Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Department of Public Health and Preventive Medicine, Airlangga University, Surabaya, Indonesia.
Diabetes Metab J. 2022 Mar;46(2):260-272. doi: 10.4093/dmj.2021.0125. Epub 2022 Mar 8.
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.
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.
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.
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.
在 2019 年冠状病毒病（COVID-19）大流行期间，突然实施封锁措施影响了全球糖尿病患者的管理。医疗设施的有限获取和生活方式的改变可能影响了处于危险中的患者的代谢参数。我们进行了一项荟萃分析，以确定在封锁前后，糖尿病患者的代谢参数控制是否存在差异。
我们对五个数据库进行了搜索。使用随机或固定效应方法对血糖控制参数进行荟萃分析作为主要结局：糖化血红蛋白（HbA1c）、随机血糖（RBG）、空腹血糖（FBG）、时间在范围内（TIR）、时间超过范围（TAR）、时间低于范围（TBR）。计算均值差（MD）、置信区间（CI）和 P 值。血脂谱是次要结局，以描述性分析呈现。
共有 21 项研究纳入了总共 3992 例 1 型或 2 型糖尿病患者（T1DM 或 T2DM）。T1DM 患者的 TIR 和 TAR 显著改善（MD=3.52% [95% CI，0.29 至 6.74]，I2=76%，P=0.03；MD=-3.36% [95% CI，-6.48 至 -0.25]，I2=75%，P=0.03），而 T2DM 患者的 FBG 显著恶化（MD=3.47mg/dL [95% CI，1.22 至 5.73]，I2=0%，P<0.01）。HbA1c、RBG 和 TBR 没有显著差异。T1DM 中使用连续血糖监测有助于良好的血糖控制。在封锁期间观察到血脂参数显著恶化，特别是甘油三酯。
在 COVID-19 大流行期间实施封锁并没有使糖尿病患者的血糖控制恶化。其他代谢参数在封锁期间有所改善，尽管脂质参数，特别是甘油三酯，有所恶化。
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