Increased diagnosis of diabetes in secondary care: Is Covid-19 the only reason?

ABSTRACT

Aim: To evaluate the prevalence of new diabetes in secondary care during the second wave of the Covid-19 pandemic. Method(s) Data were collected prospectively for patients presenting to the hospital with new diagnosis of diabetes from December 2020 to May 2021. It included demographics, risk factors, presenting glucose, other investigations and treatment. Result(s) In the six-month study period, 31 patients were diagnosed with new diabetes. Thus far, approximately 13 patients have been identified to have type 1 diabetes and the average age was 37 years. Everyone was discharged with insulin except one patient. Prior to the pandemic in the year 2019, only 17 patients were diagnosed with diabetes in the hospital. Conclusion(s) The lockdown led to a reduction in physical activity and varied diet which may have contributed to weight gain;worsening insulin resistance. It is plausible that severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) could trigger autoimmune type 1 diabetes or accelerate its presentation. Together with a hesitancy for patients to seek medical attention and reduced access to face-to- face primary care consultations, this may have contributed to the increased presentation of diabetes-related emergencies and reduction in symptomatic hyperglycaemia. Various studies found patients with pre-existing diabetes have a worse outcome if they develop Covid-19. Overall, during the pandemic, physical and mental health worsened, pre-disposing to medical conditions and impacting self-management of health and disease. We predict the increase in new diagnoses of diabetes in secondary care is multifactorial due to the effects of the pandemic rather than Covid-19 infection solely.