A systematic review and meta-analysis of 33 studies has revealed the impact of the Covid-19 pandemic on people living with type 1 (T1D) and type 2 diabetes (T2D).

The findings, which were presented at the annual meeting of the European Association for the Study of Diabetes (EASD), suggest that glycaemic control substantially improved in individuals with T1D during the pandemic. Contrastingly, lockdown contributed to a short-term worsening in blood sugar control and weight gain in many with T2D.

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The study’s researchers searched for all studies published in English or German which reported the impact of Covid-19 lockdowns on glycaemic control in patients with either T1D or T2D.

People with type 1 diabetes had better glycaemic control during lockdown

Of the 33 studies, 25 considered the impact of the pandemic on individuals with T1D. The analysis found that 18 studies (72%) showed clear improvements in glycaemic control, four (16%) showed no changes, while three studies (12%) reported a deterioration. The researchers suggest this deterioration could have been caused by an interruption in health care services, as seen in India where insulin was in short supply.

The changes in glycosylated haemoglobin (HbA1c) and the time spent in the target blood sugar range were also favourable compared to before lockdown. Participants’ reported that their HbA1c values were down significantly in 11/25 studies and improvement in TIR were reported in 18/25 studies.

Lead author Professor Claudia Eberle suspects these positive changes came about as people with T1D had more time to look after themselves and cook healthy meals during lockdown. Patients may also have been able to keep a closer eye on their blood sugar levels and benefitted from a more ordered routine, especially in relation to meal time.

Weight gain and poor blood sugar control in people with type 2 diabetes

Of the eight studies which considered the pandemic’s impact on people with T2D, half revealed short-term worsening in blood sugar control during lockdown, while a quarter showed some improvement.

The researchers discovered that HbA1C levels increased by an average of 0.14% through the lockdowns, while three studies reported increases in body mass index (BMI). Weight gain varied between 0.3 kg and 0.95 kg, while one reported a substantial improvement in BMI.

Professor Eberle suggests these results might be due to the development of “unhealthy habits” during lockdown, such as eating more snacks and less physical activity.

“At the same time, lack of sleep, increased stress, anxiety, and restricted access to hospitals and pharmacies, may have heightened the difficulty of achieving good blood sugar control,” she added.

The authors note that the findings may not be generalisable to the entire population as the studies analysed were either written in English or German and were mainly based on patients from Europe. More research should therefore be done to identify the impact of lockdown in people with diabetes on a broader scale.