Endocrine Abstracts

Introduction: Chronic hyperglycemia in type 2 diabetic patients is associated with an increased risk of micro and macrovascular complications. Therefore, glycemic control is the cornerstone of its management. The aim of this study was to evaluate glycemic control in patients with type 2 diabetes before and during COVID-19 crisis.

Methods: A cross-sectional study was conducted during December 2021, in the outpatient clinic of the department of endocrinology in Rabta University hospital. The study included 300 patients with type 2 diabetes mellitus followed up for at least two years. Each patient underwent clinical examination and data on glycaemic control during 2019 and 2021 were collected from medical files.

Results: Patients were 117 men (39%) and 183 women (61%), with a mean age of 61.6 ± 9.8 years (22-91). The mean duration of the disease was 9.6±6.1 years (2-35). The main cardiovascular risk factors were smoking (21%), hypertension (56.7%) and dyslipidaemia (57.3%). Eighty-eight percent of the patients were treated with metformin as a monotherapy in one quarter of the cases and in combination with other oral antidiabetic agents, mainly sulfonylurea in 41% or insulin therapy in 35%. The mean number of medical visits per patient was 1.78±0.67 in 2019 and 1.9±0.74 in 2021 (P=0.005). A poor compliance with medication during the past three months was noted in 27% of the patients and was explained by a lack of availability of the drugs in 46.7%. Hypoglycemia was reported by 18% of the patients. It occurred more than once a week in one quarter of the cases and it was severe in 9.8% of them. The mean annual HbA1c was 8.1±1.7 % in 2019 and 8.2±1.8 % in 2021 (P=0.12). The mean annual fasting blood glucose was 1.71±0.56 g/l in 2019 and 1.79± 0.72 g/l in 2021 (P=0.22). Compared to 2019, glycaemic control in 2021 was stable in 36.4%, worsened in 33.6% with an increase in HbA1c of 0.11%, and improved in 30% of the patients.

Conclsion: Glycaemic control was not worsened during the COVID crisis despite the difficulties in the availability of the drugs.