UC Irvine

Diabetes mellitus (DM) is a chronic condition that can be debilitating to the health and lifestyle of a patient. A patient’s inability to control their blood sugar can have devastating consequences for the individual, family, community, and society in general. Maintaining good overall control of one’s blood glucose levels is a multilayered and multifaceted endeavor that involves patient commitment, medical providers' direction, and familial and community support. With the onset of the COVID-19 pandemic, the systems that support these patients seem to have affected their ability to see their medical team and their diabetic health. Most of the research investigates the effect of the COVID-19 virus on diabetic patients or the effectiveness of self-management with diabetes, but there is no research confirming the reduction in medical visits and deterioration of meeting the diabetic outcome indices used to measure successful diabetes management. This cohort study uses McNemar Chi-Square Tests and Binary Logistic Regression Analysis with a Confidence Interval of 95% to analyze data extracted from the OMOP Database of type 2 diabetic adult patients between the ages of 18 and 75 years, who were diagnosed before March 2019 with two or more ambulatory visits to the UCI Medical Clinic, from March 2019 to February 2022. A total of 5,185 T2DM adult patients were selected from the UCI Health database that met the criteria. The HEDIS Comprehensive Diabetes Care Measure was used as the criteria for good compliance. There were 5 measures considered for diabetes outcomes, these are Screening for Glycosylated Hemoglobin (HbA1c/A1c), good compliance of less than 8.0%, poor compliance of greater than 9%, a Blood Pressure (BP) level of less than 140/90 mmHg and yearly retinal eye examination is considered a yes/ no option if the patient has this examination done within the year of the study. Nephropathy was not considered in this study because it was removed from the list of requirements in the Comprehensive Diabetes Care Measures. Based on the statistical analysis, differences in differences analysis were performed over the five sets of data. The results showed, from 2019 to 2020, there was a significant change in compliance of overall HbA1c less than 8% (p>.001), HbA1c Screening, poor compliance of overall HbA1c >9% (p>.001), BP <140/90mmHg (p>.001), and retinal eye examination (p>.001). This change did not recover from 2020 to 2021, except in Retinal Eye Examination. The change in BP is representative of the absence of patients from doctors’ visits and there was a 26% drop in HbA1c screen from 2019 to 2020. There was also a significance in these changes based on racial-ethnic profile, sex, and age. Future studies would be encouraged to identify mechanisms to prevent these gaps from occurring in the future when an event like a pandemic creates a scarcity of resources.