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

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 A_1C (HBA_1C) 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.