Huang Hsuan, Su Hsiao-Ling, Huang Chih-Hsung, Lin Yi-Hsin
Division of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, Taiwan.
Diabetes Metab Syndr Obes. 2023 Aug 24;16:2539-2547. doi: 10.2147/DMSO.S422617. eCollection 2023.
During the COVID-19 pandemic, the national lockdown had a significant impact on healthcare systems and diabetes management. The results of relevant studies were inconsistent. The aim of the study was to investigate the impact of lockdown on glycemic control among patients with type 2 diabetes mellitus(T2D) in Taiwan.
This was a retrospective study conducted in a single regional hospital in Northern Taiwan. The clinic characteristics of the patients were summarized. Anthropometric and biochemical data before and after the lockdown were collected and analyzed. Stepwise multiple regression analysis was performed to identify the independent determinants of variables, including baseline characteristics and laboratory parameters, for the changes in glycated hemoglobin(HbA1c).
A total of 943 (females 48.5%) patients with T2D were enrolled. The mean age of the patients was 60.6±12.3years, with a mean HbA1c of 7.0±1.0%, a mean diabetes duration of 7.3±4.6years, and a mean body mass index(BMI) of 26.5±4.5kg/m. The overall means of HbA1c and fasting blood glucose were significantly improved after the lockdown compared to before (7.0±1.0 vs 6.8±0.9, p<0.001 and 132.2±33.3 vs 124.4±30.0, p<0.001, respectively). The proportion of patients achieving HbA1c target (≤7%) was higher after the lockdown compared to before (61.5% vs 68.9%, p<0.001). Stepwise multiple regression analysis revealed that baseline HbA1c before the lockdown was a positive contributor to the change in HbA1c after the lockdown, whereas BMI and co-morbidity with dyslipidemia were negative contributors (standardized coefficient +0.16, p<0.001; -0.07, p=0.025; -0.12, p=0.001, respectively).
Our study highlights the benefits of lockdown measures on diabetic control in Northern Taiwan as a single-center experience with the improvement of HbA1c and fasting blood glucose. Understanding these consequences of national lockdown can help healthcare providers to improve diabetes care during the pandemic.
在新冠疫情期间，全国封锁对医疗系统和糖尿病管理产生了重大影响。相关研究结果并不一致。本研究的目的是调查台湾地区2型糖尿病（T2D）患者封锁措施对血糖控制的影响。
这是一项在台湾北部一家地区医院进行的回顾性研究。总结了患者的临床特征。收集并分析了封锁前后的人体测量和生化数据。进行逐步多元回归分析，以确定糖化血红蛋白（HbA1c）变化的变量独立决定因素，包括基线特征和实验室参数。
共纳入943例（女性占48.5%）T2D患者。患者的平均年龄为60.6±12.3岁，平均HbA1c为7.0±1.0%，平均糖尿病病程为7.3±4.6年，平均体重指数（BMI）为26.5±4.5kg/m²。与封锁前相比，封锁后HbA1c和空腹血糖的总体均值显著改善（分别为7.0±1.0 vs 6.8±0.9，p<0.001；132.2±33.3 vs 124.4±30.0，p<0.001）。封锁后达到HbA1c目标（≤7%）的患者比例高于封锁前（61.5% vs 68.9%，p<0.001）。逐步多元回归分析显示，封锁前的基线HbA1c是封锁后HbA1c变化的正向贡献因素，而BMI和合并血脂异常则是负向贡献因素（标准化系数分别为+0.16，p<0.001；-0.07，p=0.025；-0.12，p=0.001）。
我们的研究突出了台湾北部封锁措施对糖尿病控制的益处，这是一项单中心经验，显示出HbA1c和空腹血糖得到改善。了解全国封锁的这些后果有助于医疗服务提供者在疫情期间改善糖尿病护理。
