Self-management, an integral part of management of diabetes, is adversely affected in patients with diabetes who need to self-isolate due to Covid-19, according to the results of an online survey published in the journal Diabetology & Metabolic Syndrome.

To examine the effects of various factors including self-isolation on different aspects of self-management of diabetes before and during the pandemic, the researchers conducted a survey of 679 participants with diabetes between May 2020 and November 2020. An online structured questionnaire was used to conduct the survey.

Out of the 679 study participants, 242 (35.6%) reported greater fluctuations in their blood glucose levels during the pandemic compared to the levels before the pandemic. Similarly, 94 (13.8%) participants also stated that they could not easily obtain their anti-diabetes medications, particularly insulin, during the pandemic than before. Self-isolation was significantly associated with greater fluctuation in blood glucose levels (OR 1.8), reduced access to diabetes medicines (OR 1.9) and reduced access to healthy diet (OR 3.0).

Variations in blood glucose levels occurred more often (OR 2.2) in patients who had at least one diabetes-related complication such as retinopathy, neuropathy and nephropathy. 308 (45.4%) participants also reported that their overall physical activity had reduced during the pandemic. Around 21% of subjects did not have access to healthy foods they had been advised for good diabetes control.

Covid-19 pandemic has affected delivery of healthcare all across the world. Home care has become the norm with many patients being managed at home.

Managing infections in persons with diabetes is challenging. The fluctuating blood glucose levels make it difficult to treat infections. Covid-19 patients with diabetes are at a greater risk of severe disease with poor outcomes. This study has shown that self-isolation of persons with diabetes, either due to being infected or contact with a Covid-19 positive person, negatively affected self-management due to the reduced access to diabetes medicines and healthy foods indicating poor control of diabetes.

This study highlights the need to improve availability and accessibility of healthy foods as well as anti-diabetes medicines particularly for those who are on insulin treatment. It further calls for the need to formulate self-management guidelines and policies directed towards patients with diabetes who need to be isolated because of Covid-19, so that they can effectively self-manage their diabetes.

Reference

1. Pardhan S, et al. Self-isolation negatively impacts self-management of diabetes during the coronavirus (COVID-19) pandemic. Diabetol Metab Syndr. 2021 Oct 29;13(1):123.