The impact of the COVID-19 pandemic shelter in place on glycemic control, blood pressure control, and body mass index among diabetic patients at Kaiser Permanente Northern California: a retrospective cohort study.
| Title: | The impact of the COVID-19 pandemic shelter in place on glycemic control, blood pressure control, and body mass index among diabetic patients at Kaiser Permanente Northern California: a retrospective cohort study. |
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| Authors: | Yamamoto, Kyle1 (AUTHOR) kyleleeyamamoto@gmail.com, Merchant, Maqdooda2 (AUTHOR), Bommireddi, Akshay1 (AUTHOR), Vu, Joseph1 (AUTHOR), Pursnani, Seema K.1 (AUTHOR) |
| Source: | BMC Public Health. 2/28/2025, Vol. 25 Issue 1, p1-6. 6p. |
| Subject Terms: | *DIASTOLIC blood pressure, *SYSTOLIC blood pressure, *GLYCEMIC control, *STATISTICAL significance, *BODY mass index |
| Abstract: | Background/ introduction: Regional shelter-in-place (SiP) mandates had a substantial impact on physical health and access to care. The impact of SiP on chronic disease management, specifically diabetes mellitus, is unknown. We sought to quantify the impact of California's 2020 SiP order on various health parameters in the Kaiser Permanente Northern California (KPNC) diabetic population. Methods: This retrospective cohort study included 168,621 diabetic patients, stratified by pre-pandemic HbA1c level. Our primary outcome was the difference in HbA1c, systolic blood pressure (SBP), and diastolic blood pressure (DBP) comparing the pre- (September 1, 2019, to March 31, 2020) to post-SiP period (June 1, 2020, to December 31, 2020). Our secondary endpoints included use of insulin or oral hypoglycemic agents (OHAs) during the post-SiP period and change in body mass index (BMI). This study utilized a paired t-test and chi-squared testing in order to assess for statistically significant differences in pre- versus post-SiP values. Results: Patients in this cohort were 52.29% male with 37.68% White, 22.35% Hispanic, 9.30% Black and 23.54% Asian and a mean age of 63 years. In this cohort, 44.02% of patients had a HbA1c < 7%, while 29.17%, 13.67%, 6.34% and 6.81% had an HbA1c of 7-7.9%, 8-8.9%, 9-9.9% and ≥ 10%, respectively (range 4.10 to 19.50%). Mean HbA1c, SBP, and DBP increased significantly across all groups; OHA use and insulin utilization also increased overall. Patients with lower pre-SiP HbA1c demonstrated larger increases in HbA1c and OHA utilization, while patients with higher pre-SiP HbA1c demonstrated increased rates of insulin initiation and decreases in their post-SiP HbA1c. Notably, mean BMI decreased in every HbA1c subgroup. Due to the large sample size, all p-values were < 0.0001. Conclusions: Among the KPNC diabetic population, several metrics for diabetes health management were significantly worsened after California's SiP. However, diabetic patients with the highest HbA1c values showed clinically significant improvement in their HbA1c, indicating a differential effect of the SiP on diabetes management. Our study helps identify higher-risk diabetic patients who require more intensive monitoring in the setting of the recent pandemic and highlights the importance of considering long-term implications of policy decisions on diabetes care. [ABSTRACT FROM AUTHOR] |
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| Items | – Name: Title Label: Title Group: Ti Data: The impact of the COVID-19 pandemic shelter in place on glycemic control, blood pressure control, and body mass index among diabetic patients at Kaiser Permanente Northern California: a retrospective cohort study. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Yamamoto%2C+Kyle%22">Yamamoto, Kyle</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> kyleleeyamamoto@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Merchant%2C+Maqdooda%22">Merchant, Maqdooda</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bommireddi%2C+Akshay%22">Bommireddi, Akshay</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Vu%2C+Joseph%22">Vu, Joseph</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pursnani%2C+Seema+K%2E%22">Pursnani, Seema K.</searchLink><relatesTo>1</relatesTo> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22BMC+Public+Health%22">BMC Public Health</searchLink>. 2/28/2025, Vol. 25 Issue 1, p1-6. 6p. – Name: Subject Label: Subject Terms Group: Su Data: *<searchLink fieldCode="DE" term="%22DIASTOLIC+blood+pressure%22">DIASTOLIC blood pressure</searchLink><br />*<searchLink fieldCode="DE" term="%22SYSTOLIC+blood+pressure%22">SYSTOLIC blood pressure</searchLink><br />*<searchLink fieldCode="DE" term="%22GLYCEMIC+control%22">GLYCEMIC control</searchLink><br />*<searchLink fieldCode="DE" term="%22STATISTICAL+significance%22">STATISTICAL significance</searchLink><br />*<searchLink fieldCode="DE" term="%22BODY+mass+index%22">BODY mass index</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background/ introduction: Regional shelter-in-place (SiP) mandates had a substantial impact on physical health and access to care. The impact of SiP on chronic disease management, specifically diabetes mellitus, is unknown. We sought to quantify the impact of California's 2020 SiP order on various health parameters in the Kaiser Permanente Northern California (KPNC) diabetic population. Methods: This retrospective cohort study included 168,621 diabetic patients, stratified by pre-pandemic HbA1c level. Our primary outcome was the difference in HbA1c, systolic blood pressure (SBP), and diastolic blood pressure (DBP) comparing the pre- (September 1, 2019, to March 31, 2020) to post-SiP period (June 1, 2020, to December 31, 2020). Our secondary endpoints included use of insulin or oral hypoglycemic agents (OHAs) during the post-SiP period and change in body mass index (BMI). This study utilized a paired t-test and chi-squared testing in order to assess for statistically significant differences in pre- versus post-SiP values. Results: Patients in this cohort were 52.29% male with 37.68% White, 22.35% Hispanic, 9.30% Black and 23.54% Asian and a mean age of 63 years. In this cohort, 44.02% of patients had a HbA1c < 7%, while 29.17%, 13.67%, 6.34% and 6.81% had an HbA1c of 7-7.9%, 8-8.9%, 9-9.9% and ≥ 10%, respectively (range 4.10 to 19.50%). Mean HbA1c, SBP, and DBP increased significantly across all groups; OHA use and insulin utilization also increased overall. Patients with lower pre-SiP HbA1c demonstrated larger increases in HbA1c and OHA utilization, while patients with higher pre-SiP HbA1c demonstrated increased rates of insulin initiation and decreases in their post-SiP HbA1c. Notably, mean BMI decreased in every HbA1c subgroup. Due to the large sample size, all p-values were < 0.0001. Conclusions: Among the KPNC diabetic population, several metrics for diabetes health management were significantly worsened after California's SiP. However, diabetic patients with the highest HbA1c values showed clinically significant improvement in their HbA1c, indicating a differential effect of the SiP on diabetes management. Our study helps identify higher-risk diabetic patients who require more intensive monitoring in the setting of the recent pandemic and highlights the importance of considering long-term implications of policy decisions on diabetes care. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of BMC Public Health is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1186/s12889-025-21916-z Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 6 StartPage: 1 Subjects: – SubjectFull: DIASTOLIC blood pressure Type: general – SubjectFull: SYSTOLIC blood pressure Type: general – SubjectFull: GLYCEMIC control Type: general – SubjectFull: STATISTICAL significance Type: general – SubjectFull: BODY mass index Type: general Titles: – TitleFull: The impact of the COVID-19 pandemic shelter in place on glycemic control, blood pressure control, and body mass index among diabetic patients at Kaiser Permanente Northern California: a retrospective cohort study. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Yamamoto, Kyle – PersonEntity: Name: NameFull: Merchant, Maqdooda – PersonEntity: Name: NameFull: Bommireddi, Akshay – PersonEntity: Name: NameFull: Vu, Joseph – PersonEntity: Name: NameFull: Pursnani, Seema K. IsPartOfRelationships: – BibEntity: Dates: – D: 28 M: 02 Text: 2/28/2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 14712458 Numbering: – Type: volume Value: 25 – Type: issue Value: 1 Titles: – TitleFull: BMC Public Health Type: main |
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