Association of the Coronavirus Disease 2019 Outbreak on the Diabetes Self-Management in Chinese Patients: An Analytical Cross-Sectional Study

Abstract

Background

The coronavirus disease 2019 (COVID-19) outbreak has seriously affected people’s lives, especially those with chronic diseases. Diabetes self-management, which plays an important role in glycaemic control and reducing the risk of acute and long-term complications, may be discouraged by social distancing.

Purpose

To evaluate the level of self-management activities in Chinese patients with type 2 diabetes mellitus (T2DM) during the COVID-19 pandemic.

Patients and Methods

A survey of with 872 patients with T2DM in the inpatient and outpatient departments through face-to-face interviews was conducted from 1 July, 2020 to 30 September, 2020. The main outcome measures were glycaemic control status and level of self-management activities during the pandemic.

Results

In terms of glycaemic control, the data showed that patients with fasting plasma glucose (FPG) < 7.0 mmol/L (36.4%), postprandial plasma glucose (PPG) < 10.0 mmol/L (26.3%), or glycosylated haemoglobin (HbA1c) < 7.0% (18.6%) in our investigation has well-controlled blood glucose level, and 11.9% of patients experienced blood glucose <3.9 mmol/L during the outbreak. The diabetes self-management of Chinese patients decreased and the final diabetes self-management score of the Chinese patients was 3.4 ± 1.45. Patients with higher education, diabetes education, comorbidities, and online consultations had higher diabetes self-management scores (P <0.05). Adherence to diabetes self-management in the normal glycaemic control group was higher than that in the substandard glycaemic control group (P<0.05). Among all participants, 72.1% of the patients reduced the frequency of hospital visits, and 44.8% considered that they had diabetes-related stress during the pandemic. The mean anxiety level score rated by 286 patients was 5.3±2.8.

Conclusion

The COVID-19 pandemic has affected diabetes self-management, including substandard glycemic control, increased diabetes-related stress, limited exercise range and medical visits. Therefore, future interventions should focus on the online management of chronic diseases and support online consultation’ development and promotion, which can overcome physical distance and provide personalized services conveniently.

Keywords:

• coronavirus disease 2019
• diabetes self-management
• online consultation
• type 2 diabetes mellitus

Abbreviations

COVID-19, the coronavirus disease 2019; T2DM, type 2 diabetes mellitus; FPG, fasting plasma glucose; PPG, postprandial plasma glucose; HbA1c, glycosylated haemoglobin; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; ADA, American Diabetes Association; SDSCA, summary of diabetes self-care activities; BMI, body mass index; SD, standard deviation; OAD, oral antidiabetic drug; GLP-1, glucagon-like peptide 1; BP, blood pressure.

Ethics Approval

Waiving to sign the informed consent will not adversely affect the rights and health of the participants. The privacy and personal information of the participants were protected. In this study, all patients were anonymised. The risk of the study to the participants was not greater than the minimum risk. The research protocol was approved by the Ethics Committee of Zhujiang Hospital, Southern Medical University, China (approval no. 2021-KY-177-01). The survey was in accordance with the Declaration of Helsinki. All the participants provided informed consent.

Acknowledgments

This study was supported by the National Natural Science Foundation of China (Grant NO: 81770804).

Disclosure

The authors report no conflicts of interest in this work.