The following is a summary of “A comparison between different patient groups for diabetes management during phases of the COVID-19 pandemic: a retrospective cohort study in Ontario, Canada,” published in the January 2024 issue of Primary Care by Senthinathan, et al.
The COVID-19 pandemic precipitated a surge in virtual care adoption across primary care in Canada, significantly affecting the management of patients with type 2 diabetes. This reduced in-person visits, laboratory testing, and physical assessments like blood pressure (BP) monitoring. However, the persistence of these changes as the pandemic progressed and their uniform impact on different patient demographics remained unclear.
A repeated cross-sectional design with an open cohort was employed to analyze diabetes care in adults with type 2 diabetes over 6 months spanning from March 14 to September 13 across three consecutive years: 2019 (pre-pandemic), 2020 (early pandemic), and 2021 (later pandemic). Data were sourced from the University of Toronto Practice-Based Research Network (UTOPIAN) Data Safe Haven, an electronic medical records database in Ontario, Canada. Changes in diabetes care metrics, including total primary care visits, in-person visits, hemoglobin A1c (HbA1c) testing, and BP measurements, were assessed over the phases of the pandemic. Variations in diabetes care among patient groups, such as age, sex, income quintile, prior HbA1c levels, and prior BP levels, were also examined.
The study included 39,401 adults with type 2 diabetes. Compared to the pre-pandemic period, there was a significant reduction in in-person visits during the early pandemic (OR = 0.079 (0.076–0.082)), with a partial recovery in the later pandemic (OR = 0.162 (95% CI: 0.157–0.169)). Compared to the pre-pandemic period, there was a notable reduction in total visits (OR = 0.486, 95% CI: 0.470–0.503), HbA1c testing (OR = 0.401, 95% CI: 0.389–0.413), and BP measurement (OR = 0.121, 95% CI: 0.116–0.125) during the early pandemic, with some improvement observed later in the pandemic.
All aspects of diabetes care experienced substantial declines during the early pandemic phase, with some improvement seen across all patient groups in the later pandemic phase. The shift towards virtual care during the COVID-19 pandemic has had a detrimental impact on diabetes management, persisting even a year after the onset of the pandemic.
Reference: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02272-0