"The results show that specialist nurses across Europe have observed significant increases in physical and psychological problems in the population with diabetes, and in Portugal psychological risks represent more than half of the concerns compared to physical risks.

The data also reflect the significant interruption of clinical services for diabetes in Europe," the Association of Diabetics of Portugal (APDP) said in a statement.

The entity participated in the research promoted by the European Federation of Nurses in Diabetes, which had the participation of 1,829 nurses specialists in diabetes from 27 European countries, including Portugal.

In the European Consortium of Diabetes Specialist Nurses, there was a large increase in clinical problems such as anxiety (82 percent), diabetes (65 percent), depression (49 percent), acute hyperglycemia (39 percent) and foot complications (18 percent). In addition, 47 percent of the interviewees identified that the level of care provided to people with diabetes decreased extremely or severely. "For all we know, this is the first study to assess the impact of covid-19 on people with diabetes in Europe, from the experiences of health professionals who specialize in the disease. It is worrying that, during this period of great needs, the pandemic of covid-19 is also hampering the routine care of people with diabetes. It is necessary to keep in mind that diabetes is a complex chronic condition and people living with it need continued and interdisciplinary support," said APDP nurse Ana Cristina Paiva, one of the participants in the consortium of specialist nurses who developed the study.

According to João Filipe Raposo, clinical director of the APDP, "the pandemic has brought enormous challenges and these figures are a reflection of a growing inequality in access to health care that, throughout Europe, are almost exclusively dedicated to combating covid-19. According to the guardian, "another of the worrying factors demonstrated in this study was that 18 percent of respondents reported an increase in foot complications. Although it is a relatively small percentage compared to other problems, we are well known about the consequences of this type of complication and the importance of physical examination and rapid intervention." Psychological support as well as support in self-management and diabetes education were also assessed as having decreased greatly or severely during the pandemic by 34 percent, 31 percent and 63 percent, respectively.

"This study reinforces the evidence of the need to adapt the monitoring and support circuits to minimize the impact of the pandemic on people with diabetes. At APDP we have made every effort not to interrupt care and maintain the capacity in care, through the use of telemedicine in follow-up consultations, and in person in first-time consultations, foot, ophthalmology, among other complications", said João Filipe Raposo. APDP has a telephone hotline available to provide expert advice to all people with diabetes. The Diabetes Helpline (21 381 61 61) is available from 9am to 5pm, including weekends and public holidays.