medwireNews: COVID-19 restrictions do not significantly impact glycated hemoglobin (HbA1c) levels in individuals with type 2 diabetes, but those with poor psychologic wellbeing may experience worsening glycemic control, suggest findings from an Italian study.
The researchers compared data from 141 adults (median age 68 years) attending one of three diabetes centers during a COVID-19 lockdown period who did not require intensification of their usual diabetes therapy, and 123 control individuals with type 2 diabetes (median age 69 years) who attended the study centers 1 year previously.
The median disease duration in both groups was 13 years and 61% were men. For the lockdown group, baseline data were collected from December 2019 to March 2020, and follow-up data from June to July 2020. For the control group, the researchers used the same time frames in 2018–2019.
As reported in Diabetes, Obesity and Metabolism, median HbA1c levels decreased by 0.1% from baseline to follow-up in both the lockdown and the control groups, and there was no significant difference in HbA1c levels at follow-up, at 7.3% (56 mmol/mol) versus 7.4% (57 mmol/mol).
BMI remained consistent in the lockdown and control groups during the study period, with median baseline values of 28.2 and 26.2 kg/m2, respectively. There were also statistically comparable decreases in glucose (6.0 vs 0.0 mg/dL) and high-density lipoprotein cholesterol (1.0 vs 2.0 mg/dL) from baseline to follow-up.
In a subgroup analysis, the investigators looked at changes in HbA1c and BMI among people in the lockdown group with different degrees of psychologic wellbeing, assessed by the Psychological General Well-Being Index (PGWBS). They found that people in the lowest tertile for PGWBS score, indicating worse psychologic health, experienced worsening HbA1c and BMI during follow-up, whereas those in the highest tertile did not.
“[T]his evidence suggests that patients with diabetes are at increased risk of mental issues related to the pandemic, which then may translate into a significant worsening of metabolic control, calling for health care systems to consider special psychological support for this category,” conclude the investigators.
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