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Association of the COVID-19 Pandemic with HbA1c Testing and Complication Screening in Patients with Diabetes Mellitus

Jieun Jang1,2, Doo Woong Lee2,3,4, Junghwan Suh5

  • 1Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, Korea.

Yonsei Medical Journal
|October 23, 2024
PubMed

Insights

High COVID-19 transmission levels were linked to fewer diabetes complication screenings, including eye exams and kidney disease checks. Glycated hemoglobin (HbA1c) testing was not significantly affected. Further efforts are needed to ensure screenings in outbreak areas.

Area of Science:

  • Public Health
  • Epidemiology
  • Diabetes Management

Background:

  • The COVID-19 pandemic significantly impacted healthcare delivery globally.
  • Diabetes mellitus requires regular monitoring and screening for complications to prevent adverse outcomes.
  • Understanding the effect of disease outbreaks on routine health screenings is crucial for public health preparedness.

Purpose of the Study:

  • To investigate the association between coronavirus disease 2019 (COVID-19) transmission levels and the uptake of glycated hemoglobin (HbA1c) testing and complication screenings in patients with diabetes mellitus.
  • To assess if high COVID-19 transmission regions influenced the likelihood of diabetes patients undergoing essential health checks.

Main Methods:

  • Utilized data from the 2020 Korean Community Health Survey, including 3601 diabetes patients for HbA1c and fundus examination analysis and 3592 for kidney disease screening.
  • Classified regions into low and high COVID-19 transmission areas based on outbreak data.
  • Employed multiple logistic regression to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to determine the association between transmission levels and screening uptake.

Main Results:

  • A lower proportion of patients in high COVID-19 transmission regions underwent diabetes complication screenings (fundus examination: 38.0% vs. 42.3%; kidney disease screening: 45.7% vs. 48.9%).
  • High COVID-19 transmission was significantly associated with reduced odds of undergoing fundus examination (OR, 0.82; 95% CI, 0.69-0.98) and kidney disease screening (OR, 0.76; 95% CI, 0.63-0.91).
  • No significant association was found between COVID-19 transmission levels and undergoing HbA1c testing.

Conclusions:

  • Elevated COVID-19 transmission levels correlated with decreased rates of essential diabetes complication screenings, specifically eye and kidney disease checks.
  • These findings highlight potential barriers to accessing diabetes care during disease outbreaks.
  • Targeted strategies are necessary to overcome challenges and ensure continued access to diabetes complication screenings, particularly in regions heavily affected by outbreaks.
Abstract

Keywords:
COVID-19diabetes complications screeningdiabetes mellitus

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