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Aims Spain has been one of the worst affected countries by the COVID-19 pandemic. A very strict lockdown at home was imposed with a tough restriction of mobility. We aimed to evaluate the impact of this exceptional scenario on glucose profile of patients with T1D prone to hypoglycemia using standalone continuous glucose monitoring. Methods Patients with T1D prone to hypoglycemia using multiple daily injections and either a Dexcom G5® or a Free Style Libre® CGM systems for at least 6 months under the funding of National Health Service were included in an observational, retrospective study. Data were collected in two periods: pre-lockdown (PL), February 23rd-March 7th and within lockdown (WL), April 1st–14th 2020. The primary outcome was the difference in the proportion of time in target glucose range of 70–180 mg/dL (TIR). Additional glucometric data were also analysed. Results 92 patients were included: 40 women, age 42.8 ± 3.9 years, disease duration of 23.1 ± 12.6 years. Seventeen patients used Dexcom G5® and 75 Free Style Libre®. TIR 70–180 mg/dL (59.3 ± 16.2 vs 62.6 ± 15.2%), time > 180 (34.4 ± 18.0 vs 30.7 ± 16.9%), >250 (11.1 ± 10.6 vs 9.2 ± 9.7%) and Glucose Management Indicator (7.2 ± 0.8 vs 7.0 ± 0.8%) significantly improved (PL vs WL, respectively, p < 0.05). Time in hypoglycemia remained unchanged. Conclusions Lockdown conditions imposed by the COVID-19 pandemic may be managed successfully in terms of glycemic control by population with T1D prone to hypoglycemia using CGM. The strict daily routine at home could probably explain the improvement in the time in glycemic target without increasing the time in hypoglycemia.

Objective: To study the local and systemic behavior of the tumor necrosis factor-α (TNF-α) in patients with active uveitis. Methods: TNF-α levels were measured in aqueous humor and peripheral blood samples using an enzyme-linked immunosorbent assay from 23 patients with uveitis and 16 control patients who had been operated on for uncomplicated cataracts. Results: Aqueous humor and sera of patients with uveitis showed higher levels of TNF-α than those of controls (p < 0.001). A comparison of cytokine levels between aqueous humor and sera showed significantly higher levels of TNF-α in serum than aqueous humor (p < 0.001). Correlation studies using the regression test for successive steps showed that serum TNF-α levels correlated with recurrent uveitis (r = 0.4150; p = 0.0489). Conclusions: TNF-α is a cytokine that participates actively in the pathogenesis of clinical uveitis. Our data emphasize the greater systemic than local participation of TNF-α. Finally, an elevated serum TNF-α seems to be associated with a recurrent pattern of uveitis.

The control of type 1 diabetes (T1D) in young subjects is especially troublesome in adolescence. In this period, young T1D subjects are usually transferred to adult diabetes units. Transfer conditions could be a determinant factor to achieve adequate treatment compliance and optimal metabolic control.The aim of this study was to evaluate the impact of a specifically designed transition therapeutic education programme (TEP) on glycaemic control, self-management and quality of life, 12 months after the transfer of young subjects with T1D from a paediatric to an adult diabetes unit.The study included 80 young T1D subjects (aged 19.0±1.3 years, 39 females, T1D duration 7.3±1. In all, 72 out of 80 subjects completed the TEP. We observed an improvement in metabolic control (HbA 1c 8.5±1.7 vs 7.4±1.5, p<0.001) with a decrease in the number of hypoglycaemic episodes (severe: 0.39 vs 0.14 episodes/patient/year, p<0.001; >5 non-severe/weak: 15% vs 0% patients, p<0.005). There were no differences in terms of total daily insulin dose. However, an increase was observed in the proportion of rapid-acting insulin (23% vs 52%, p<0.001). After 12 months of TEP, a higher proportion of subjects were able to perform self-adjustment of insulin doses (13% vs 48%, p<0.001). Likewise, TEP improved their knowledge in T1D management (DKQ2 25/35 vs 29/35, p<0.001) without worsening the quality of life score.In conclusion, the use of a special transition TEP achieves an improvement in metabolic control and self-management abilities without worsening the quality of life of young T1D subjects transferred from a paediatric to an adult diabetes unit.

Aims Spain has been one of the worst affected countries by the COVID-19 pandemic. A very strict lockdown at home was imposed with a tough restriction of mobility. We aimed to evaluate the impact of this exceptional scenario on glucose profile of patients with type 1 diabetes (T1D) prone to hypoglycaemia using sensor-augmented pump (SAP). Methods Patients with T1D prone to hypoglycaemia using SAP (640G Medtronic-Minimed ® ) for at least 6 months under the funding of a National Health Service were included in an observational, retrospective study. Data were collected in two periods: pre-lockdown (PL), February 23rd–March 7th and within lockdown (WL), April 1st to 14th 2020. The primary outcome was the difference in the proportion of time in target glucose range of 70–180 mg/dL (TIR). Additional glucometric data and total daily insulin were also analysed. Results Fifty-nine patients were included: 33 women, age 46.17 ± 13.0 years and disease duration of 30.2 ± 12.0 years. TIR 70–180 mg/dL (67.6 ± 11.8 vs. 69.8 ± 12.0%), time > 180 (28.1 ± 13.6 vs. 25.5 ± 13.1%), time > 250 (6.9 ± 6.1 vs. 5.1 ± 4.8) and estimated HbA 1c (6.94 ± 0.8 vs. 6.75 ± 0.7%) significantly improved (PL vs. WL, respectively, p < 0.05). Time in hypoglycaemia, coefficient of variation, sensor usage and total daily insulin dose remained unchanged. Conclusions Lockdown conditions imposed by the COVID-19 pandemic may be managed successfully in terms of glycaemia control by population with DT1 prone to hypoglycaemia using SAP. The strict daily routine at home could probably explain the improvement in the time in glycemic target without increasing the time hypoglycaemia.

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CSII, commenced according to the criteria for a nationally funded clinical programme, improves glycaemic control and quality-of-life outcomes with fewer hypoglycaemic episodes in T1D subjects previously conventionally treated with MDI.

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