Endocrine Abstracts

Aims

During April and May 2020 in Turkey, changing priorities in the health system and some restrictions on daily life in order to prevent the spread of SARS-CoV-2 infection may worsen metabolic control of people with diabetes. We aimed to investigate whether glycemic dysregulation or disturbance of lipid metabolism occur in people with diabetes during the lockdown period.

Methods

This retrospective study included 132 participants with type 2 diabetes mellitus and 6 participants with type 1 diabetes mellitus. We compared some metabolic parameters [HbA1c (Glycated haemoglobin), LDL (Low density lipoprotein), HDL (High density lipoprotein), Triglyceride, Body weight] of these people in pre-lockdown and post-lockdownperiod.

Results

HbA1c levels of the participants were higher in post-lockdown period when compared with pre-lockdown period (mean HbA1c 8.1% (65 mmol/mol) and 7.7% (60.7 mmol/mol) respectively, P = 0.001). In people with uncontrolled diabetes whose HbA1c > 7% (53 mmol/mol) in pre-lockdown period, higher triglyceride levels were detected in post-lockdown period (P = 0.036). There was no significant change in LDL, HDL levels and bodyweight.

Discussion

There are few studies analyzing real-life data specific to the metabolic control of people with diabetes during the pandemic period. In a Chinese study of 135 participants aged older than 65, HbA1c change between January and March in 2020 was statistically significant compared with the same period last year. In a study from India with 52 people with type 1 diabetes, it was observed that the average HbA1c values, which were 72.7 mmol/mol (8.8%) before COVID-19 lockdown period, increased to 85.8 mmol/mol (10%) after lockdown period. Our findings replicated the main outcomes of these two studies. In contrast with the Indian study, the majority of our sample was diagnosed with type 2 diabetes. Our study showed that triglyceride levels increased statistically significant in individuals with uncontrolled diabetes. The lockdown period may cause metabolic dysregulation due to physical inactivity, increased carbohydrate intake, weight gain, sarcopenia, and emotional stress.

Conclusion

Our results reflect the real-world experience of metabolic dysregulation of people with diabetes during lockdown. Considering these results; special measures like home exercise programs, telemedicine consultations, and the spread of technologies for diabetes should be taken for follow-up of individuals with diabetes during the pandemic lockdown.

References

1. Banerjee M. et al. Diabetes self-management amid COVID-19 pandemic. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020.

2. Verma A. et al. Impact of lockdown in COVID 19 on glycemic control in patients with type 1 Diabetes Mellitus. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(5):1213–6.