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

Abstract

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.

Impact of COVID-19 Pandemic on Daily Life, Physical Exercise, and General Health among Older People with Type 2 Diabetes: A Qualitative Interview Study

“…As a consequence, some participants declared difficulty in performing basic tasks (i.e., cleaning the house, climbing stairs). Overall, the findings of a meta-analysis showed that COVID-19 lockdowns resulted in a significant increase in the levels of glycated haemoglobin (0.34%; 95% CI: 0.30–0.38), fasting plasma glucose (7.19 mg/dL; 95% CI: 5.28–9.10) and body mass index (1.13 kg/m 2 ; 95% CI: 0.99–1.28) in patients with T2DM [ 9 ]. Obesity is a significant risk factor for increased morbidity and mortality in people with T2DM, whereas reduction in body weight or the prevention of weight gain confers significant benefits in glycaemic and blood pressure control [ 54 ].…”

“…Type 2 diabetes mellitus (T2DM) comprises 90–95% of all diabetes cases [ 7 ]. Such worrying data confirm this disease as being a significant global challenge that may be exacerbated by the consequences of COVID-19 [ 8 , 9 , 10 , 11 ].…”

“…Researchers have conducted studies that have raised concerns about the impact of COVID-19 on different aspects of the lifestyle and health of people with T2DM. Perceiving themselves as being a high risk group, they were found to be more worried about contracting the virus and, due to this, show evidence of negative effects of COVID-19 on psychosocial health (i.e., distress, loneliness, feeling isolated) [ 18 , 19 ], glycaemic control (i.e., glycated haemoglobin, fasting plasma glucose) [ 9 ], dietary patterns [ 18 ], exercise habits and body composition [ 19 ]. However, most of these studies focused on an exploration of the socio-behavioural changes in terms of descriptive data through cross-sectional design.…”

Investigation of COVID-19 fear, treatment compliance, and metabolic control of patients with type 2 diabetes mellitus during the pandemic

“…Experienced stress and lifestyle changes have been associated with increased body weight and HbA1c levels [37] . In the systematic review and meta-analysis study of Ojo et al (2022), they stated that glycosylated hemoglobin, fasting glucose and body mass index levels increased in patients with type 2 diabetes during the quarantine period compared to pre-COVID-19 [38] . DM management includes many factors that make compliance difficult for the patients.…”

Impact of National Lockdown From COVID-19 Pandemic in Patients With Type 2 Diabetes: An Observational Study

“…3 However, the impact of a national lockdown on long-term glucose controls using glycated hemoglobin (HbA 1c ) and other metabolic parameters among T2D yield conflicting results. 4,5 The aim of this study was to investigate the impact of the national lockdown on regularly scheduled clinic visitation and changes in biochemical parameters among patients with T2D.…”