Impact of COVID-19 lockdown on glucose control of elderly people with type 2 diabetes in Italy. (April 2021)

• Record Type: Journal Article
• Authors: Falcetta, Pierpaolo; Aragona, Michele; Ciccarone, Annamaria; Bertolotto, Alessandra; Campi, Fabrizio; Coppelli, Alberto; Dardano, Angela; Giannarelli, Rosa; Bianchi, Cristina; Del Prato, Stefano
• Is Part Of: Diabetes research and clinical practice. Volume 174(2021)
• Publication Date: 2021-04
• Subjects: Covid-19 -- Lockdown -- Type 2 diabetes -- Metabolic control -- Age -- Insulin therapy; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2021.108750
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: There was no overall glycemic deterioration in type 2 diabetic subjects during lockdown. Nonetheless, greater risk for worse glucose control was apparent in older patients. Also, insulin therapy was associated with higher odds of glycemic derangement. Age and insulin therapy may identify individuals requiring special protective programs. Abstract: Aims: to evaluate the effect of home confinement related to COVID-19 lockdown on metabolic control in subjects with T2DM in Italy. Methods: we evaluated the metabolic profile of 304 individuals with T2DM (65% males; age 69 ± 9 years; diabetes duration 16 ± 10 years) attending our Diabetes Unit early at the end of lockdown period (June 8 to July 7, 2020) and compared it with the latest one recorded before lockdown. Results: There was no significant difference in fasting plasma glucose (8.6 ± 2.1 vs 8.8 ± 2.5 mmol/L; P = 0.353) and HbA1c (7.1 ± 0.9 vs 7.1 ± 0.9%; P = 0.600) before and after lockdown. Worsening of glycaemic control (i.e., ΔHbA1c ≥ 0.5%) occurred more frequently in older patients (32.2% in > 80 years vs 21.3% in 61–80 years vs 9.3% in < 60 years; P = 0.05) and in insulin users (28.8 vs 16.5%; P = 0.012). On multivariable analysis, age > 80 years (OR 4.62; 95%CI: 1.22–16.07) and insulin therapy (OR 1.96; 95%CI: 1.10–3.50) remained independently associated to worsening in glycaemic control. Conclusions: Home confinement related to COVID-19 lockdown did not exert a negative effect on glycaemic control in patients with T2DM. However, age and insulin therapy can identify patients at greatest risk of deterioration of glycaemic control.