Evidence map›Paper›PMID 40510009›Full record

ArticleFamily practice2025

Primary care insights on the management of diabetes: results from a mixed method study of care changes and impacts during the COVID-19 pandemic.

Karla Freeman, Shuaib Hafid, Dee Mangin, Andrea Carruthers, Meredith Vanstone, Kris Aubrey-Bassler, Jennifer Lawson, Marie-Thérèse Lussier, Kathryn Nicholson, Neil Drummond and 2 more

Abstract read
In one paragraph

Article in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
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

12 authors.

Karla FreemanDepartment of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.ORCID 0000-0002-7638-8190
Shuaib HafidDepartment of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.ORCID 0000-0002-2853-6881
Dee ManginDepartment of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.ORCID 0000-0003-2149-9376
Andrea CarruthersDepartment of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
Meredith VanstoneDepartment of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
Kris Aubrey-BasslerPrimary Healthcare Research Unit, Memorial University of Newfoundland, 230 Elizabeth Ave, St. John's, A1B 1T5, Canada.
Jennifer LawsonDepartment of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
Marie-Thérèse LussierDépartement de Médecine de famille et de Médecine d'urgence, Université de Montréal, 2900 Bd Édouard-Montpetit, Montréal, QC H3T 1J4, Canada.
Kathryn NicholsonDepartment of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
Neil DrummondDepartment of Family Medicine, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada.
John A QueenanDepartment of Family Medicine, Queen's University, 99 University Ave, Kingston, ON K7L 3N6, Canada.
Michelle HowardDepartment of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.ORCID 0000-0001-8127-5492

Funding

Canada Research Chair (Tier 2) in Ethical Complexity in Primary CareCanadian Institutes for Health Research W11-179885
6 · The paper itself

Abstract

backgroundIn Canada, primary care manages most diabetes care. The COVID-19 pandemic disrupted primary care, reducing access to care and monitoring.

objectivesWe aim to describe changes in diabetes monitoring during the first 21 months of the pandemic, patients' experiences with these changes, and impact on HbA1c and blood pressure (BP) control.

methodsWe conducted a two-phase mixed methods study: (i) A retrospective pre-post cohort study using de-identified electronic medical record data to compare HbA1c and BP measurement frequency and results in diabetic patients prepandemic (22 June 2018 to 12 March 2020) and during the pandemic (13 March 2020 to 3 December 2021); (ii) A qualitative descriptive analysis using semistructured interviews to understand patient experiences navigating diabetes care during the pandemic.

resultsThe cohort included 84 617 patients with validated diabetes case definition. Proportion of patients with <1 HbA1c test increased by 10% during the pandemic. For those with ≥1 test, mean HbA1c remained unchanged [mean (SD) HbA1cPre: 7.2 (1.3); HbA1cDuring: 7.2 (1.3); P = .51]. Proportion of patients with <1 BP measurement increased by 23%. For those with ≥1 measurement, mean BP remained clinically similar [mean (SD) sBPPre: 131.8 (13.7); sBPDuring: 132.9 (15.2); P < .01. Mean dBPPre: 74.9 (8.6); dBPDuring: 75.1 (9.1); P = .63]. Nineteen participants were interviewed, discussing virtual care, challenges with self-monitoring, and self-management strategies.

conclusionsMean HbA1c and BP values remained clinically stable during the pandemic despite reductions in monitoring frequency, likely due to continuity of care and patient self-management. Future research should evaluate a de-intensified frequency of diabetes monitoring and address care gaps.

Indexed as

COVID-19Diabetes MellitusPrimary Health CareAdultAgedCanadaFemaleGlycated HemoglobinHumansMaleMiddle AgedPandemicsQualitative ResearchRetrospective StudiesSARS-CoV-2Glycated HemoglobinCOVID-19diabetes mellituselectronic health recordsprimary health carequalitative researchretrospective studies

Identifiers

PMID40510009
PMCPMC12163313

What OpenQuestion holds

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Registered trials

None linked

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.