Uncovering the COVID-19 Collateral Impact on Diabetes Management

The COVID-19 response has left more than a million people with diabetes in the UK without access to the routine blood testing they need to manage their diabetes. Diabetic people should keep their blood glucose (sugar) levels as close to the normal range as possible.

However, the COVID-19 pandemic has brought never known disruptions to many routine healthcare services, including blood test monitoring that is key to diabetes diagnosis and management.

Uncontrolled diabetes can cause great damage to the body. Failure to focus on the wider implications for diabetic people and other groups with chronic conditions may put them at increased risk of poor outcomes from COVID-19, as well as longer-term health problems.

“As many as a third of COVID-19 deaths in the UK have been people with diabetes, and more may be at risk of the worst of the virus’ effects because so many have been unable to manage their diabetes effectively or have gone undiagnosed”, says lead author David Holland from The Benchmarking Partnership, UK.

A new study investigated the impact of the COVID-19 pandemic on diabetes diagnosis and management, using routinely collected laboratory data on the key diabetes test, glycosylated hemoglobin (HbA1c)—a measure of blood sugar levels over the preceding three months.

Researchers analyzed data from six UK testing centers (supporting 3.7 million people, 6% of the UK population) between October 2017 and September 2020, including 3.6 million HbA1c tests on 1.7 million people.

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From these data, researchers estimated the number of missed HbA1c tests, both for diagnostic and management purposes, during the UK lockdown between 23rd March 2020 and 30th September 2020.

They then calculated the potential impact of these missed tests on diabetes monitoring (those already diagnosed with diabetes), screening (as part of general health), and the detection of new cases.

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The study results indicate that HbA1c testing fell dramatically during the 6-month UK lockdown.

Compared to the 12 months before the lockdown, the number of monitoring tests dropped from 32,000 to 19,000 per month during the lockdown, screening tests fell from 46,000 to 32,000 a month, and diagnostic tests more than halved from 31,000 to 12,000.

A further 1.4 million monitoring tests in diabetic people were also missed nationally, including over 500,000 in people with high blood glucose levels.

This delay in monitoring was linked to an average increase in HbA1c of 2-3 mmol/mol.The study findings were published in the journal Diabetologia.

This increases the likelihood of immediate and long-term complications such as hyperglycemia, heart disease, kidney disease, blindness, and nerve damage, in addition to life-threatening conditions such as heart attack and stroke.

COVID-19 caused more damage than we realized. Access to healthcare services became very difficult during the pandemic, with canceling or postponing appointments for routine testing and review as the country went into ‘lockdown’.

The impact may last well beyond the crisis, potentially creating long-term health repercussions and placing new demands on an already overburdened NHS.

The healthcare system urgently needs to find a way to test and review the most at-risk diabetic patients before the increased risks they face to their long-term health become a reality.



Source-Medindia