Korean Diabetes Association

Articles

[2022 Mar;46(2)] Impact of COVID-19 Lockdown on the Metabolic Control Parameters in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis

2022.07.15
Hit 361

https://e-dmj.org/journal/view.php?number=2638 (클릭 170회)

Original Article

COVID-19

Diabetes & Metabolism Journal 2022;46(2):260-272.

Published online: March 8, 2022

DOI: https://doi.org/10.4093/dmj.2021.0125

Impact of COVID-19 Lockdown on the Metabolic Control Parameters in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis

Ifan Ali Wafa^1,^*

, Nando Reza Pratama^1,^*

, Nurizzah Farahiyah Sofia^1,^*

, Elsha Stephanie Anastasia¹, Tiffany Konstantin¹, Maharani Ayuputeri Wijaya¹, M. Rifqi Wiyono¹, Lilik Djuari², Hermina Novida³

¹Faculty of Medicine, Airlangga University, Surabaya, Indonesia

²Department of Public Health and Preventive Medicine, Airlangga University, Surabaya, Indonesia

³Department of Internal Medicine, Airlangga University, Surabaya, Indonesia

Corresponding author: Hermina Novida https://orcid.org/0000-0001-5899-1589 Department of Internal Medicine, Airlangga University, Jalan Mayjen Prof. Dr. Moestopo No.47, Surabaya 60131, Indonesia, E-mail: hermina-n@fk.unair.ac.id

^* Ifan Ali Wafa, Nando Reza Pratama, and Nurizzah Farahiyah Sofia contributed equally to this study as first authors.

Received June 14, 2021 Accepted September 10, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Abrupt implementation of lockdowns during the coronavirus disease 2019 (COVID-19) pandemic affected the management of diabetes mellitus in patients worldwide. Limited access to health facilities and lifestyle changes potentially affected metabolic parameters in patients at risk. We conducted a meta-analysis to determine any differences in the control of metabolic parameters in patients with diabetes, before and during lockdown.

Methods

We performed searches of five databases. Meta-analyses were carried out using random- or fixed-effect approaches to glycaemic control parameters as the primary outcome: glycosylated hemoglobin (HbA1c), random blood glucose (RBG), fasting blood glucose (FBG), time-in-range (TIR), time-above-range (TAR), time-below-range (TBR). Mean difference (MD), confidence interval (CI), and P value were calculated. Lipid profile was a secondary outcome and is presented as a descriptive analysis.

Results

Twenty-one studies enrolling a total of 3,992 patients with type 1 or type 2 diabetes mellitus (T1DM or T2DM) were included in the study. Patients with T1DM showed a significant improvement of TIR and TAR (MD=3.52% [95% CI, 0.29 to 6.74], I²=76%, P=0.03; MD=−3.36% [95% CI, −6.48 to −0.25], I²=75%, P=0.03), while FBG among patients with T2DM significantly worsened (MD=3.47 mg/dL [95% CI, 1.22 to 5.73], I²=0%, P<0.01). No significant difference was found in HbA1c, RBG, and TBR. Use of continuous glucose monitoring in T1DM facilitated good glycaemic control. Significant deterioration of lipid parameters during lockdown, particularly triglyceride, was observed.

Conclusion

Implementation of lockdowns during the COVID-19 pandemic did not worsen glycaemic control in patients with diabetes. Other metabolic parameters improved during lockdown, though lipid parameters, particularly triglyceride, worsened.

Keywords: COVID-19; Diabetes mellitus; Meta-analysis; Systematic review; Triglycerides

List