Vnitr Lek 2026, 72(6):E1-E5 | DOI: 10.36290/vnl.2026.077

Changes in diabetes care assessed from the number of HbA1c assays performed during COVID pandemic in Slovakia

Martin Jankovsky1, Jozef Lacka2, Viktor Oliver Rácz3, 4, 5, Petra Ištokovičová6, Elena Tibenská7, Peter Jackuliak1
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

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

Accepted: September 16, 2026; Published: October 2, 2026  Show citation

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Jankovsky M, Lacka J, Rácz VO, Ištokovičová P, Tibenská E, Jackuliak P. Changes in diabetes care assessed from the number of HbA1c assays performed during COVID pandemic in Slovakia. Vnitr Lek. 2026;72(6):E1-5. doi: 10.36290/vnl.2026.077.
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