Secondary Impacts of the COVID-19 Pandemic on Access to Health Services for People with Diabetes Mellitus: A Scoping Review Protocol.

This project consists of a scoping review aimed at systematically mapping and synthesizing the scientific and technical literature on the secondary impacts of the COVID-19 pandemic on access to healthcare services for people with Diabetes Mellitus. It is based on the understanding that the pandemic represented an unprecedented disruption to healthcare systems on a global scale, requiring the reorganization of services, the redirection of healthcare resources, and the prioritization of care for COVID-19 cases. This context produced significant indirect effects on the care of chronic conditions, particularly diabetes, whose management depends on continuous follow-up, regular access to services, and systematic clinical monitoring. The main objective of the review is to identify, map, and synthesize the available evidence regarding these secondary impacts, understood as effects not resulting from direct infection by SARS-CoV-2, but resulting from the organizational, social, economic, and healthcare transformations imposed by the pandemic. Specifically, this study aims to characterize the types of health services affected, the access modalities available during the pandemic period, the main indirect outcomes related to the interruption or delay of care, as well as the barriers and facilitators that influenced the access of people with Diabetes Mellitus to health services in different contexts and levels of care. The review will be conducted according to the Joanna Briggs Institute methodology for scoping reviews and will follow the recommendations of the PRISMA-ScR checklist, ensuring methodological rigor, transparency, and reproducibility. The search strategy will encompass multiple national and international databases, as well as grey literature sources, including studies published between December 2019 and August 2025, in Portuguese, English, and Spanish. The selection of studies, data extraction and organization will be carried out systematically and in a standardized manner, with synthesis of results through descriptive and thematic analyses. The results of this review are expected to provide a comprehensive overview of the extent and nature of the secondary impacts of the COVID-19 pandemic on access to healthcare services for people with Diabetes Mellitus, highlighting recurring patterns, knowledge gaps, and inequalities in access to care. Additionally, the findings should contribute to understanding the weaknesses and resilience strategies of health systems in the face of health crises, supporting the planning of public policies, the organization of care for chronic conditions, and the strengthening of continuity of care in public health emergency scenarios.