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)

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Diabetes Metab J. 2021;45(2):275-276
Publication date (electronic) : 2021 March 25
doi : https://doi.org/10.4093/dmj.2020.0288
Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
Corresponding author: Junghyun Noh Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea E-mail: jhnoh@paik.ac.kr

The coronavirus disease 2019 (COVID-19) pandemic emerged in December, 2019, and is still in progress. Glycemic control in diabetic patients as well as diabetes itself has been identified as an important risk factor for COVID-19 outcomes including disease severity and mortality [1,2]. Close attention and timely, adequate care of diabetes are critical in the COVID-19 pandemic era. However, social distancing and stay-at-home policies which are essential during the COVID-19 pandemic, may result in changes to lifestyle behaviors that worsen glycemic control in diabetic patients. An international electronic survey detailed changes in lifestyle behaviors that reduced physical activity at all intensity levels (vigorous, moderate, walking, and overall), increased sitting time and unhealthy food consumption during social distancing due to COVID-19 [3]. These results suggest that lifestyle changes caused by the COVID-19 pandemic will adversely affect glycemic control in diabetic patients, although there is a lack of studies that assess the effects of behavior changes on glycemic control in diabetic patients during the COVID-19 pandemic.

Park et al. [4] reported that glycosylated hemoglobin (HbA1c) level was increased in the COVID-19 cohort (2019 to 2020) in people with type 2 diabetes mellitus (T2DM) but not in the non-COVID-19 cohorts defined at the same dates during the 2 previous years. This study included all T2DM patients aged ≥19 years who visited hospitals and had their HbA1c levels measured during the designated periods. Many newly diagnosed diabetic patients usually experience a rapid decrease in HbA1c with proper management. Since access to health care services might be more difficult for patients who may be reluctant to visit health care facilities during the pandemic period, it is suspected that the number of newly diagnosed diabetic patients is smaller in the COVID-19 cohort. The different number of new-onset patients may affect changes in HbA1c level. It might be reasonable to exclude newly diagnosed patients from this study to clarify this suspicion. It is critical to identify the effect of the COVID-19 pandemic on glycemic control, to identify the factors that affect deterioration of glycemic control during the pandemic, and to find solutions for these issues. In that sense, Park et al.’s [4] study is a very important start.

Notes

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

References

1. Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia: a systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr 2020;14:395–403.
2. Jeong IK, Yoon KH, Lee MK. Diabetes and COVID-19: global and regional perspectives. Diabetes Res Clin Pract 2020;166:108303.
3. Ammar A, Brach M, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 International Online Survey. Nutrients 2020;12:1583.
4. 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.

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