Self-Isolation During Pandemic Limited Access to Medication, Impacted Glucose Control In Patients with Diabetes

An analysis of survey data from patients in multiple countries provides clinicians with an overview of the effects of self-isolation during the COVID-19 pandemic on diabetes management, including access to insulin and blood glucose fluctuations.

A new analysis of data from nearly 700 patients with diabetes details the effects of self-isolation during the COVID-19 pandemic on several aspects of diabetes management.

Results of the study, which was performed by investigators at Anglia Ruskin University, suggest self-isolation was associated with greater fluctuations in blood glucose level, reduced access to healthy diet, and reduced access to diabetes medications, particularly among insulin users, among patients with diabetes reporting self-isolation during the pandemic compared to the pre-pandemic period.

“People with diabetes are at a greater risk of serious complications from COVID-19. Self-management of diabetes is therefore of paramount importance, and we wanted to compare people’s self-management before and during the pandemic,” said Shahina Pardhan, Director of the Vision and Eye Research Institute at Anglia Ruskin University, in a statement. “We found a concerning association between self-isolation and blood sugar fluctuations, reduced access to medicines, lower levels of physical activity and a less healthy diet. All these elements are crucial to successful self-management of diabetes.”

With quarantine and stay-at-home orders increasing the number of patients, including patients with diabetes, experiencing self-isolation, Pardhan and a team of colleagues sought to explore how isolation may have influenced various aspects of diabetes management during the pandemic. Using responses from a cross-sectional online surgery administered from May 2020-November 2020, investigators identified a cohort of 679 participants aged 18 years or older with self-reported diabetes who had completed the survey.

Patients included in the study were from the United Kingdom, Bangladesh, India, and Nepal. Additionally, investigators noted patients reporting any type of diabetes were included in the study. The cohort was 52% male, 61% were 50 years of age or older, and 8.6% reported having at least 1 form of long-term complications from diabetes. When assessing factors related to diabetes, 30.4% of the cohort was on insulin treatment, 57% reported having diabetes for more than 5 years, and 20.6% reported the need to self-isolate because of the COVID-19 infection in themselves or someone living with or experiencing COVID-19 like symptoms.

Specific outcomes of interest for the study were fluctuation of blood glucose levels, access to diabetes medicine, access to healthy diet, and physical activity. Variables of interest for the analysis included demographics and self-isolation as well as duration, treatment, and complications of diabetes. These associations were assessed using adjusted multiple regression analysis for each outcome variable against each exposure variable.

Upon analysis, results suggested self-isolation was significantly associated with increased fluctuations in blood glucose levels (OR, 1.8 [95% CI, 1.2–2.6]; P=.005), reduced access to diabetes medicine (OR, 1.9 [95% CI, 1.1–3.1]; P=.02) and reduced access to healthy diet (OR, 3.0 [95% CI, 2.0–4.6]; P <.001). Further analysis suggested fluctuations in blood glucose levels was also significantly associated with having at least 1 complication of diabetes (OR, 2.2 [95% CI, 1.2-3.9]; P=.008) and reduced access to diabetes medicine was significantly greater among patients who reported insulin use (OR, 2.1 [95% CI, 1.3-3.3]; P=.001).

“Given that access to health services was limited during the pandemic, it is of vital importance that people are able to self-manage their condition,” Pardhan added. “Public health policies should give priority to those people with diabetes who need to isolate during the pandemic and also those who have diabetes complications in order to ensure that they are able to manage their diabetes appropriately at this time.”

This study, “Self-isolation negatively impacts self-management of diabetes during the coronavirus (COVID-19) pandemic,” was published in Diabetology & Metabolic Syndrome.