The COVID-19 lockdown does not necessarily worsen diabetes control, in spite of lower physical activity - a systematic review

Abstract

Introduction: This review aimed to synthesize evidence on the impact of the COVID-19 lockdown on the glycaemic control, physical activity, and diet of diabetic patients. Material and methods: Two electronic databases (PubMed and Scopus) were searched from January 2020 to February 2021. A total of 161 unique records were retrieved. Out of these, 25 articles met the eligibility criteria and were included in the final review. The quality of the studies was assessed by using the modified Newcastle-Ottawa Quality Assessment Scale for observational studies. Results: Out of the 25 studies included in the review, 18 (72%) were cross sectional, 5 (20%) were retrospective analyses, and 2 (8%) were cohort studies. Thirteen studies included type I diabetics, 8 studies included type II diabetics, and 4 studies included both. In the quality assessment, 17 (68%) of the studies met the criteria of satisfactory quality. Overall glycaemic parameters were improved during the lockdown. Dietary patterns were affected during the lockdown, but the direction of change - either negative or positive - could not be inferred. However, physical activity patterns were found to be deteriorated during the lockdown. Conclusion: The review found that lockdowns for curbing COVID-19 had no negative impact on glucose control, while there was a decline in the physical activity among diabetics. Furthermore, available studies are subject to various biases, which calls for robust studies in future with representative samples. There is also a need to promote physical activity and a healthy diet among diabetic patients, with follow-up through telemedicine during such confinement periods.