Vnitr Lek 2026, 72(6):E1-E5 | DOI: 10.36290/vnl.2026.077
Zmeny v starostlivosti o diabetes hodnotené podľa počtu vyšetrení HbA1c vykonaných počas pandémie COVID-19 na Slovensku
- 1 Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia,
- 2 JAL Ltd., Diabetologic Outpatient Clinic, Trnava, Slovakia
- 3 Medical Faculty, Safarik University, Kosice, Slovakia
- 4 Faculty of Health Sciences, Miskolc University, Miskolc, Hungary
- 5 Cumulus Ltd., Biochemical Laboratory, Kosice, Slovakia
- 6 Institute of Health Analyses, Health Ministry of Slovak Government, Bratislava, Slovakia
- 7 Medirex Group Laboratories Inc., Pezinok, Slovakia
Úvod: Na Slovensku došlo počas prvých dvoch rokov pandémie COVID-19 k výraznému nárastu úmrtnosti u pacientov s diabetes mellitus, ktorá sa v záverečnej fáze (2022) vrátila takmer na pôvodné hodnoty. Pacienti s diabetes mellitus potrebujú pravidelné meranie HbA1c. Cieľom tejto štúdie bolo vyhodnotiť vplyv pandémie na počet meraní HbA1c vykonaných pred (2019), počas (2020; 2021) a v záverečnej fáze (2022) pandémie.
Metódy: Vyhodnotilo sa 382 803 meraní HbA1c z laboratórnej siete spoločnosti Medirex Inc. a 23 779 analýz z malého aboratória (Cumulus Inc.).
Výsledky: Počet meraní HbA1c v laboratóriách Medirex v roku 2020 klesol o 18,7 % oproti 2019. V roku 2021 sa mierne zvýšil a v roku 2022 vzrástol o 4,4 %. V laboratóriách Cumulus bol pokles v roku 2020 podobný ako v laboratóriách Medirex, avšak v nasledujúcich dvoch rokoch nedošlo k úplnému návratu k prepandemickým hodnotám. Analýza podľa typu cukrovky (súbor údajov spoločnosti Medirex) odhalila, že k obnoveniu počtu meraní v roku 2022 došlo len u pacientov s T2DM, nie však u pacientov s T1DM. Analýza podľa veku ukázala široké rozloženie, pričom u najstarších pacientov s T1DM (> 75 rokov) došlo k poklesu o 28,3 % a u najstarších pacientov s T2DM k nárastu o 12,6 %. Napriek zmenám v počte testov zostala celková úroveň kompenzácie, hodnotená na základe hladín HbA1c, stabilná.
Závery: Pandémia bola záťažovou skúškou pre laboratóriá poskytujúce biochemické testy. Zvýšená úmrtnosť diabetických pacientov počas pandémie pravdepodobne nebola spôsobená zhoršením základného ochorenia, ako to vyplýva z hodnotenia hladín HbA1c, ale ochorením COVID-19 a jeho komplikáciami.
Klíčová slova: COVID-19, diabetes mellitus, HbA1c, glykemická kompenzácia.
Changes in diabetes care assessed from the number of HbA1c assays performed during COVID pandemic in Slovakia
Introduction: In Slovakia during the first two years of COVID-19 pandemic a significant increase of mortality in diabetic patients occurred, which returned near to the initial values in its last stage (2022). Patients with diabetes mellitus need regular assessment of HbA1c. The aim of this study was evaluation of the effect of pandemic on the number of HbA1c measurements performed before (2019), during (2020; 2021), and in the last stage (2022) of pandemic.
Methods: 382 803 HbA1c measurements from Medirex Inc. laboratory chain and 23 779 assays from a local laboratory (Cumulus Inc.) were evaluated.
Results: The number of HbA1c measurements in Medirex dropped down in 2020 by 18,7%, returned slightly in 2021 and increased by 4,4% in 2022. In Cumulus the decrease in 2020 was similar to Medirex, but in the next two years no full recovery occurred. Analysis according to type of diabetes (Medirex dataset) revealed that the recovery in 2022 was present only in T2DM patients and not in those with T1DM. Analysis according to age showed a broad distribution, with a 28,3% drop in the oldest T1DM (> 75 years) and an increase by 12,6% in oldest T2DM patients. Despite the changes in assay number the overall level of compensation, assessed by HbA1c levels, remained stable.
Conclusions: The pandemic was a load test for laboratories providing biochemical assays The increased mortality of diabetic patients during the pandemic was probably not due to deteriorating of basic disease as assessed by HbA1c, but by COVID-19 and its complications.
Keywords: COVID-19, diabetes mellitus, HbA1c, glycaemic compensation
Přijato: 16. září 2026; Zveřejněno: 2. říjen 2026 Zobrazit citaci
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