Type 2 Diabetes mellitus and COVID-19: Impact of lockdown and clinical profile.

Author(s): Rajashree Khot, Bharat Rathod, Amol Dube, P P Joshi

Abstract: Recent Covid 19 pandemic has posed the biggest challenge to global healthcare systems. Diabetes and Covid 19 share a bidirectional relationship. India initially imposed strict lockdown measures. Post lockdown, the infection spread like fire and Diabetes became an important association. In a cross-sectional observational study, we enrolled 150 consecutive patients to study the impact of lockdown on Chronic illnesses. Of these 63(42%) patients were diabetics.Subset analysis of these patients revealed that Glycemic control improved in 15(23.8%), worsened in 26(41.1%) and steady in 22(34.9%). The factors responsible for improved control were improved self-management of diabetes, eating home cooked food and use of telemedicine and for worsened control were lack of exercise, non-availability of drugs and financial problems. Weight was unchanged in 43(68.2%). On statistical analysis glycemic control worsened significantly during lockdown period. In an ongoing longitudinal cohort study of clinical profile of hospitalized COVID 19 confirmed cases, prevalence of Diabetes was 9.15% i.e.42/459 patients. On interim analysis of subset of Diabetic patients 39.47% were asymptomatic,50.9% had mild infection,36% had moderate and 1.74% had severe illness. Mortality was 1.7%. Mean Admission blood glucose was 168.9 + 12.5 mg/dl in mild and 228 + 14.8 mg/dl in severe cases. To conclude, lockdown period affected the glycemic control in both positive and negative manner, with lack of exercise being the most common factor for worsening. Diabetes is an important risk factor for COVID 19 infection. Admission blood glucose is significantly associated with severity of infection and mortality in T2DM patients with COVID19 infection.