A.MOH1, S.LOW1, S.F.ANG1, J.WANG1, E.YEOH2, C.F.SUM2, S.TAVINTHARAN2, S.C.LIM2
Khoo Teck Puat Hospital1, Admiralty Medical Centre2
In 2020, escalating COVID-19 infections forced Singapore to enter the Disease Outbreak Response System Condition (DORSCON) Orange (Feb 5) and Circuit Breaker (CB; Apr 7–Jun 1). These measures abruptly changed the daily routine and lifestyle of people; and non-essential clinical services were deferred. Conflicting data regarding the impact of COVID-19 restrictions on glycaemic control exist. This study examined the effects of COVID-19 restrictions on glycaemic control in patients with diabetes.
Retrospective clinical and lifestyle data of patients attending the Diabetes Clinic at Admiralty Medical Centre (n=695; age:59±15 years, 49.6% men, 87.7% type 2 diabetes) were analysed, spanning their last clinic visit before DORSCON Orange (baseline) and first clinic visit after CB (Jun 1). The primary outcome was percentage change in glycated haemoglobin (%ΔHbA1c) from baseline to post-CB [(post-CB−baseline)/baseline*100].
HbA1c level improved from baseline 8.7±1.8% to 8.3±1.7% post-CB (P<0.001). The median %ΔHbA1c was -2.0% (interquartile range:-10.7–3.8). Multiple linear regression showed that exercise habits were associated with 10.3% (95% CI:-17.9 to -2.8, P=0.008) decrease in %ΔHbA1c, after adjustment for baseline age, gender, diabetes duration, body mass index, HbA1c and albumin: creatinine ratio. Except for HbA1c, none of the other baseline clinical parameters and lifestyle factors (including dietary habits, smoking, and alcohol intake) were independently associated with %ΔHbA1c.
Improved glycaemic control was observed in patients with diabetes following tight COVID-19 restrictions. This improvement may be partly explained by regular exercise habits. Further investigations are needed to determine whether positive lifestyle changes during CB are associated with glycaemic benefits.