eISSN: 2449-8580
ISSN: 1734-3402
Family Medicine & Primary Care Review
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4/2023
vol. 25
 
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abstract:
Original paper

Effects of delay in visiting a specialist doctor in type 2 diabetic patients on glycemic control: a retrospective cohort study with a 4-year follow-up

Mohadeseh Ghanbari-Jahromi
1
,
Erfan Kharazmi
2
,
Peivand Bastani
3
,
Mesbah Shams
4
,
Mohammad Aryaie
5
,
Mohammad Amin Bahrami
2

  1. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
  2. Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
  3. College of Health and Human Sciences, Faculty of Health, Charles Darwin University, Darwin, Australia
  4. Endocrinology and Metabolism Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
  5. School of Public Health, Imperial College London, London, United Kingdom
Family Medicine & Primary Care Review 2023; 25(4): 393–398
DOI: https://doi.org/10.5114/fmpcr.2023.132612
Online publish date: 2023/12/27
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Background
Diabetic patients’ delay in visiting a specialist doctor can have significant effects on blood sugar factors. The present study aimed to determine the effects of delay in visiting a specialist doctor in type 2 diabetic patients on glycaemic factors.

Material and methods
The patients’ demographic and clinical information included in medical records of 209 type 2 diabetic patients referred to diabetes clinics in Shiraz city, south of Iran, were analysed using logistic mix-model regression. Due to the occurrence of COVID-19 during the follow-up period, data analyses were done separately before and after the pandemic.

Results
The mean age of the patients was 63.47 ± 8.89 years, and 67.94% of the type 2 diabetic patients were female. After COVID-19, haemoglobin A1C (HBA1C) of the patients who had delays of < 3, 3–6 and > 6 months in referring to a specialist increased by 1.81 (OR: 1.12–2.93), 2.56 (OR: 1.81–5.56) and 3.69 (OR: 1.79–7.63), respectively, compared to the group without delays. In this period, 2-hour Postprandial Glucose (2-hpp) of the patients with delays of 3–6 and > 6 months and the Fasting Blood Sugar (FBS) of the patients with delays of > 6 months had a significant increase of 1.92 (OR: 1.01–3.65), 2.14 (OR: 1.09–4.21) and 2.36 (confidence interval of 95%: 1.27–4.39), respectively, compared to the patients without delays in visits. The above trends had a non-significant increase before COVID-19, though.

Conclusions
Healthcare providers should ensure the continuity of providing services to diabetes patients, especially during health crises, by taking appropriate measures.

keywords:

diabetes mellitus, type 2, glycaemic control, COVID-19

  
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