The effect of COVID-19 lockdown on glycemic control in patients with type 2 diabetes mellitus in Turkey

Abstract

Background and aims A national lockdown to prevent the spread of coronavirus disease (COVID-19) in Turkey was introduced in March 2020. We think that lockdowns may lead to weight gain and worsening of glycemic parameters in patients with type 2 diabetes mellitus (DM). The purpose of this study was to investigate how type 2 DM patients were affected by the lockdown. Method Type 2 DM patients unable to attend regular follow-ups due to lockdown over a 75-day period between March and June 2020 and who again attended polyclinic follow-up when the lockdown was lifted were included in the study. These patients’ glycemic control and weight status were compared with the pre-lockdown period. In addition, patients’ general habits, and adherence to diet and exercise were evaluated, while their general health was assessed using the Short-Form 36-item survey. Result The research involved 101 type 2 DM patients, 57 men (56.5%) and 44 women (44.5%), with a mean age of 55 ± 13. Patients’ mean pre-lockdown weight was 84.7 ± 16.4 kg, rising to 85.5 ± 16.8 kg post-lockdown, although the increase was not statistically significant (p = 0.781). In terms of glycemic parameters, Hba1c rose from 7.67 ± 1.76 to 8.11 ± 2.48, and fasting glucose from 157.9 (83–645) mg/dl to 163.2 (84–550) mg/dl, none of which were statistically significant (p = 0.253, p = 0.079, respectively). Conclusion In addition to weight gain among type 2 DM patients during the Covid 19 lockdown, statistically insignificant increases were also observed in such glycemic parameters. This was a small sample and further studies with larger sample are needed.

Systematic review of the effects of pandemic confinements on body weight and their determinants

“…Two studies were from preprints and were included after assessing their qualities individually (22,52) . The included studies had the following countries of origin: Brazil (59) , China (40,57) , Croatia (51,64) , France (47,52,56) , Jordan (58) , India (48,55) , Iraq (61) , Italy (21,23,24,35,36,45,45,53) , Korea (50) , Lithuania (39) , Netherlands (60) , Poland (25,42,51) , Spain (44,46,63) , Turkey (43,49,65,66) , United Arab Emirates (33) , United Kingdom (54) and the United States of America (26,38,41,67) . Furthermore, multi-regional studies conducted intercontinentally (22) , among eighteen countries in the Middle East and North Africa (MENA) region (34) , and Paraguay and Italian based multinational research (62) are included in our analysis.…”

“…In our study, 7.2%-72.4% of all participants including both adults and children , experienced an increase in body weight during the confinement periods (21,23,25,26,33,(35)(36)(37)(39)(40)(41)43,44,(44)(45)(46)(47)(48)(49)(49)(50)(51)(52)55,57,(57)(58)(59)(60)(61)(62)(64)(65)(66)(67)(68) ( Figure 2). The mean weight gain ranged from 0.6 (±1.3) to 3.0 (±2.4) kg.…”

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

“…Such mild hyperglycemia without previous history of diabetes could also occur during home quarantine with mild COVID-19 infections, however, it is detected only in those who have glucose meter at home or subsequent visit to laboratory ( 11 ). Severe hyperglycemia with or without ketosis/ketoacidosis with COVID-19 or during COVID-19 era: Severe Hyperglycemia without ketosis/ketoacidosis in patient with T2DM: Pre-existing diabetes without COVID-19 and with worsening of hyperglycemia: This is ascribed to poor dietary habits, inadequate exercise and weight gain, stress and overall low testing for blood glucose( 12 , 13 , 14 , 15 ). Patients with T2DM/prediabetes having moderate-severe COVID-19 infection requiring hospitalization : …”

“…Severe hyperglycemia with or without ketosis/ketoacidosis with COVID-19 or during COVID-19 era: Severe Hyperglycemia without ketosis/ketoacidosis in patient with T2DM: Pre-existing diabetes without COVID-19 and with worsening of hyperglycemia: This is ascribed to poor dietary habits, inadequate exercise and weight gain, stress and overall low testing for blood glucose( 12 , 13 , 14 , 15 ). Patients with T2DM/prediabetes having moderate-severe COVID-19 infection requiring hospitalization : …”

“…Pre-existing diabetes without COVID-19 and with worsening of hyperglycemia: This is ascribed to poor dietary habits, inadequate exercise and weight gain, stress and overall low testing for blood glucose( 12 , 13 , 14 , 15 ).…”