Elsevier

Primary Care Diabetes

Volume 17, Issue 3, June 2023, Pages 229-237
Primary Care Diabetes

The indirect impact of the COVID-19 pandemic on people with type 2 diabetes mellitus and without COVID-19 infection: Systematic review and meta-analysis

https://doi.org/10.1016/j.pcd.2023.02.006Get rights and content

Highlights

  • Investigates the indirect impact of the pandemic on T2DM patients without infection.

  • Meta-analysis shows that hemoglobin A1c and body mass index changed insignificantly.

  • Meta-analysis shows that triglyceride and total cholesterol might worsen.

Abstract

Background

The effect directly from the coronavirus disease 2019 (COVID-19) infection on health and fatality has received considerable attention, particularly among people with type 2 diabetes mellitus (T2DM). However, evidence on the indirect impact of disrupted healthcare services during the pandemic on people with T2DM is limited. This systematic review aims to assess the indirect impact of the pandemic on the metabolic management of T2DM people without a history of COVID-19 infection.

Methods

PubMed, Web of Science, and Scopus were systematically searched for studies that compared diabetes-related health outcomes between pre-pandemic and during-pandemic periods in people with T2DM and without the COVID-19 infection and published from January 1, 2020, to July 13, 2022. A meta-analysis was performed to estimate the overall effect on the diabetes indicators, including hemoglobin A1c (HbA1c), lipid profiles, and weight control, with different effect models according to the heterogeneity.

Results

Eleven observational studies were included in the final review. No significant changes in HbA1c levels [weighted mean difference (WMD), 0.06 (95% CI −0.12 to 0.24)] and body weight index (BMI) [0.15 (95% CI −0.24 to 0.53)] between the pre-pandemic and during-pandemic were found in the meta-analysis. Four studies reported lipid indicators; most reported insignificant changes in low-density lipoprotein (LDL, n = 2) and high-density lipoprotein (HDL, n = 3); two studies reported an increase in total cholesterol and triglyceride.

Conclusions

This review did not find significant changes in HbA1c and BMI among people with T2DM after data pooling, but a possible worsening in lipids parameters during the COVID-19 pandemic. There were limited data on long-term outcomes and healthcare utilization, which warrants further research.

Systematic review registration

PROSPERO CRD42022360433.

Abbreviations

SARS-CoV-2
coronavirus type 2
COVID-19
coronavirus disease 2019
T2DM
type 2 diabetes mellitus
HbA1%
glycated hemoglobin
BMI
body mass index
BP
blood pressure
SBP/DBP
systolic pressure / diastolic pressure
TG
triglyceride
TC
total cholesterol
LDL
low-density lipoprotein
HDL
high-density lipoprotein
PICOS
population, intervention, control, outcome, and study design
95% CI
95% confidence intervals
JBI
Joanna Briggs Institute
IQR
interquartile range
SD
standard deviation
WMD
weighted mean difference

Keywords

Type 2 diabetes mellitus
Hemoglobin A1c
COVID-19
Indirect effect
Systematic review
Meta-analysis

Cited by (0)

1

Zhuoran Hu and Hin Moi Youn contributed equally to the manuscript.

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