COVID-19 Lockdown Periods in 2020: Good Maintenance of Metabolic Control in Adults with Type 1 and Type 2 Diabetes

Abstract

During the COVID-19 pandemic, there were increased concerns about glycemic control in patients with diabetes. Therefore, we aimed to assess changes in diabetes management during the COVID-19 lockdown for patients with type 1 or type 2 diabetes mellitus (T1DM, T2DM) in Germany. We included data from 24,623 patients (age>18 years) with T1DM (N=6,975) or T2DM (N=17,648) with documented data in 2019 and 2020 from the multicenter Diabetes-Prospective Follow-up registry (DPV). We conducted a groupwise comparison of identical patients in 2019 and 2020 for different time periods of pandemia. Pairwise differences of continuous parameters of treatment modalities and metabolic outcome between 2019 and 2020 were adjusted for seasonality, age, and diabetes duration. We presented these outcomes as adjusted medians with 95% confidence intervals. Rates were compared using negative-binomial models, dichotomous outcomes were compared using logistic models. Models were additionally adjusted for age and diabetes duration. These outcomes were presented as least-square means with 95% confidence intervals, p-values of<.05 were considered significant.In participants with T1DM, CGI (combined glucose indicator) increased only by 0.11–0.12% in all time periods of 2020 compared to 2019 (all p<0.001) while BMI decreased slightly by −(0.09–0.10) kg/m² (p<0.0001). In participants with T2DM, HbA1c increased by 0.12%, while BMI decreased slightly by −(0.05–0.06) kg/m² (p<0.0001).During the COVID-19 lockdown period, patients with T1DM and T2DM experienced only clinically insignificant changes in glucose control or body weight. Despite lockdown restrictions, patients were able to maintain metabolic control.

The impact of the COVID‐19 pandemic on glycaemic control in people with diabetes: A systematic review and meta‐analysis

“…The reliance on observational evidence within this review is also a confounding variable that may have increased heterogeneity and the risk of within‐study and across‐study biases 43 . The authors acknowledge that additional studies have been published since their comprehensive search in February 2021, although further works correspond with the summarized findings 44–46 …”

“…43 The authors acknowledge that additional studies have been published since their comprehensive search in February 2021, although further works correspond with the summarized findings. [44][45][46] The LD measures and restrictions imposed by multiple governments in the context of the COVID-19 pandemic differ from country to country and thus could also be responsible for some of the observed heterogeneity, as could issues with study reporting and risk of bias. To limit the potential for bias, this review adhered to the PRI-SMA guidelines, including prespecifying the protocol online.…”

“… 43 The authors acknowledge that additional studies have been published since their comprehensive search in February 2021, although further works correspond with the summarized findings. 44 , 45 , 46 …”

Year‐long effects of COVID‐19 restrictions on glycemic control and body composition in patients with glucose intolerance in Japan: A single‐center retrospective study

“…In the lockdowns, strict social restrictions, such as stay‐at‐home orders, were imposed. For patients with diabetes, the dramatic social changes have raised concerns about negative effects on glycemic control and body composition through increased mental stress and lifestyle changes 2 , 3 , 4 . Several studies about how the lockdowns affected glycemic control in patients with glucose intolerance (GI) including diabetes mellitus have been carried out, but the reported results have varied 3 , 4 , 5 , 6 , 7 , 8 .…”

“…For patients with diabetes, the dramatic social changes have raised concerns about negative effects on glycemic control and body composition through increased mental stress and lifestyle changes 2 , 3 , 4 . Several studies about how the lockdowns affected glycemic control in patients with glucose intolerance (GI) including diabetes mellitus have been carried out, but the reported results have varied 3 , 4 , 5 , 6 , 7 , 8 . In contrast, the state of emergency (SoE) in Japan entailed less strict restrictions; people were requested to stay at home, and the use of public transportation and facilities was restricted 2 .…”