Glucose control in diabetes during home confinement for the first pandemic wave of COVID-19: a meta-analysis of observational studies

Abstract

Aim To assess the effect on glycaemic control of confinement due to lockdown measures, during COVID-19 pandemic, in people with type 1 (T1DM) and type 2 (T2DM) diabetes. Methods Meta-analysis of observational studies reporting measures of glucose control and variability before and during and/or after periods of confinement caused by COVID-19 in 2020 and/or 2021. Results We included 27 studies on T1DM. No significant change in Hba1c was observed after lockdown (WMD − 1.474 [− 3.26; 0.31] mmol/mol, I2 = 93.9). TIR significantly increased during and after lockdown (WMD: 2.73 1.47; 4.23 %, I2 = 81% and 3.73 [1.13; 5.33] %, I2 = 85%, respectively).We retrieved nine studies on T2DM patients. No significant variation in HbA1c was detected (WMD − 1.257 − 3.91; 1.39 mmol/mol, I2 = 98.3%). HbA1c had a more favourable trend in studies performed in Asia than in Europe (p = 0.022 between groups). Conclusion Lockdown showed no significant detrimental effect on HbA1c in either T1DM or T2DM. Conversely, home confinement led to a reduction in mean glucose and glucose variability in T1DM, although with a high heterogeneity of results.

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

“…The findings of this review in respect of the blood glucose parameters would appear to confirm the result of a previous systematic review [31] which reported that the COVID-19 lockdown resulted in short-term worsening of glycaemic control in patients with type 2 diabetes. However, the result is different from the outcome of a previous meta-analysis of observational studies [17] which showed that COVID-19 lockdown had no detrimental effect on glycated haemoglobin in either patients with type 1 diabetes or type 2 diabetes, and that it led to a reduction in mean glucose and glucose variability in patients with type 1 diabetes. Variations in the designs of the studies and differences in the countries where the studies were conducted may explain the differences in the findings of our review compared with the previous review by Silverii et al [17].…”

“…However, the result is different from the outcome of a previous meta-analysis of observational studies [17] which showed that COVID-19 lockdown had no detrimental effect on glycated haemoglobin in either patients with type 1 diabetes or type 2 diabetes, and that it led to a reduction in mean glucose and glucose variability in patients with type 1 diabetes. Variations in the designs of the studies and differences in the countries where the studies were conducted may explain the differences in the findings of our review compared with the previous review by Silverii et al [17]. Furthermore, the inclusion of studies involving people with type 1 and type 2 diabetes was a primary difference our review and the earlier reviews [17,31].…”

“…Although it has been hypothesised that the lockdown measures did not affect glycaemic control in patients with diabetes, there are contrasting studies globally suggesting that these measures either promoted or played a detrimental role in regulating glycaemia and other metabolic parameters in patients with type 2 diabetes [14]. A meta-analysis of observational studies conducted by Silverii et al [17] focused only on glycaemic control in patients with type 1 and type 2 diabetes during the lockdown. In contrast, the current review focuses on patients with only type 2 diabetes and the effect of the lockdown on glycemic control and lipid profile.…”

Glycaemic control during the lockdown for COVID-19 in adults with type 1 diabetes: A meta-analysis of observational studies

“…As such, our results support and expand those recently published by Silverii et al [31] as other features such as estimated HbA1c and use of the sensor have been included.…”

Impact of Working from Home on Cardiovascular Health: An Emerging Issue with the COVID-19 Pandemic

“…Observational studies have also investigated the impact of lockdown on pre-existing cardiometabolic diseases. A meta-analysis including 10,765 patients with diabetes (1174 with type 1 and 9591 with type 2) reported an improvement in glycemic control during lockdown in type 1 diabetes, and no significant effect on glucose control in type 2 diabetes [54]. Although the information on the share of patients working from home was not available in several of the studies included in this meta-analysis, the increased time available to cope with complex diabetes management, such as glucose monitoring and insulin titration, may at least partially explain the better glycemic control during the lockdown reported in type 1 diabetes patients who stayed home.…”