Retrospective Study on the Impact of COVID-19 Lockdown on Patients with Type 2 Diabetes in Northern Taiwan

Abstract

Background

During the COVID-19 pandemic, the national lockdown had a significant impact on healthcare systems and diabetes management. The results of relevant studies were inconsistent. The aim of the study was to investigate the impact of lockdown on glycemic control among patients with type 2 diabetes mellitus(T2D) in Taiwan.

Methods

This was a retrospective study conducted in a single regional hospital in Northern Taiwan. The clinic characteristics of the patients were summarized. Anthropometric and biochemical data before and after the lockdown were collected and analyzed. Stepwise multiple regression analysis was performed to identify the independent determinants of variables, including baseline characteristics and laboratory parameters, for the changes in glycated hemoglobin(HbA1c).

Results

A total of 943 (females 48.5%) patients with T2D were enrolled. The mean age of the patients was 60.6±12.3years, with a mean HbA1c of 7.0±1.0%, a mean diabetes duration of 7.3±4.6years, and a mean body mass index(BMI) of 26.5±4.5kg/m². The overall means of HbA1c and fasting blood glucose were significantly improved after the lockdown compared to before (7.0±1.0 vs 6.8±0.9, p<0.001 and 132.2±33.3 vs 124.4±30.0, p<0.001, respectively). The proportion of patients achieving HbA1c target (≤7%) was higher after the lockdown compared to before (61.5% vs 68.9%, p<0.001). Stepwise multiple regression analysis revealed that baseline HbA1c before the lockdown was a positive contributor to the change in HbA1c after the lockdown, whereas BMI and co-morbidity with dyslipidemia were negative contributors (standardized coefficient +0.16, p<0.001; −0.07, p=0.025; −0.12, p=0.001, respectively).

Conclusion

Our study highlights the benefits of lockdown measures on diabetic control in Northern Taiwan as a single-center experience with the improvement of HbA1c and fasting blood glucose. Understanding these consequences of national lockdown can help healthcare providers to improve diabetes care during the pandemic.

Keywords:

• COVID-19 lockdown
• type 2 diabetes mellitus
• glycemic control

Abbreviations

SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2; COVID-19, coronavirus disease 2019; T2D, type 2 diabetes mellitus; BMI, body mass index; HbA1c, glycated hemoglobin; FBG, fasting blood glucose; TC, total cholesterol; TG, triglyceride; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; Cr, creatinine; S-GPT, serum glutamate pyruvate transaminase; uACR, urine albumin-creatinine ratio; eGFR, estimated glomerular filtration rate.

Ethics Approval and Informed Consent

1. Conflict of interest: All authors declare no conflict of interest.

2. Informed Consent Statement: Informed consent was obtained from the patients included in the study.

3. This study was conducted under the Declaration of Helsinki and was approved by the Institutional Review Board of Taiwan Adventist Hospital, Taipei, Taiwan (approval number: 111-E-07).

4. Approval date of Registry and the Registration No. of the study/trial: N/A.

5. Animal Studies: N/A.

Consent for Publication

All authors confirm that the details of any images, videos, recordings, etc can be published, and that the person(s) providing consent have been shown the article contents to be published.

Acknowledgments

The authors would like to express their deepest gratitude to all the people who participated in this study. Our heartfelt thanks go to the hospital officials for their guidance and support for this study. Finally, the paper is dedicated to our beloved family, especially our daughter, Lindsey.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that there are no conflicts of interest.

Additional information

Funding

The research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.