Yasemin EMÜR GÜNAY, Hülya ÇOŞKUN, Egemen ÜNAL, Damla TÜFEKÇİ, Ahmet Suat DEMİR, Muhammet Cüneyt BİLGİNER, Özge ÜÇÜNCÜ, İrfan NUHOĞLU, Mustafa KOÇAK

The effect of Covid-19 ‘stay home process’ on metabolism parameters in diabetes mellitus patients: A single center, cross-sectional study

Aim: We aimed to investigate the impact of quarantine (stay home process) on laboratory parameters (fasting blood glucose, HbA1c), diet, exercise and medication compliance in patients with diabetes mellitus (DM) during the COVID -19 pandemic. Materials and Methods: This study included 93 diabetes mellitus patients, who presented to our outpatient clinic. Biochemical parameters (glucose, HbA1c, lipid profile), dietary and exercise compliance of the patients were evaluated before and after the threemonth quarantine in Turkey. Frequency of blood glucose measurement, medication compliance, hypoglycemia/hyperglycemia, need for hospitalization, and whether patients had an infection were self-reported. Results: The mean age of the 93 patients included in the study was 56.70 ± 13.51 years. 55.9% (n = 52) of patients were female and 44.1% (n = 41) were male. 89.2% (n = 83) of participants were type 2 DM and 10.8% (n = 10) were type 1 DM. 82.8% (n = 53) of patients were aged between 18 and 64 years. It was found that 78.5% (n = 73) of patients had dietary compliance. We found that 41.9% (n = 39) of the patients exercised at home, 53.8% (n = 50) took their medications regularly, and 43.0% (n = 40) checked their blood glucose daily. When biochemical values were compared before and after the study, a statistically significant decrease in fasting glucose (pre-post 141-121 mg/dl) (p=0.026) and body mass index (pre-post 32.00-31.86 kg/m2) (p=0.008) was observed. There was no statistically significant difference in HbA1c and lipid levels in our analysis. Conclusion: In this study, patients who adhered to their diet and monitored their blood glucose at home during quarantine had more stable blood glucose levels. In the future, prevention strategies should be considered for patients with chronic diseases during possible quarantines.

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1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China,2019. N Engl J Med 2020;382:727-33.
2. Ghosh A, Arora B, Gupta R, Anoop S, Misra A. Effects of nationwide lockdown during COVID-19 epidemic on lifestyle and other medical issues of patients with type 2 diabetes in North India. Diabetes Metab Syndr 2020;14:917-20.
3. Singhai K, Swami MK, Nebhinani N, et al. Psychological adaptive difficulties and their management during COVID-19 pandemic in people with diabetes mellitus. Diabetes Metab Syndr 2020;14:1603-05.
4. Hussain A, Bhowmik B, Do Vale Moreira NC. COVID-19 and diabetes: knowledge in progress. Diabetes Res Clin Pract 2020;162:108142.
5. Shearer D. COVID-19: the underestimated pandemic impacting people with diabetes. J Diabetes Sci Technol 2020;14:778-9.
6. Verma A, Rajput R, Verma S, et al. Impact of lockdown in COVID 19 on glycemic control in patients with type 1 Diabetes Mellitus, Diabetes Metab Syndr 2020;14:1213-6.
7. Tornese G, Ceconi V, Monasta L, et al. Glycemic control in type 1 diabetes mellitus during COVID-19 quarantine and the role of in-home physical activity. Diabetes Technol Therapeut 2020;22:462-7.
8. American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020; 43:S66.
9. Nachimuthu S, Vijayalakshmi R, Sudha M, Viswanathan V. Coping with diabetes during the COVID e 19 lockdown in India: Results of an online pilot survey. Diabetes&Metabolic syndrome :Clinical Research&Reviews 2020;14:579-82.
10. Ruiz-Roso MB, Knott-Torcal C, Matilla-Escalante DC , et al. COVID-19 lock-down and changes of the dietary pattern and physical activity habits in a cohortof patients with type 2 diabetes mellitus. Nutrients 2020;12:2327.
11. Ghosal S, Sinha B, Majumder M, Misra A. Estimation of effects of nationwide lockdown for containing coronavirus infection on worsening of glycosylated haemoglobin and increase in diabetes-related complications: a simulation model using multivariate regression analysis. Diabetes Metab Syndr 2020;14:319-23.
12. American Diabetes Association. Facilitating behavior change and well-being to Improve health outcomes: Standards of medical care in diabetes-2020. Diabetes Care 2020;43:S48-S65.
13. Umpierre D, Ribeiro PA, Kramer CK, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA 2011;305:1790-9.
14. Egan AM, Mahmood WA, Fenton R, et al. Barriers to exercise in obese patients with type 2 diabetes. QJM 2013;106:635-8.
15. Ozgur R, Mavis O, Ayalp P. The Relationship Between Self Monitoring of Blood Glucose Frequency and HbA1c in Patients With Type 2 Diabetes Mellitus.The Medical J Okmeydani Training and Research Hospital 2011;27:70-5.
16. Miller KM, Beck RW, Bergenstal RM, et al. Evidence of a strong association between frequency of selfmonitoring of blood glucose and hemoglobinA1c levels in T1D exchange clinic registry participants. Diabetes Care 2013;36:2009-14.
17. Kearney PM, Blackwell L, Collins R, et al. Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy of cholesterol-lowering therapy in 18 686 people with diabetes in 14 randomised trials of statins: a metaanalysis. Lancet 2008;371:117-25.
18. Sniderman AD, Scantlebury T, Cianflone K. Hypertriglyceridemic hyperapo B: the unappreciated atherogenic dyslipoproteinemia in type 2 diabetes mellitus. Ann Intern Med 2001;135:447-59.
19. Bittner V, Hardison R, Kelsey SF, et al. Non-highdensity lipoprotein cholesterol levels predict five-year outcome in the Bypass Angioplasty Revascularization Investigation (BARI). Circulation 2002;106:2537-42.
20. Lu W, Resnick HE, Jablonski KA, et al.Non-HDL cholesterol as a predictor of cardiovascular disease in type 2 diabetes: the Strong Heart Study. Diabetes Care 2003;26:16-23.