Bioethical aspects of the rehabilitation of patients with type 2 diabetes in conditions of anti-pandemic restrictions

Abstract

Introduction. Rehabilitation is essential for many health conditions such as acute stroke, cardiac events and endocrine diseases and others. It is estimated that due to the SARS COV-2 pandemic, an estimated range of 1.3–2.2 million people in Europe had to interrupt their rehabilitation treatments. Shortly after the start of the pandemic, there were reports of an increase in new-onset diabetes presentations. Having diabetes was a risk factor for worse COVID-19, but also having COVID-19 was a risk factor for newly diagnosed diabetes and hyperglycemic emergencies. An essential support in rehabilitation in covid is that of bioethics. Aim of study. Evaluation of the specificity of rehabilitation in patients with type 2 diabetes during the period of anti-pandemic restrictions through the lens of bioethical benchmarks. Methods and materials. Data from the scientific literature were studied, identified from the databases PubMed, Cochrane, Scopus, international clinical protocols, about 50 sources. Results. According to studies, it has been shown that during the COVID-19 pandemic, rehabilitation services and outpatient visits were affected, practically suspended, general healthcare services were reduced, face-to-face consultations were restricted, virtual consultations were switched to and some aspects of the consultation such as blood tests were omitted. A study of 25 million patients in the UK reported a significant reduction in type 2 diabetes diagnoses during the pandemic period. A recent report from the National Health Services (NHS), UK, World Health Organization (WHO) outlined the ethical obligations of healthcare providers during the pandemic in three distinct categories: moral, professional, legal. Guiding principles were emphasized to guide the conduct of ethics during the Covid-19 period: social and clinical value, favorable riskbenefit ratio, independent review, informed consent and respect for patients. Rehabilitation should be performed in a self-supervised manner via telemedicine. The most valuable bioethical benchmarks were the principles of information, autonomy, therapeutic integrity, vulnerabilities and the doctor-patient relationship. In some cases, it may be wiser to delay admission to rehabilitation until patients are no longer at risk of spreading COVID-19 to uninfected people, but poor blood glucose control is associated with serious complications, including mortality, and improving the control of risk factors is a priority. Conclusion. Anti-pandemic restrictions have imposed new conditions on the rehabilitation act. The pandemic has highlighted the importance of guidance according to bioethical principles. events and endocrine diseases and others. It is estima ted that due to the SARS COV-2 pandemic, an estimated range of 1.3–2.2 million people in Europe had to int errupt their rehabilitation treatments. Shortly after the start of the pandemic, t here were reports of an increase in new-onset diabetes presentations. Having diabetes was a risk factor for worse COVID-19, but also having COVID-19 was a risk factor for newly diagnosed diabetes a nd hyperglycemic emergencies. An essential support in rehabilitation in covid is that of bioethi cs. Aim of study. Evaluation of the specificity of rehabilitation in patie nts with type 2 diabetes during the period of anti-pandemic restrictions through the lens of bioethical benchmarks. Methods and materials. Data from the scientific literature were studied, identifie d from the databases PubMed, Cochrane, Scopus, international clinic al protocols, about 50 sources. Results. According to studies, it has been shown that during the COVID -19 pandemic, rehabilitation services and outpatient visits were affecte d, practically suspended, general healthcare services were reduced, face-to-face consultations were restricted, virtual consultatio ns were switched to and some aspects of the consultation such as blood tests were omitted. A study of 25 million patients in the UK reported a significant reduc tion in type 2 diabetes diagnoses during the pandemic period. A recent report from the National Healt h Services (NHS), UK, World Health Organization (WHO) outlined the ethical obligations of healt hcare providers during the pandemic in three distinct categories: moral, professional, legal. Guiding principles were emphasized to guide the conduct of ethics during the Covid-19 period: social an d clinical value, favorable riskbenefit ratio, independent review, informed consent and respec t for patients. Rehabilitation should be performed in a self-supervised manner via telemedicine. The most valuable bioethical benchmarks were the principles of information, autonomy, therapeutic integrity, vulnerabilities and the doctor-patient relationship. In some cases, it may be wiser to delay admission to rehabilitation until patients are no longer at risk of spr eading COVID-19 to uninfected people, but poor blood glucose control is associated with serious compli cations, including mortality, and improving the control of risk factors is a priority. Conclusion. Anti-pandemic restrictions have imposed new conditions on the rehabilitation act. The pandemic has highlighted the importance of guidance acc ording to bioethical principles.