Endocrinol Metab.  2021 Oct;36(5):1142-1146. 10.3803/EnM.2021.1154.

Year-Long Trend in Glycated Hemoglobin Levels in Patients with Type 2 Diabetes during the COVID-19 Pandemic

• Jin J
• Lee SW
• Lee WK
• Jeon JH
• Kim JG
• Lee IK
• Choi YK
• Park KG

• KMID: 2521961
• DOI: http://doi.org/10.3803/EnM.2021.1154

Abstract

It has been suggested that the coronavirus disease 2019 (COVID-19) pandemic has had a negative impact on glycemic control in patients with type 2 diabetes mellitus (T2DM). However, no study has examined yearly trends in glycated hemoglobin (HbA1c) levels after the start of the COVID-19 outbreak. Here, we performed a retrospective analysis of HbA1c concentrations during the early period of the COVID-19 outbreak (COVID-19 cohort) and then compared the yearly trend in the mean HbA1c level, along with fluctuations in HbA1c levels, with those during previous years (non-COVID-19 cohorts). We observed that the mean HbA1c level in patients with T2DM increased during the first 6 months of the COVID-19 outbreak. After 6 months, HbA1c levels in the COVID-19 cohort returned to levels seen in the non-COVID-19 cohorts. The data suggest that vulnerable patients with T2DM should be monitored closely during the early period of a pandemic to ensure they receive appropriate care.

Keyword

COVID-19; Physical distancing; Glycated hemoglobin A; Diabetes mellitus

Figure

• 

  Fig. 1 Changes in glycated hemoglobin (HbA1c) levels from Period 1 to Period 5 in all three cohorts. Values are expressed as the mean±standard error. There were no significant differences between non-coronavirus disease 2019 (COVID-19) cohort 1 and cohort 2 during any period. NS, not significant. aP<0.01, COVID-19 cohort vs. non-COVID-19 cohort 1; bP<0.05, COVID-19 cohort vs. non-COVID-19 cohort 1; cP<0.01, COVID-19 cohort vs. non-COVID-19 cohort 2.

• 

  Fig. 2 Changes in glycated hemoglobin (HbA1c) levels (data adjusted for baseline HbA1c level and sex). ΔHbA1c from baseline period to each period is shown for all three cohorts. Values are expressed as the mean±standard error. COVID-19, coronavirus disease 2019; NS, not significant. aP<0.01; bP<0.05.

Reference

1. Sharma A, Tiwari S, Deb MK, Marty JL. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): a global pandemic and treatment strategies. Int J Antimicrob Agents. 2020; 56:106054.

2. Bae TW, Kwon KK, Kim KH. Mass infection analysis of COVID-19 using the SEIRD model in Daegu-Gyeongbuk of Korea from April to May, 2020. J Korean Med Sci. 2020; 35:e317.

3. Park IN, Yum HK. Stepwise strategy of social distancing in Korea. J Korean Med Sci. 2020; 35:e264.

4. Ruiz-Roso MB, Knott-Torcal C, Matilla-Escalante DC, Garcimartin A, Sampedro-Nunez MA, Davalos A, et al. COVID-19 lockdown and changes of the dietary pattern and physical activity habits in a cohort of patients with type 2 diabetes mellitus. Nutrients. 2020; 12:2327.

5. Tanaka N, Hamamoto Y, Kurotobi Y, Yamasaki Y, Nakatani S, Matsubara M, et al. Lifestyle changes as a result of COVID-19 containment measures: bodyweight and glycemic control in patients with diabetes in the Japanese declaration of a state of emergency. J Diabetes Investig. 2021; 12:1718–22.

6. Park SD, Kim SW, Moon JS, Lee YY, Cho NH, Lee JH, et al. Impact of social distancing due to coronavirus disease 2019 on the changes in glycosylated hemoglobin level in people with type 2 diabetes mellitus. Diabetes Metab J. 2021; 45:109–14.

7. Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attina A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020; 18:229.

8. Ghosh A, Arora B, Gupta R, Anoop S, Misra A. Effects of nationwide lockdown during COVID-19 epidemic on lifestyle and other medical issues of patients with type 2 diabetes in north India. Diabetes Metab Syndr. 2020; 14:917–20.

9. Alessi J, de Oliveira GB, Franco DW, Brino do Amaral B, Becker AS, Knijnik CP, et al. Mental health in the era of COVID-19: prevalence of psychiatric disorders in a cohort of patients with type 1 and type 2 diabetes during the social distancing. Diabetol Metab Syndr. 2020; 12:76.

10. Dasgupta K, Joseph L, Pilote L, Strachan I, Sigal RJ, Chan C. Daily steps are low year-round and dip lower in fall/winter: findings from a longitudinal diabetes cohort. Cardiovasc Diabetol. 2010; 9:81.

11. Gikas A, Sotiropoulos A, Pastromas V, Papazafiropoulou A, Apostolou O, Pappas S. Seasonal variation in fasting glucose and HbA1c in patients with type 2 diabetes. Prim Care Diabetes. 2009; 3:111–4.

12. Kim YJ, Park S, Yi W, Yu KS, Kim TH, Oh TJ, et al. Seasonal variation in hemoglobin a1c in Korean patients with type 2 diabetes mellitus. J Korean Med Sci. 2014; 29:550–5.

13. Pereira MT, Lira D, Bacelar C, Oliveira JC, de Carvalho AC. Seasonal variation of haemoglobin A1c in a Portuguese adult population. Arch Endocrinol Metab. 2015; 59:231–5.

14. Tao J, Gao L, Liu Q, Dong K, Huang J, Peng X, et al. Factors contributing to glycemic control in diabetes mellitus patients complying with home quarantine during the coronavirus disease 2019 (COVID-19) epidemic. Diabetes Res Clin Pract. 2020; 170:108514.