Metabolic control of diabetic patients assisted by private and public health care systems during the COVID-19 pandemic: a retrospective cohort study

Abstract

Aims We sought to analyze the impacts of social restriction measures imposed by the pandemic COVID-19 on the control of metabolic parameters in diabetic patients.

Methods We accessed the medical records of patients who underwent clinical follow-up in the public and private health systems between July 2019 and June 2021. The sample consisted of 288 patients (111 adults and 177 older individuals). A two-way ANOVA mixed model was used to test the effects of intra- (time: baseline and after 24 months) and inter-subject factors. Linear regression analysis was used to predict the difference in body weight considering age, sex, HbA1c, health care system and insulin use.

Results Among adults, we observed an increase in body weight and LDL-c levels, especially for insulin users (p ≤ 0.05). Adults assisted by the public health care system showed higher HbA1c levels (p = 0.001). Among older individuals using insulin, blood glucose levels decreased (p = 0.019). Body weight decreased in those assisted by the private system (p = 0.005), while glycemia decreased for patients assisted by both health care systems (p = 0.043). The linear regression model confirmed that the increase in body weight was more pronounced in adults than in older individuals.

Conclusion The social restriction measures imposed by the pandemic affected the metabolic control of diabetic patients, especially adults assisted by the public health care system.