Glycemic control of type 2 diabetes: primary care pre-pandemic versus COVID-19 pandemic
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Keywords
Primary Health Care, COVID-19, Diabetes Mellitus, Type 2
Abstract
Background: Keeping an adequate glycemic control is a major global challenge. Approximately 42% of individuals achieve the recommended HbA1c targets.
Objective: To compare glycemic control in 2 independent cohorts of patients with type 2 diabetes mellitus treated before and during the COVID-19 pandemic in primary care in Mexico City.
Material and methods: Analytical observational study; records of 3598 patients with 2 HbA1c determinations (2562 pre-pandemic and 1036 pandemic) from 213 health units were analyzed. Means, proportions, and t and chi-squared tests were calculated; metabolic control was defined as HbA1c ≤ 8%.
Results: Mean HbA1c was 9.1% in both groups in the first measurement; at the last measurement, it was lower in the pre-pandemic group (8.0% vs. 8.3%; p < 0.001). The percentage of controlled patients increased from 38.5% to 58.5% pre-pandemic and from 37.8% to 54.2% during the pandemic (p = 0.017). Dual oral therapy achieved the greatest increase in control (22.5% pre-pandemic, 28.3% pandemic); isolated insulin therapy and absence of pharmacological treatment were less effective under pandemic conditions.
Conclusions: The pandemic was associated with lower glycemic control; however, regimens with 1 or 2 oral antidiabetic agents retained their effectiveness. Ensuring continuity of care, drug supply, and support for lifestyle measures will be crucial in future crises.
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