Impact of SARS-CoV-2 Lockdown on Glycaemic Control: A Retrospective Observational Cohort Study in a Tertiary Setting

Abstract

We analysed the effects of Swiss national lockdown due to the COVID-19 pandemic on the glycaemic control in patients with diabetes mellitus. In a retrospective observational cohort study with observation period 16 December 2018–27 July 2020, we included tertiary care patients with diabetes and at least one glycated haemoglobin A1c (HbA1c) measurement before and after the lockdown beginning. Main outcome measure was change in HbA1c after the lockdown. We included 1078 patients (86% diabetes type 2) with a mean HbA1c of 55.63 mmol/mol (7.24%). Glycaemic control was susceptible to seasonal changes with higher mean HbA1c in winter as compared to spring (57.49 mmol/mol (7.41%) vs. 55.52 mmol/mol (7.23%), p = 0.013). The lockdown did not affect the mean HbA1c values of all patients. However, we found a higher proportion of type 2 diabetes patients with a worsening HbA1c after the lockdown as compared to the year before (32% vs. 22.9%, p = 0.02). In a mixed-model regression multivariable analysis, inappropriate alcohol intake and hypothyroidism were associated with an increase in HbA1c after the lockdown. In conclusion, the national lockdown had no effect on overall mean HbA1c values but affected a proportion of type 2 diabetes patients with worsening HbA1c, whose individual risk factors were identified.

Quality outcome of diabetes care during COVID-19 pandemic: a primary care cohort study

“…A strength of this study is the large database used whose validity is also supported, being the distribution of age, gender, as well as prescription proportions of anti-diabetic medications in agreement with Swiss health care settings [ 4 , 34 ].…”

“…Results of glycaemic decompensation, during lockdown or after few months, are conflicting [13]: no differences [3][4][5]; worsening [6-8, 14, 15]; improving [9][10][11][12].…”

“…Several studies have examined short-term effects of COVID-19 pandemic, during or after lockdown, on glycaemic control [3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

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 European nations and other countries, studies have shown varying degrees of the influence of lockdowns on glycemic control status in patients with GI, probably because of characteristics of the countries or regions, study periods or study populations 3 , 4 , 5 , 6 , 7 , 8 , 18 , 19 , 20 , 21 . The present study was carried out in Japan, where only request‐based restrictions, such as the SoE, were imposed instead of lockdowns, and we observed no significant changes in HbA1c levels during the SoE in the patients with GI (Table 1 ).…”

Metabolic control during the first two years of the COVID-19 pandemic in pediatric patients with type 1 diabetes: results from the German DPV initiative

“…To guarantee education for all children, no statewide school closures were reimplemented in the second half of 2021. During the first months of the SARS-CoV2 pandemic in 2020, glycemic control in pediatric patients with T1D remained stable in different patient cohorts despite social distancing means [ 2 – 6 ]. An analysis of adult patients with T1D and T2D in Germany also shows stable metabolic control [ 7 ].…”