According to a global study conducted by a health researcher at the University of Massachusetts Amherst, the pandemic has led to an increase in non-COVID-19-related deaths among people with diabetes, as well as vision loss disorders related to diabetes complications for this vulnerable population.
The study, titled The Lancet Diabetes and Endocrinology, commissioned by the World Health Organization (WHO) and published on January 23, examined 138 studies comparing pre-pandemic and pandemic periods in various regions worldwide. Co-lead author Jamie Hartmann-Boyce, Assistant Professor of Health Policy and Promotion at the UMass Amherst School of Public Health and Health Sciences, noted an overall negative impact on diabetes outcomes worldwide.
The study also revealed a disturbing increase in pediatric intensive care admissions related to diabetes, as well as a rise in cases of diabetic ketoacidosis (DKA) among children and adolescents. Some cases were linked to newly diagnosed diabetes, coinciding with the diagnosis of DKA, a serious and potentially life-threatening diabetes complication. There was no increase in the frequency or severity of DKA among adults.
Hartmann-Boyce, who has lived with type-1 diabetes since the age of 10, initially conducted another study review for WHO on the direct effects of the pandemic on people with diabetes. The evidence indicated a higher risk of death from COVID-19 and severe illness among those with diabetes.
„We know that not getting regular eye exams while having diabetes leads to greater vision loss. In England, we saw an increase in diabetes-related mortality and overall mortality during the first wave, which was not due to COVID but likely associated with limited access to healthcare and reduced healthcare utilization,“
– Jamie Hartmann-Boyce, Assistant Professor of Health Policy and Promotion, UMass Amherst School of Public Health and Health Sciences
The researchers found an increase in new cases of type-1 diabetes compared to expectations and noted that children newly diagnosed with type-1 diabetes were much sicker during the pandemic. Furthermore, routine primary care visits often lead to the discovery of type-1 diabetes, but limitations during the pandemic hindered the diagnosis.
Regardless of the type of diabetes, the disease requires self-management through diet, physical activity, and consistent routines. Hartmann-Boyce’s team conducted interviews with people with diabetes, inspiring them to pursue this research.
Likewise, they intend to update the review in the next decade or so, as additional indirect pandemic effects may become evident. The study’s co-lead author, Patrick Highton, a research fellow at the University of Leicester’s Diabetes Research Centre in the UK, emphasized that the negative impacts were most pronounced among women, younger individuals, and racial and ethnic minorities.
„One would hope that those engaged in pandemic planning are mindful of this information when considering communication and care for people with diabetes in the event of future pandemics,“ said Hartmann-Boyce. „The review also underscores the importance of ensuring consistent access to diabetes medications and care for all people with diabetes, especially those from disadvantaged groups.“
University of Massachusetts Amherst
Hartmann-Boyce, J., et al. (2024) The impact of the COVID-19 pandemic and associated disruptions to healthcare on clinical outcomes for people with diabetes: a systematic review. The Lancet Diabetes and Endocrinology. doi.org/10.1016/S2213-8587(23)00351-0.