Abstract:Aims The aim of this study is to determine the impact of the COVID-19 pandemic on the management and disease control of the patients with diabetes mellitus in Kocaeli. Methods This study was carried out in six leading central hospitals in five major districts of Kocaeli. The study was conducted between June 2020 and November 2020. The patients who had previous admissions to these clinics within 6 months prior to the pandemic were enrolled in the study. Results A total of 283 patients were enrolled in the study… Show more
“…years the HbA1c values increased slightly, despite treatment intensification. The results are in concordance with some but not all studies that evaluated the glycemic control during COVID-19 pandemic in patients with T2DM, as some of them showed deterioration of HbA1c values, others indicated an improvement, and others reported no change [19][20][21][22]. However, our results are in accordance with a systematic review that included data from 1823 patients with T2DM (and showed a mean increase in HbA1c of +0.14 [95%CI: −0.13 to 0.40]), and with the results of a meta-analysis of 11 studies (n=16,895) indicating a significant increase of HbA1c levels (0.34% [95%CI: 0.30 to 0.38]) during the COVID-19 pandemic [23,24].…”
Objective: The study aimed to evaluate the metabolic control during the COVID-19 pandemic in subjects with type 2 diabetes mellitus (T2DM) and whether care through telemedicine significantly impacted it.
Material and methods: This was a retrospective study for which three time-periods were prespecified: the COVID-19 pandemic period, pre-COVID-19 period, and before pre-COVID-19. The following information were collected: anthropometric and laboratory parameters (glycated hemoglobin (HbA1c), blood glucose, lipid profile, creatinine, eGFR, etc.), self-measured blood glucose (SMBG), blood pressure (BP), diabetes therapy, number of on-site and of telemedicine consultations. The mean values of all available measurements for HbA1c, SMBG, BP, weight, and body mass index (BMI) were calculated.
Results: During the COVID-19 pandemic, the HbA1c values increased (6.78±0.77% to 6.96±0.87%, p<0.0001; + 0.18±0.67%), despite treatment intensification (p<0.01), while BMI and total cholesterol values slightly decreased (32.01±5.5 kg/m2 to 31.7±5.4 kg/m2, p<0.0001, and 178.1±40.8 mg/dl to 170.5±38.4 mg/dl, p<0.05). The deterioration of glycemic control (to HbA1c >7%) were rather seen in males (to 7.01±0.92%, p<0.0001), patients from rural areas (to 7.08±0.96%, p<0.001) and younger than 65 y.o. (to 7.05±0.82%, p<0.001). More male patients had a mean HbA1c increase of >0.5% during the COVID-19 pandemic (32.3% vs 21.5%, p<0.05). Patients who received more diabetes care visits through telemedicine had a more attenuated increase in HbA1c (6.79±0.80% to 6.90±0.83%, p<0.05 vs 6.76±0.72% to 7.08±0.92%, p<0.0001).
Conclusions: The glycemic control slightly deteriorated during the COVID-19 pandemic (but with overall HbA1c within target), with certain patient categories being more affected. Diabetes care though telemedicine allowed the maintenance of the metabolic control.
“…years the HbA1c values increased slightly, despite treatment intensification. The results are in concordance with some but not all studies that evaluated the glycemic control during COVID-19 pandemic in patients with T2DM, as some of them showed deterioration of HbA1c values, others indicated an improvement, and others reported no change [19][20][21][22]. However, our results are in accordance with a systematic review that included data from 1823 patients with T2DM (and showed a mean increase in HbA1c of +0.14 [95%CI: −0.13 to 0.40]), and with the results of a meta-analysis of 11 studies (n=16,895) indicating a significant increase of HbA1c levels (0.34% [95%CI: 0.30 to 0.38]) during the COVID-19 pandemic [23,24].…”
Objective: The study aimed to evaluate the metabolic control during the COVID-19 pandemic in subjects with type 2 diabetes mellitus (T2DM) and whether care through telemedicine significantly impacted it.
Material and methods: This was a retrospective study for which three time-periods were prespecified: the COVID-19 pandemic period, pre-COVID-19 period, and before pre-COVID-19. The following information were collected: anthropometric and laboratory parameters (glycated hemoglobin (HbA1c), blood glucose, lipid profile, creatinine, eGFR, etc.), self-measured blood glucose (SMBG), blood pressure (BP), diabetes therapy, number of on-site and of telemedicine consultations. The mean values of all available measurements for HbA1c, SMBG, BP, weight, and body mass index (BMI) were calculated.
Results: During the COVID-19 pandemic, the HbA1c values increased (6.78±0.77% to 6.96±0.87%, p<0.0001; + 0.18±0.67%), despite treatment intensification (p<0.01), while BMI and total cholesterol values slightly decreased (32.01±5.5 kg/m2 to 31.7±5.4 kg/m2, p<0.0001, and 178.1±40.8 mg/dl to 170.5±38.4 mg/dl, p<0.05). The deterioration of glycemic control (to HbA1c >7%) were rather seen in males (to 7.01±0.92%, p<0.0001), patients from rural areas (to 7.08±0.96%, p<0.001) and younger than 65 y.o. (to 7.05±0.82%, p<0.001). More male patients had a mean HbA1c increase of >0.5% during the COVID-19 pandemic (32.3% vs 21.5%, p<0.05). Patients who received more diabetes care visits through telemedicine had a more attenuated increase in HbA1c (6.79±0.80% to 6.90±0.83%, p<0.05 vs 6.76±0.72% to 7.08±0.92%, p<0.0001).
Conclusions: The glycemic control slightly deteriorated during the COVID-19 pandemic (but with overall HbA1c within target), with certain patient categories being more affected. Diabetes care though telemedicine allowed the maintenance of the metabolic control.
“…Moreover, patients were not familiarized with healthy lifestyle habits [ 5 ]. Surprisingly, some studies showed that glycemic control has not changed and even improved during lockdown [ 6 , 7 , 8 , 9 ]. It was also confirmed that patients with diabetes had a higher risk of developing COVID-19 and diabetes-related late complications during the pandemic [ 10 ].…”
Section: Introductionmentioning
confidence: 99%
“…However, it appears that lockdown and the restrictions of outdoor activity reduced the risk of trauma and DFU occurrence which may have resulted in a lower number of newly diagnosed patients with DFU. As mentioned above, some studies showed, for example, that glycemic control improved during the lockdown, so it is important to verify whether the impact of the pandemic was negative or positive for patients with DFU [ 5 , 6 , 7 , 8 , 9 ]. We would like to present the first data from the national registry gathered from the Polish population comparing the number of hospitalizations, amputations, and death rate among patients with DFU in 2020 in a country with a relatively low healthcare expenditure in comparison with Western Europe and the United States.…”
The COVID-19 pandemic revealed a breakdown of the system of DFU patient care. This retrospective national cohort study analyses the epidemiological status of DFU patients in relation to urgent and elective hospitalizations, amputation rates, and deaths in Poland from 2017 to 2019, and during 2020 when the COVID-19 pandemic began. The data were obtained from national medical records gathered by the National Health Fund (NHF). Discharge diagnoses were categorized according to ICD-10 and ICD-9 codes. Analysis of the data showed a statistically significant decrease in elective hospital admissions (from 29.6% to 26.3%, p = 0.001). There was a decrease in the percentage of hospitalizations related to limb-salvage procedures (from 79.4% to 71.3%, p = 0.001). The opposite tendency was observed among urgent hospital admissions (from 67.0% to 73.2%, p = 0.01), which was related to a significant increase in the number of minor amputations (from 3146 to 4269, p = 0.017). This rise was in parallel with the increase in the percentage of patients who died during hospitalization due to DFU (from 3.9% to 4.8%, p = 0.03). The number of deaths has not changed significantly (from 590.7 to 668.0, p = 0.26). The results of the conducted analyses confirm the negative tendencies in the medical care of patients with DFU during the first year of the pandemic in Poland. Changes in therapy schemes and stronger patient support following this period are necessary to avoid further complications in patients with DFU.
“…The results of the systematic review showed that the COVID-19 outbreak did not significantly change HbA1c (%) (n = 5) [30] , [33] , [34] , [35] , [36] . Deteriorated HbA1c (%) (n = 4) [37] , [38] , [39] , [40] were reported in Japan and Korea, which did not implement lockdown, and in Italy and Turkey, which imposed strict lockdown regulations.…”
Section: Resultsmentioning
confidence: 98%
“…6b ). For TG, deterioration [35] , [37] and stability [30] , [34] were equally reported, but its recalculated WMD suggests a significant increase (16.34, 95%CI 5.10 – 27.58) after removing D’Onofrio et al [30] based on the sensitivity analysis for reducing the potential publication bias. Fig.…”
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