Cross-sectional descriptive study including patients with type 2 diabetes for <5 years since diagnosis. We investigated the presence of DPN using a 128 Hz tuning fork test, the 10 g monofilament, and the sudomotor dysfunction in feet using Sudoscan. We compared patients with and without alterations in the Sudoscan. A logistic regression model analyzed variables independently associated with sudomotor dysfunction., Results: From 2013 to 2020, 2243 patients were included, 55.1% women, age 51.8 years, and 17.1% with normal weight. Monofilament tests and/or tuning fork examination were abnormal in 29% (95% CI 0.23% to 0.27%) and 619 patients (27.6%, 0.25% to 0.29%) had sudomotor alterations. In logistic regression analysis, age (β=1.01, 0.005-1.02), diastolic blood pressure (β=0.98, 0.96-0.99), heart rate (β=1.01, 1.00-1.02), glucose (β=1.00, 1.00-1.03), albuminuria (β=1.001, 1.000-1.001), beta-blockers=1.98, 1.21-3.24) and fibrate use=0.61, 0.43-0.87) were associated with sudomotor dysfunction. The AUC (area under the curve) for Sudoscan was 0.495 (0.469-0.522), with sensitivity and specificity of 24% and 71%, respectively., Conclusion: The Sudoscan identified an important proportion of patients with dysfunction, allowing prompt intervention to decrease the risk for complications., Trial Registration Number: NCT02836808., Competing Interests: Competing interests: CAA-S is part of the Editorial Board of BMJ Open Diabetes Research and Care., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)