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
Autor
Ghosal, Samit
Sinha, Binayak
Majumder, Milan
Misra, Anoop
Institución
Resumen
Introduction: and aims: To prevent the spread of coronavirus disease (COVID19) total lockdown is in
place in India from March 24, 2020 for 21 days. In this study, we aim to assess the impact of the duration
of the lockdown on glycaemic control and diabetes-related complications.
Materials and methods: A systematic search was conducted using Cochrane library. A simulation model
was created using glycemic data from previous disasters (taken as similar in impact to current lockdown)
taking baseline HBA1c and diabetes-related complications data from India-specific database. A multivariate regression analysis was conducted to analyse the relationship between the duration of lockdown
and glycaemic targets & diabetes-related complications.
Results: The predictive model was extremely robust (R2 ¼ 0.99) and predicted outcomes for period of
lockdown up to 90 days. The predicted increment in HBA1c from baseline at the end of 30 days and 45
days lockdown was projected as 2.26% & 3.68% respectively. Similarly, the annual predicted percentage
increase in complication rates at the end of 30-day lockdown was 2.8% for non-proliferative diabetic
retinopathy, 2.9% for proliferative diabetic retinopathy, 1.5% for retinal photocoagulation, 9.3% for
microalbuminuria, 14.2% for proteinuria, 2.9% for peripheral neuropathy, 10.5% for lower extremity
amputation, 0.9% for myocardial infarction, 0.5% for stroke and 0.5% for infections.
Conclusion: The duration of lockdown is directly proportional to the worsening of glycaemic control and
diabetes-related complications. Such increase in diabetes-related complications will put additional load
on overburdened healthcare system, and also increase COVID19 infections in patients with such uncontrolled glycemia.