Endocrine Abstracts

Introduction: COVID-19 is a novel pandemic affecting globally. It has led to an unprecedented global health crisis assessing health system’s preparedness to deal with health disasters. The aim of our study was to evaluate the impact of COVID-19 on the follow up care of diabetic patients.

Methods: We conducted a retrospective study in 100 insulin-requiring diabetic patients. Data regarding treatment availability, weigh, glycemic control and follow up care during two years before (T1: 2018-2019) and during the pandemic of COVID-19 (T2 : 2020-2021) were collected.

Results: The study population included 60 women and 40 men. The mean age was 58.6 ± 1.3 years. Among our 100 patients, 30% have type 1 diabetes mellitus and 70% have type 2 diabetes mellitus. Fifty-seven patients were using insulin alone and 43 patients were treated by insulin with metformin. Hypertension and dyslipidemia prevalence was respectively 55% and 56%. Insulin had always been available. However, metformin, anti-hypertensive drugs and anti-dyslipidemic drugs disponibility in public health facilities decreased, with respectively 57%, 36% and 75% of cases before pandemic versus 79%, 59% and 85% in T2 (P = 0.022, P = 0.004 and P = 0.332 respectively). Eight patients missed at least one medical consultation in T1 versus 46 patients in T2 (P < 10-3). Fundoscopy and screening for microalbuminuria were performed respectively in 83% and 89% of patients in T1 and in 41% and 87% in T2 (P < 10-3, P = 0.839 respectively). Glycosylated hemoglobin increased in 75% of patients. Its mean raised from 8.9% to 9.3% (P < 10-3). The percentage of patients with well-controlled diabetes decreased from 29% in T1 to 19% in T2 (P = 0.013). A weight gain was documented in 57% of patients. The mean of weight increased from 76.9 Kg to 78.3 Kg (P < 10-3). Out of 100 patients, cardiovascular events were documented in one patient in T1 and in five patients in T2 (P = 0.219).

Conclusion: A significant impairment in the follow up care of diabetic patients and their glycemic control has been revealed through our study. This can be partially explained by the impact of lockdown on treatment facilities availability, healthy lifestyle habits and by the stressful condition related to this pandemic. However, defective health systems have contributed to worsen this critical situation. Hence, effective preparedness are needed in future so that complications can be minimized.