Socioeconomic status and the effect of prolonged pandemic confinement on anthropometric and glycaemic outcomes in adults with type 2 diabetes mellitus

Chandana Wijeweera; Ummul Muhfaza; Reginald V Lord; Peter Petocz; Juliana Chen; Veronica Preda

doi:10.1016/j.pcd.2024.02.002

Socioeconomic status and the effect of prolonged pandemic confinement on anthropometric and glycaemic outcomes in adults with type 2 diabetes mellitus

Prim Care Diabetes. 2024 Mar 5:S1751-9918(24)00036-6. doi: 10.1016/j.pcd.2024.02.002. Online ahead of print.

Authors

Chandana Wijeweera¹, Ummul Muhfaza², Reginald V Lord³, Peter Petocz⁴, Juliana Chen⁵, Veronica Preda²

Affiliations

¹ Macquarie University Faculty of Medicine and Health Sciences, Australia. Electronic address: chandana.wijeweera@students.mq.edu.au.
² Healthy Weight Clinic, Macquarie University Hospital, Macquarie Park, Australia.
³ Department of Surgery, University of Notre Dame School of Medicine, Sydney Australia.
⁴ Macquarie University, Department of Statistics, Macquarie Park, Australia.
⁵ Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

PMID: 38448261
DOI: 10.1016/j.pcd.2024.02.002

Abstract

Aim: This systematic review and meta-analysis aimed to investigate the impact of COVID19 lockdown on the anthropometric and glycaemic outcomes of adults with type 2 diabetes mellitus (T2DM) and assess whether socioeconomic status (SES) was relevant to these changes.

Methods: A search of three databases was conducted. Meta-analyses using random effects models were undertaken to combine anthropometric and glycaemic measures pre- and post-confinement. Subgroup analyses according to SES were also conducted.

Results: This systematic review of 19 articles demonstrated that prolonged pandemic-related confinement is associated with a deterioration in both anthropometric and glycaemic outcomes among adults with T2DM. Furthermore, SES was found to be relevant to these changes. Specifically, BMI (kg/m²) showed an increase in mean difference of 0.72 (95% CI; 0.13, 1.31; p<0.05) between pre and post lockdown cohorts. High income countries displayed a greater increase in BMI compared to their lower middle-income counterparts. Regarding, fasting blood glucose (FBG), a statistically significant difference was observed in the upper middle-income group (mean difference: 5.10; 95% CI: 2.92, 7.27), and high-income group (mean difference: 6.03; 95% CI: 0.04, 12.02). There were no significant changes to weight, waist circumference, or HbA1C over the lockdown period.

Conclusion: Our findings suggest adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. Clinics and care providers may need to adopt more intensive contact and treatment plans in the post lockdown period to prevent lasting impacts on disease progression and metabolic sequelae.

Keywords: BMI; COVID19; Diabetes; Epidemiology; FBG; HbA1c; Income; Lockdown; Public health; SES; Socioeconomic; T2DM; Waist circumference; weight gain.

Publication types

Review