{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:06:13Z","timestamp":1788401173308,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T00:00:00Z","timestamp":1656979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. 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Our study aims to describe the challenges faced by people living with Type 1 diabetes mellitus (T1DM) to access care during the COVID\u201019 pandemic in Peru.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A sequential explanatory mixed\u2010method study was conducted between May and September 2020 including health professionals involved in T1DM care, people with T1DM and their caregivers. The study consisted of a quantitative strand to gather general information through electronic surveys and a qualitative strand that involved in\u2010depth interviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For the quantitative study, we included 105 people with T1DM, 50 caregivers and 76 health professionals. The qualitative study included a total of 31 interviews; 16 people with T1DM, 14 health care professionals, and one representative from the Peruvian Ministry of Health (MoH). People with T1DM faced difficulties accessing consultations, insulin, monitoring devices and laboratory testing during the pandemic. Different phases of the Peruvian health system response were found. Firstly, an initial informal response to addressing T1DM care during the pandemic characterised by local initiatives to ensure continuity of care for people with T1DM. Following from this, a formal response was implemented by the MoH which focussed on reinforcing the primary level of care. Measures included teleconsultations and delivery of medicines, although these were not implemented in all health care establishments. Throughout the pandemic patient associations played an important role in organising and helping to counteract the impact of COVID\u201019 on people with T1DM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The Peruvian health care system slowly adapted to the COVID\u201019 pandemic to provide care for people with T1DM. However, people with T1DM had difficulties to access care. Thus, reinforcement of interventions such as communication between levels of care, teleconsultations and delivery of medicines was urgently needed. Patient associations' capacity to respond should be considered by local authorities and civil society should be part of the health system response.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hpm.3536","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T11:05:15Z","timestamp":1657019115000},"page":"129-143","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["COVID\u201019's impact on type 1 diabetes management: A mixed\u2010methods study exploring the Peruvian experience"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6386-6643","authenticated-orcid":false,"given":"Jessica Hanae","family":"Zafra\u2010Tanaka","sequence":"first","affiliation":[{"name":"CRONICAS Centre of Excellence in Chronic Diseases Universidad Peruana Cayetano Heredia  Lima Peru"},{"name":"Division of Tropical and Humanitarian Medicine University of Geneva and Geneva University Hospitals  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizzete","family":"Najarro","sequence":"additional","affiliation":[{"name":"CRONICAS Centre of Excellence in Chronic Diseases Universidad Peruana Cayetano Heredia  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janeth","family":"Tenorio\u2010Mucha","sequence":"additional","affiliation":[{"name":"CRONICAS Centre of Excellence in Chronic Diseases Universidad Peruana Cayetano Heredia  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Lazo\u2010Porras","sequence":"additional","affiliation":[{"name":"CRONICAS Centre of Excellence in Chronic Diseases Universidad Peruana Cayetano Heredia  Lima Peru"},{"name":"Division of Tropical and Humanitarian Medicine University of Geneva and Geneva University Hospitals  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Bartra","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n de Diabetes en Ni\u00f1os y Adolescentes (ADINA Per\u00fa)  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Baz\u00e1n","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n de Diabetes en Ni\u00f1os y Adolescentes (ADINA Per\u00fa)  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Claudia","family":"Berghusen Anteparra","sequence":"additional","affiliation":[{"name":"Diabetes 1 Per\u00fa (DM1 Per\u00fa)  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Bonilla","sequence":"additional","affiliation":[{"name":"Diabetes 1 Per\u00fa (DM1 Per\u00fa)  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Motta","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n de Diabetes Juvenil del Per\u00fa (ADJ)  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Beran","sequence":"additional","affiliation":[{"name":"Division of Tropical and Humanitarian Medicine University of Geneva and Geneva University Hospitals  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.04.018"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30272-2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875\u2010020\u201001326\u20103"},{"key":"e_1_2_10_5_1","unstructured":"Centers for Disease Control and Prevention (CDC) \u2010 National Center for Health Statistics.Reduced Access to Care;2020. 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