The effect of the Covid-19 shutdown on glycemic testing and control

Abstract

Background The coronavirus disease 2019 (COVID-19) pandemic caused a halt to in-person ambulatory care. We evaluated how the reduction in access to care affected HbA1c testing and patient HbA1c levels. Methods HbA1c data from 11 institutions were extracted to compare testing volume and the percentage of abnormal results between a pre-pandemic period (January-June 2019, period 1) and a portion of the COVID-19 pandemic period (Jan-June 2020, period 2). HbA1c results greater than 6.4% were categorized as abnormal. Results HbA1C testing volumes decreased in March, April and May by 23, 61 and 40% relative to the corresponding months in 2019. The percentage of abnormal results increased in April, May and June (25, 23, 9%). On average, we found that the frequency of abnormal results increased by 0.31% for every 1% decrease in testing volume (p < 0.0005). Conclusion HbA1c testing volume for outpatients decreased by up to 70% during the early months of the pandemic. The decrease in testing was associated with an increase in abnormal HbA1c results.

A National Laboratory Perspective: The Impact of the Covid-19 Pandemic on the Management of Patients With Non-Communicable Disease in South Africa: Impact of COVID-19 on patients with noncommunicable diseases

“…25 In the study by Sharma et al , the HbA1c request volumes from 11 institutions across the United States and Canada, decreased during March – May 2020 compared to 2019, and returned to baseline in June 2020. 21 Lum et al reviewed cancer cases from a large cancer registry in the United States. They compared the number of new cancer diagnoses made in 2020 to the case number in 2019.…”

Adherence to Diabetes Medications and Health Care Use During the COVID-19 Pandemic Among High-Risk Patients

“…In contrast to our findings, one study of private claims data documented a higher rate of inpatient admissions for diabetes complications in the postpandemic period through 2021. 26 Several studies found lower rates of hemoglobin A1c tests, 27,28 lower adherence to asthma medications for Medicare patients, 29 and a higher rate of discontinuation of chronic medications for patients in Massachusetts during the pandemic, 30 so some health systems and populations may have experienced greater disruptions to chronic condition care than our population of high-risk VA patients.…”

The impact of lockdown measures during the SARS-CoV-2 pandemic on the management of diabetes in a Northern Gauteng Region of South Africa

“…Varying studies have shown that during the early months of the pandemic, the number of HbA1c tests performed on outpatients decreased by up to 70% [ 5 , 20 , 21 ]. The number of HbA1c tests was observed to have declined sharply in April 2020 and gradually increased thereafter globally [ 21 ].…”