Evidence map›Paper›PMID 40022046›Full record

ArticleBMC public health2025

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.

Kyle Yamamoto, Maqdooda Merchant, Akshay Bommireddi, Joseph Vu, Seema K Pursnani

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kyle YamamotoKaiser Permanente, 700 Lawrence Expressway, Santa Clara, CA, 95051, USA. kyleleeyamamoto@gmail.com.
Maqdooda MerchantDivision of Research, Kaiser Permanente Northern California, 4480 Hacienda Drive, Pleasanton, CA, 94588, USA.
Akshay BommireddiKaiser Permanente, 700 Lawrence Expressway, Santa Clara, CA, 95051, USA.
Joseph VuKaiser Permanente, 700 Lawrence Expressway, Santa Clara, CA, 95051, USA.
Seema K PursnaniKaiser Permanente, 700 Lawrence Expressway, Santa Clara, CA, 95051, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

introductionRegional 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.

methodsThis 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.

resultsPatients 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.

conclusionsAmong 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.

Indexed as

Body Mass IndexCOVID-19Diabetes MellitusGlycemic ControlAgedBlood PressureCaliforniaFemaleGlycated HemoglobinHumansHypoglycemic AgentsMaleMiddle AgedRetrospective StudiesGlycated HemoglobinHypoglycemic AgentsCovid-19Diabetes mellitusHealth policyPandemic

Identifiers

PMID40022046
PMCPMC11869442

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.