COVID-19 pandemic: Effects of national lockdown on the state of health of patients with type 2 diabetes mellitus in a Moroccan population

Abstract

Background The complete lockdown caused by the COVID-19 pandemic had imposed a new behavior and lifestyle especially in terms of diet, physical activity, and the management of patients with chronic diseases. Aim The present study aimed to analyze the impact of lockdown on the monitoring and care of type 2 diabetes mellitus (T2DM) patients in a Moroccan population from the Doukkala region. Subjects and methods We conducted a retrospective observational study including 121 T2DM patients recruited from the Diabetes Diagnosis and Treatment Center of El Jadida city. Demographic, anthropometric, and biochemical data of our T2DM patients were recorded before and after lockdown that lasted 82 days. All patients have signed an informed consent after being informed about the purely scientific aims of the study. Results Our sample involved 84 women and 37 men with an age average of 57.31 ± 0.91 years. The effects of lockdown were more marked in women than in men: women showed a significant tendency to gain weight (from 78.13 ± 1.36 kg to 81.80 ± 1.45 kg; p -value < 0.000), that impacted the body mass index ( p -value < 0.000); they also showed significant increases in HbA1c values ( p -value = 0.001), significant decrease in systolic blood pressure ( p -value = 0.0302) and a surprising increase in high-density lipoprotein cholesterol ( p -value = 0.0132). The prevalence of metabolic syndrome in the women sample increased from 46.4% to 54.8% after the lockdown. In men, the negative effect of lockdown was observed only in HbA1c that values increased significantly from 8.66 ± 0.21% to 9.51 ± 0.25% ( p -value = 0.0127). Conclusion Our results reveal that lockdown had impacted negatively the health status of T2DM patients, especially women. We suggest an urgent development of programs aiming to improve the hygiene of life and to reduce the impact of future crises on patients suffering chronic diseases such as T2DM.

The Effects of COVID-19 Lockdown on Glycaemic Control and Lipid Profile in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

“…Eleven studies were included in the systematic review and meta-analysis. Three studies each were conducted in India [21,28,29] and Italy [14,22,23], while one each was conducted in France [24], Japan [25], Morocco [9], South Korea [27] and Turkey [26]. Six of these studies were retrospective, two each were prospective and cross sectional, while only one study was case control.…”

“…In this regard, changes in behaviour patterns and daily life, including exercise levels, stress and anxiety influence self-management of diabetes and glycaemic control [11]. These changes have significant implications for clinical outcomes during the lockdown [9].…”

“…The results of the systematic review are outlined in Table 2. In particular, it was shown that COVID-19 lockdown either significantly (p < 0.05) increased glycated haemoglobin (HbA1c) (%) in patients with type 2 diabetes in some studies [9,22,25], did not change HbA1c significantly [14,26,29] or that there was overall improvement in glycaemic control [24,28].…”

“…Seven studies [14,21,[24][25][26][27][28] showed low risk of bias in all the domains assessed, while three studies [22,23,29] were of concern in bias due to confounding. One study [9] was assessed as having high risk with respect to bias due to confounding and was graded as having high overall risk. The results of the systematic review and meta-analysis identified three distinct areas: glycaemic control, lipid parameters and body mass index.…”

“…The global prevalence of diabetes is estimated to rise to 700 million by 2045, from 463 million in 2019 who were living with the disease [7]. On the other hand, the COVID-19 pandemic has led to more than 100 million infections and more than two million deaths globally, as of 20 February 2021 [9].…”