Effects of COVID-19 pandemic lockdown on gestational diabetes mellitus: A retrospective study

Abstract

Objective The objective of our study was to evaluate the impact of the lockdown period on the glycemic balance in patients with GDM. Methods A retrospective study in one center (Lille, France) compared two periods: the COVID-19 lockdown of 18 March 2020 to 7 May 2020 versus the same period during 2019. Glucose targets were defined by a capillary fasting glucose target < 5.1mmol/L and/or a 2-hour postprandial capillary glucose < 6.6 mmol/L. GDM control was defined as: good (< 20% of the glycemic values were not within the target range), acceptable (20 to 40% of the glycemic values were not within the target range) or poor (> 40% of the glycemic values were not within the target range). Results Two hundred twenty-nine patients were included in 2019 and 222 in 2020. The same mean number of capillary blood sugar tests was performed by the two groups. Postprandial blood sugar was significantly less well controlled in 2020, with a lower rate of good control (61.6% vs 69.4%) and higher rates of acceptable (24.7% vs 21.8%) and poor control (13.7% and 8.7%) (p < 0.05). Use of insulin therapy was significantly higher in 2020 compared with 2019 (47.7% and 36.2%, respectively; p < 0.05). Conclusion Diabetes control was lower during the COVID-19 pandemic lockdown, even if follow-up was not impacted. This may be explained by reduced physical activity, modified dietary habits and anxiety during this period.

Impact of lockdown COVID-19 on metabolic control in type 2 diabetes mellitus and healthy people

“…Raise in HbA1c was a similar result to earlier studies that Verma et al found in type 1 diabetes patients. A similar result from France, including a comparison between gestational diabetes patients from 2019 to 2020 showed lower diabetes control in pandemic lockdown [ 10 ]. As easily suspected, several factors can have been responsible for increasing blood glucose and lipid levels.…”

Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity

“…Furthermore, some patients required additional medications to control blood glucose levels during lockdown [ 57 ]. In women with GDM, the use of insulin therapy was significantly higher in 2020 (47.7%) compared with 2019 (36.2%) [ 58 ]. These results were explained by anxiety, dietary habits, and reduced physical activity [ 58 ].…”

“…In women with GDM, the use of insulin therapy was significantly higher in 2020 (47.7%) compared with 2019 (36.2%) [ 58 ]. These results were explained by anxiety, dietary habits, and reduced physical activity [ 58 ]. In France, a higher rate of poor postprandial glycemic control was observed during the COVID-19 lockdown from 18 March 2020 to 7 May 2020 (13.7%), as compared with the same period during 2019 (8.7%) [ 58 ].…”

“…These results were explained by anxiety, dietary habits, and reduced physical activity [ 58 ]. In France, a higher rate of poor postprandial glycemic control was observed during the COVID-19 lockdown from 18 March 2020 to 7 May 2020 (13.7%), as compared with the same period during 2019 (8.7%) [ 58 ]. In Italy, it has been reported that diet therapy and/or insulin were sufficient to obtain a favorable maternal and fetal outcome in women with GDM and a concomitant SARS-Cov-2 infection [ 59 ].…”

Heterogeneity in presentation of hyperglycaemia during COVID-19 pandemic: A proposed classification

“… Gestational diabetes with/without COVID -19 infection: This issue has been less researched. As shown for patients with type 2 diabetes, lockdown during COVID-19 could lead to worsening of glycemia ( 32 ). In a meta-analysis 128176 non-pregnant patients (228 studies) and 10000 pregnant patients (121 studies) with confirmed COVID-19 were included.…”