The Effect of Metabolic Control on Diabetes Complication Rates and the Need for Medical Care During COVID-19 Social Isolation in Adjara, Georgia

Abstract

INTRODUCTION: Social isolation or distancing during the COVID-19 pandemic was associated with poor metabolic control in patients with diabetes mellitus. It might have contributed to the high mortality rate of those with diabetes who became infected. This study aims to determine the degree or level of metabolic control in patients with diabetes mellitus, the progression of its complications, and the need for emergency care during social isolation caused by the COVID-19 pandemic. MATERIALS AND METHODS: A retrospective study was conducted in Georgia on 752 diabetic patients aged under 65 years old. Results showed that many patients did not control their blood glucose levels, measure their blood pressure, or know their cholesterol and glycated hemoglobin levels before and after the pandemic. Over 35% of patients experienced glycemic profile fluctuations. We compared metabolic rates with complications of diabetes and the need for emergency medical care during isolation. It was found that the testability of glycemia (p = 0.006), fluctuations in glucose (p = 0.001), and glycated hemoglobin levels before (p = 0.001) and after the pandemic (p = 0.004) increased the prevalence of diabetes-related heart disease and multiple micro- and macroangiopathies. Blood pressure (p = 0.001), cholesterol levels (p = 0.001), and glucose control (p = 0.012) affected the condition of patients with diabetes mellitus. It increased the need for medical care due to infarction, hypertension crisis, and hyperglycemia. CONCLUSIONS: In a crisis where medical care is limited, the management of diabetes patients requires more attention. Our study proves that active middle-aged patients during isolation had poor metabolic control in terms of self-control of the disease. It is necessary to constantly inform and educate patients about the importance of metabolic parameters in progressing diabetes complications. Proper metabolic control could prevent complications of diabetes and improve a patient's quality of life.