Impact of COVID-19 Lockdown on the Metabolic Control Parameters in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis

Background: The abrupt implementation of COVID-19 lockdown had impacted the management of diabetes mellitus. Limited access to health facilities and alterations in daily lifestyle put metabolic control among patients at risk. Thus, we observed the differences in metabolic control parameters in diabetic patients before and during the lockdown. Methods: We performed searches from five databases. Meta-analyses were done using random or fixed-effect approaches with glycemic control parameters (HbA1c, RBG, FBG, TIR, TAR, TBR) as primary outcomes. Mean difference (MD), Confidence Interval (CI), and p-value were calculated. Lipid profile presented as secondary outcome. Results: 21 studies with 3992 diabetic patients were included in the study. Meta-analysis presented an increase on HbA1c of T1D and T2D patients [MD=+0.06% (95%CI -0.10–0.23), I²=77%, p=0.45], TBR of T1D patients [MD=-0.05% (95%CI -0.38–0.28), I²=0%, p=0.77], FBG of T2D patients [MD=+3,47 mg/dL (95%CI 1.22–5.73), I²=0%, p=0.002], and lipid profile on qualitative analysis. However, TIR, TAR, and RBG of T1D patients were improved [MD=+3.52% (95%CI 0.29–6.74), I²=76%, p=0.03; MD=-3.36% (95%CI -6.48–-0.25), I²=75%, p=0.03; MD=-0.91 mg/dL (95%CI -4.52–6.34), I²=88%, p=0.74]. Conclusion: Lockdown enforcement did not worsen the glycemic control parameter in diabetic patients. Particular parameters inclined to improve during the lockdown.