Exploring the impact of the COVID-19 pandemic on patients with type 2 diabetes and primary care utilisation: a scoping review

Background: During the coronavirus disease 2019 (COVID-19) pandemic, changes in healthcare organisation may have affected the management of chronic patients, such as those with type 2 diabetes (T2D), who require close monitoring. Although there are studies that analyse the access and management of patients with T2D in Primary Care (PC) during the pandemic, there is no synthesis of the results that inform us about the care provided. The aim of this study is to summarise the existing evidence on the care provided in PC settings to patients with T2D during the COVID-19 pandemic, as well as their follow-up care and outcomes, in order to understand the impact of the pandemic on their management. Methods: A scoping review was conducted according to the approach described by Arksey and O'Malley. Structured search strategies were developed for each of the selected databases (PubMed, EMBASE and Web of Science). We included articles published in English and Spanish up to 30 November 2024 on access to care for patients with T2D in PC during the pandemic. Two independent reviewers screened titles and abstracts to select studies related to the population, intervention, and outcomes of interest. In cases of disagreement, a third reviewer resolved the discrepancy. One of the reviewers extracted data and summarised them. Results: From a total of 441 articles, 19 full-text articles were finally selected for inclusion. Europe had the highest number of publications. The majority of the studies were retrospective cohort studies and the most commonly used source of data was electronic health records. The two topics of interest were identified: access to healthcare services and results regarding disease management. There was a general decrease in face-to-face visits made by patients with T2D, with reduced checks of laboratory parameters, blood pressure and weight. The results of monitoring during and after the pandemic were not always worse that the results previously obtained. Conclusions: During the COVID-19 pandemic, face-to-face care for patients with T2D in PC was reduced without a clear impact on control outcomes, highlighting the importance of virtual visits to ensure continuity of care. Protocol registration number INPLASY202360057.