| 總結: | Covid-19 pandemic and lock down (LD) has affected diabetes care. We aimed to identify, appraise and synthesise available evidence on the impact of the pandemic on glycaemic control in people with diabetes.
Materials and Methods
We searched multiple databases up to 02/02/2021 for studies reporting: glycated haemoglobin (HbA1c); time in range (TIR); average or fasting glucose; severe hypoglycaemia; diabetic ketoacidosis. Data were pooled using random-effects meta-analysis and presented as mean difference (MD) with 95% confidence intervals (CI). This review was pre-registered on PROSPERO (CRD42020179319).
Results
We include 59 studies; 44 (n=15,464) were included in quantitative syntheses and 15 were narratively synthesised. Pooled data were grouped by diabetes type. Results from 28 studies (n=5,048 T1D and combined diabetes participants) showed that TIR increased during LD compared to before LD (MD 2.74%, 95% CI 1.80 to 3.69). Data from 10 studies (n=1,294 T1D participants) showed TIR increased after LD compared to before LD (MD 5.14%, 95% CI 3.12 to 7.16). Pooled results from 12 studies (n= 4,810 T1D and T2D participants), resulted in average glucose decreasing after LD compared to before LD (MD -6.86 mg/dL, 95% CI -8.54 to -5.18). Results for other outcomes, including HbA1c, were not statistically significantly different.
Conclusions
The Covid-19 pandemic was associated with small improvements across multiple outcomes of glycaemic control, though there was insufficient evidence to suggest this led to changes in HbA1c. Most evidence came from people with access to diabetes technologies in high income countries; more research is needed in less advantaged populations.
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