Endocrine Abstracts

Introduction

Due to the COVID pandemic, Portugal was forced to start lockdown on March 18 ^th that lasted until June 1st. Lockdown caused a lot of changes in the daily activities of the Portuguese people, such as eating habits, exercise, time spent at home and stress management. After the lockdown people noticed difficult access to healthcare.

Objective

Our aim was to evaluate if these changes had an impact in the glycemic and weight control of patients with diabetes.

Material and methods

We performed a retrospective study and included patients with type 1 and type 2 diabetes followed in our hospital. We checked hemoglobin A1c (%) between December 2020-February 2021 (before lockdown), between June-August 2021 (during lockdown) and after September 2021 (after lockdown), and we evaluated weight (Kg) before and after lockdown. In the group of type 1 diabetes we also analyzed TIR (time in range (%)) and TBR (time below range (%)) before lockdown (January-February), during lockdown (April-June) and after lockdown (July-September).

Results

We included data from 233 patients, 119 with type 1 diabetes, (43.9 ± 1.2 years; 51% women and 49% men) and 114 with type 2 diabetes (65.4 ± 1.2 years; 52% men and 48% women). Our analysis showed no significant changes in any of these variables, but showed a trend for improvement in the glycemic control in type 2 diabetes (A1c before lockdown 8.1 ± 0.14 vs during 7.8 ± 0.18 vs after 7.8 ± 0.2; P = 0.323). In patients with type 1 diabetes we noticed a trend for glycemic improvement during lockdown but not after (A1c 8 ± 0.1 vs 7.7 ± 0.1 vs 8 ± 0.2; P = 0.2), and also better TIR during lockdown (45.5 ± 1.8 vs 51.7 ± 2.1 vs 48.2 ± 1.8; P = 0.08). However, our analysis showed an elevation of the time spent in hypoglycemia after lockdown (TBR 5.2 ± 0.6 vs 5.3 ± 0.7 vs 6.5 ± 0.6; P = 0.3). There was a trend for reduction in weight in type 2 diabetes after lockdown (82.47 ± 2.4 vs 80.44 ± 2.7; P = 0.576).

Conclusion

Glycemic control can improve during lockdown maybe because people can more easily manage diabetes at home. At the long term, the pandemic can worsen the glycemic control, because of the lack or difficult access to healthcare and increased stress. The new diabetes technologies can help us managing these patients, especially during the pandemic.