Epidemiology and Public Health
IDF2022-0354 The impact of COVID-19 lockdown on the changes in glycated hemoglobin in patients with type 2 diabetic in Taiwan

https://doi.org/10.1016/j.diabres.2023.110441Get rights and content

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Background

Previous studies found lack of physical activities and increased dietary intake following COVID-19 lockdown among patients with type 2 diabetes (T2DM) may lead to poor glycemic control. The impact of the COVID-19 lockdown on glycemic control in T2DM was studied widely but results were heterogeneous in different countries. In Taiwan, due to a surge of COVID-19 cases in 2021, the government raised nation-wide COVID-19 alert to level 3, a lockdown-like measure which persisted for 69 days since May

Aim

This study aimed to explore the impact of the COVID-19 level 3 alert on glycemic control in adult patients with type 2 diabetes in Taiwan.

Method

For this retrospective cohort study, patients with T2DM with HbA1c data in 3 months before and after May 19 in the same year were enrolled. Three cohorts including the non-COVID-19 cohort in 2019, the COVID-19 without level 3 alert cohort in 2020, and the COVID-19 with level 3 alert cohort in 2021 were conducted; 9116 patients, 9082 patients, and 8664 patients, respectively were enrolled. We used a generalized estimated equation to analyze the change in mean HbA1c between before and after May

Results

Mean HbA1c levels after May 19 were lower than those before May 19 in 2019 (7.267 ± 1.276% vs 7.431 ± 1.383%, P < 0.001), in 2020 (7.270 ± 1.279% vs 7.374 ± 1.346%, P < 0.001), and in 2021 (7.030 ± 1.225% vs 7.169 ± 1.295%, P < 0.001). There was no significant difference of ΔHbA1c in in 2021 as compared with ΔHbA1c in 2019 (β = –0.02%, 95% confidence interval [CI]: –0.04–0.00%, P = 0.109). ΔHbA1c in 2021 was higher as compared with ΔHbA1c in 2020 (β = 0.04%, CI: 0.02–0.07%, P < 0.001).

Conclusion

A reduction of mean HbA1c after the COVID-19 level 3 alert in 2021 and similar seasonal changes of HbA1c in 2019 and 2020 were observed. There was no deteriorated change in ΔHbA1c after the COVID-19 level 3 alert in 2021 as compared with ΔHbA1c in 2019 and 2020.

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