It’s always a good feeling to be told that you’re doing things right. And according to a new nationwide study, American diabetes patients should give themselves a pat on the back.
An analysis just published in JAMA Internal Medicine reported that during the many months of the ongoing COVID-19 pandemic, people with diabetes continued to fill their medication prescriptions and did well in controlling their blood sugar.
The study was sparked by reports of dramatic reductions in outpatient visits and laboratory testing during the early phase of the pandemic. Such reports, the researchers wrote, “raised concerns about gaps in diabetes management and glycemic control,” which led them to look into what effect these reductions might have had on the health of diabetes patients.
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The researchers, who were led by Sadiq Y. Patel, PhD, of Harvard Medical School, used data from the OptumLabs Data Warehouse, a collaborative research center based at the University of California, Davis, that contains anonymous data on over 160 million medical patients. From this data, the researchers created two cohorts (groups) of patients ages 18 and above who had type 2 diabetes and were enrolled in commercial or Medicare Advantage health plans. The 2019 cohort contained 1,357,029 patients and the 2020 cohort 1,364,522. The researchers compared the two cohorts in terms of weekly rates of outpatient medical visits, screening tests, prescription medication fills, and blood sugar levels (as measured by HbA1c tests).
It came as no surprise to discover that routine testing of diabetes patients fell during the entire studied pandemic period. The proportion of people with diabetes who had at least one outpatient visit (either in-person or by telemedicine) declined 2.6% between 2019, when the pandemic was just beginning, and 2020, when it peaked. Similarly, there was a decline in routine testing of diabetes patients — by 6.5% in HbA1c testing, by 18.8% in retinopathy testing, and by 8.5% in kidney disease (nephropathy) testing. However, the researchers reported that the sharp decline in outpatient visits was mostly characteristic of the “early pandemic” period (weeks 11 through 29 of 2020) and that by the “later pandemic” period (week 30 through December 1, 2020) patient visits had returned to 2019 levels.
The researchers were gratified to report that, despite the drop in medical visits and testing, the patients kept up with their medications during the pandemic and maintained control of their blood sugar. The rate at which they filled their prescriptions even increased a bit ─ by 3.6%. As the authors put it, “While diabetes-related outpatient visits and testing fell during the pandemic, we observed no evidence of a negative association with medication fills or glycemic control.” They speculated that the slight increase in prescription fill rates “may have protected against any disruptions in diabetes self-management during the pandemic and hence staved off detrimental effects on glycemic control.” It’s likely, they added, that the ability to get medications from mail-order pharmacies and pharmacy deliver services “may have been key during the pandemic in ensuring patients receive their medications.”
Interestingly, these actions, the authors pointed out, were in keeping with the diabetes disaster preparedness guidelines established by the U.S. Centers for Disease Control (CDC), recommendations that stress the priority of access to medications over access to health care professionals. Finally, the authors said the “unprecedented” increase in consultation by telemedicine might have prevented “substantive disruptions in medication prescribing.” This finding led to the realization that there is not necessarily a relationship between how often patients see their health care provider and how well they control their blood sugar.
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Source URL: https://www.diabetesselfmanagement.com/news-research/2021/07/30/people-with-diabetes-get-high-marks-for-management-during-pandemic/
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