Impact of COVID-19 lockdown on glycemic control in patients with type 1 and type 2 diabetes mellitus: a systematic review

Wang

et al. 2022

IJERPH

The impact of the COVID-19 lockdown on glycaemic control and other metabolic parameters in patients with type 2 diabetes is still evolving. Aim: This systematic review and meta-analysis aims to examine the effects of COVID-19 lockdown on glycaemic control and lipid profile in patients with type 2 diabetes. Methods: The PRISMA framework was the method used to conduct the systematic review and meta-analysis, and the search strategy was based on the population, intervention, control and outcome (PICO) model. The Health Sciences Research databases was accessed via EBSCO-host, and EMBASE were searched for relevant articles. Searches were conducted from inception of the databases until 17 September 2021. Results: The results identified three distinct areas: glycaemic control, lipid parameters and body mass index. It was found that COVID-19 lockdown led to a significant (p < 0.01) increase in the levels of glycated haemoglobin (%) compared with pre-COVID group (gp) with a mean difference of 0.34 (95% CI: 0.30, 0.38). Eleven studies contributed to the data for glycated haemoglobin analysis with a total of 16,895 participants (post-COVID-19 lockdown gp, n = 8417; pre-COVID gp, n = 8478). The meta-analysis of fasting plasma glucose (mg/dL) also showed a significant (p < 0.05) increase in levels of post-COVID-19 lockdown gp compared with pre-COVID gp, with a mean difference of 7.19 (95% CI: 5.28, 9.10). Six studies contributed to fasting plasma glucose analysis involving a total of 2327 participants (post-COVID-19 lockdown, n = 1159; pre-COVID gp, n = 1168). The body mass index (BMI) (kg/m2) analysis also demonstrated that post-COVID-19 lockdown gp had a significantly (p < 0.05) higher BMI than the pre-COVID gp with a mean difference of 1.13 (95% CI: 0.99; 1.28), involving six studies and a total of 2363 participants (post-COVID-19 lockdown gp, n = 1186; pre-COVID gp, n = 1177). There were significantly (p < 0.05) lower levels of total cholesterol (mmol/L), triglyceride (mmol/L) and LDL cholesterol (mmol/L), and higher levels of HDL cholesterol (mg/dL) in the post-COVID-19 lockdown gp compared with pre-COVID gp, although these results were not consistent following sensitivity analysis. Conclusion: The findings of the systematic review and meta-analysis have demonstrated that COVID-19 lockdown resulted in a significant increase (p < 0.05) in the levels of glycated haemoglobin, fasting glucose and body mass index in patients with type 2 diabetes. In contrast, the effect of the lockdown on lipid parameters, including total cholesterol, triglycerides, LDL and HDL cholesterol was not consistent.

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 72%

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

Wang

et al. 2022

IJERPH

Section: Discussionmentioning

confidence: 99%

“…The assessment of various variables additionally allows phenotyping patients and dividing them into groups with a greater or lesser potential risk of diabetes decompensation in the future, i.e., during sudden, unexpected changes that we observed in the first months of pandemic. So far, such a complex analysis has not been carried out for this period [25]. With regard to the main parameter-HbA1c, we assessed: the change its absolute the direction of this change (lowering/increasing), and whether the HbA1c of participants is within the normal range.…”

Section: Discussionmentioning

confidence: 99%

The impact of lockdown caused by the COVID-19 pandemic on glycemic control in patients with diabetes

et al. 2022

Purpose The aim the study was to assess the impact of the lockdown due to COVID-19 on diabetes control. Methods The HbA1c value from a pre-lockdown visit (V1) from patients with diabetes was compared to the lockdown visit one (V2) after 3–5 months of its duration. Additional information on how the HbA1c changed and which variables can modify HbA1c during lockdown was also studied. Results Records from 65 patients (type 2 diabetes −96,9%) were eligible and revealed that: HbA1c was at the target in 60% of the patients at V2 compared to 40% at V1; HbA1c decreased and normalized in 19, but worsened in 4 participants during the lockdown. No impact on HbA1c of: sex, age, diabetes duration, therapy type and modification before the pandemic, abandonment of the treatment, previous problems with glycemic control, or change in body weight and physical activity during the lockdown, was found. The previous macrovascular complications were the only variable that affected the increase in HbA1c (p = 0.0072), OR = 5.33. Conclusions The COVID-19 pandemic has not revealed worsened glycemic control in patients with type 2 diabetes, in general. The patients with macrovascular complications turned out to be at risk of the harmful impact of the restrictions on the HbA1c.

Front. Clin. Diabetes Healthc.

“…The pandemic has affected the financial security of many individuals globally, causing downstream effects on financial stress and psychopathology (10), such that it can be anticipated that patients with T2DM have encountered additional barriers that further reduced their medication intake in the context of the COVID-19 pandemic. Accordingly, researchers have examined changes in metabolic outcomes in patients with T2DM during the COVID-19 pandemic (11)(12)(13)(14)(15). Data are equivocal and suggest metabolic control has either decreased or remained stable in patients with T2DM during the pandemic (11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Lifestyles Under Lockdown: A Scoping Review of International Studies on Type 2 Diabetes Self-Management Behaviors During COVID-19

Cummings¹,

Seng²,

Tweet³

et al. 2022

BackgroundThe effect of the COVID-19 pandemic on diabetes self-management behaviors is unclear.ObjectivesThis paper is a scoping review of studies examining health behaviors among people with type 2 diabetes during the COVID-19 pandemic.Eligibility CriteriaWe searched articles available in English using the Search terms “COVID” and “diabetes”, and, separately, each of the following terms: “lifestyle”, “health behavior”, “self-care”, “self-management”, “adherence”, “compliance”, “eating”, “diet”, “physical activity”, “exercise”, “sleep”, “self-monitoring of blood glucose”, or “continuous glucose monitoring”.Sources of EvidenceWe searched PubMed, PsychInfo, and Google Scholar databases from December 2019 through August 2021.Charting MethodsData were extracted by 4 calibrated reviewers and study elements were charted.ResultsThe search identified 1,710 articles. After screening for relevance and eligibility, 24 articles were included in this review. Findings show the strongest evidence for reduced physical activity and stable glucose monitoring and substance use. There was equivocal evidence for deleterious changes in sleep, diet, and medication intake. With one minor exception, there was no evidence for favorable changes in health behaviors. Limitations of the literature include small samples, predominantly cross-sectional study designs, reliance on retrospective self-reports, sampling through social media, and few standardized measures.ConclusionsEarly studies of health behaviors among people with type 2 diabetes during the COVID-19 pandemic suggest a need for novel interventions to support diabetes self-management, especially targeting physical activity. Future studies should go beyond documenting changes in health behaviors and examine predictors of change over time.