Factors Related to Improvement of Glycemic Control Among Adults with Type 1 Diabetes During Lockdown Due to COVID-19

Moreno-Domínguez, Óscar; Villar, Noemí González-Pérez de; Barquiel, Beatriz; Hillman-Gadea, Natalia; Gaspar-Lafuente, Ruth; Arévalo-Gómez, Montserrat; Herranz, Lucrecia

doi:10.1089/dia.2020.0550

Cited by 15 publications

(20 citation statements)

References 6 publications

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“…Other studies investigating the two week period following the end of lockdown, have found comparable results to our study, showing a sustained increase in %TIR and reduction in % TAR1 [14,15] or TAR 251-400mg/dL [16]. A small Spanish dataset of participants on MDI using isCGM, found no change in glycaemic metrics between pre and during lockdown but an 1.0 (0.5-1.6) 0.9 (0.4-1.9) 0.9 (0.4-1.7) <0.001…”

Section: Plos Onesupporting

confidence: 90%

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Improved glycaemia during the Covid-19 pandemic lockdown is sustained post-lockdown and during the “Eat Out to Help Out” Government Scheme, in adults with Type 1 diabetes in the United Kingdom

et al. 2021

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Aims The majority of studies report that the Covid-19 pandemic lockdown did not have a detrimental effect on glycaemia. We sought to explore the impact of lockdown on glycaemia and whether this is sustained following easing of restrictions. Methods Retrospective, observational analysis in adults and children with type 1 diabetes attending a UK specialist centre, using real-time or intermittently scanned continuous glucose monitoring. Data from the following 28-day time periods were collected: (i) pre-lockdown; (ii) during lockdown; (iii) immediately after lockdown; and (iv) a month following relaxation of restrictions (coinciding with Government-subsidised restaurant food). Data were analysed for times in glycaemic ranges and are expressed as median (IQR). Results 145 adults aged 35.5 (25.8–51.3) years with diabetes duration of 19.0 (7.0–29.0) years on multiple daily injections of insulin (60%) and continuous insulin infusion (40%) were included. In adults, % time in range (70-180mg/dL) increased during lockdown (60.2 (45.2–69.3)%) compared to pre-lockdown (56.7 (43.5–65.3)%; p<0.001). This was maintained in the post-lockdown time periods. Similarly, % time above range (>180mg/dL) reduced in lockdown compared to pre-lockdown (p = 0.01), which was sustained thereafter. In children, no significant changes to glycaemia were observed during lockdown. In multivariable analysis, a greater increase in %TIR 3.9-10mmol/L (70-180mg/dL) during lockdown was associated with higher levels of deprivation (coefficient: 4.208, 95% CI 0.588 to 7.828; p = 0.02). Conclusions Glycaemia in adults improved during lockdown, with people from more deprived areas most likely to benefit. This effect was sustained after easing of restrictions, with government-subsidised restaurant eating having no adverse impact on glycaemia.

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Section: Plos Onesupporting

confidence: 90%

“…Few studies have investigated glycaemic metrics following the end of lockdown during the relaxation of restrictions. These studies demonstrated sustained improvements for up to a 2-week period but have not investigated further [14][15][16][17].…”

Section: Introductionmentioning

confidence: 98%

Improved glycaemia during the Covid-19 pandemic lockdown is sustained post-lockdown and during the “Eat Out to Help Out” Government Scheme, in adults with Type 1 diabetes in the United Kingdom

et al. 2021

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“…Therefore, the negative effect due to the reduction in weekly sports activity was completely offset and overcome by the positive "lockdown effect", an effect in fact opposite to what was initially predicted by clinicians, but in line with the data available in the literature. Studies in the adult population showed improvement in glycemic control (19)(20)(21)(22)(23)(24)(25)(26)(27)(28) unlike those on the pediatric and adolescent population which showed discordant data. Tornese et al (29) showed glycemic improvement in a small and selected sample of patients (13 subjects, hybrid closed loop-HCL users).…”

Section: Discussionmentioning

confidence: 92%

“…Despite the concerns of diabetologists, some studies unexpectedly showed that glycemic control in T1D patients remained stable or improved during the lockdown period (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). However, these studies included both small and overselected samples of patients, with different treatment schedules or adult patients.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Lockdown and Physical Activity on Glycemic Control in Italian Children and Young Patients With Type 1 Diabetes

et al. 2021

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AimsThe purpose of the study was to evaluate the impact of the lockdown established by the Italian government to limit the spread of Coronavirus disease (COVID-19) on glycemic control in a large sample of patients with type 1 diabetes (T1D) based on age, type of insulin therapy, number of telemedicine visits and physical activity.Material and MethodsWe retrospectively evaluated glycemic control in young T1D patients using the DexcomG6® system before the Italian lockdown (February 10–23, 2020—Time 0) and during lockdown (April 17–30, 2020—Time 1). Data on age, type of insulin therapy, number of telemedicine visits and physical activity of 202 patients with T1D and a median age of 18.2 years (range: 6–39) were collected.ResultsData showed a significant improvement of TIR from 54.58% at T0 to 59.09% at T1 (p ≤0.0001). Glycemic control improved significantly in patients ≥14 years old, showing the best outcome in the “university students and young adults” group (55.40% at T0 and 61.37% at T1, p ≤0.001). All patients reduced physical activity during lockdown; in the 56 patients of “intense physical activity” group both at T0 and T1 TIR increased from ±56.91 to 64.11% (p ≤0.0001).ConclusionsOverall, the lockdown led to an unexpected improvement in glycemic control of young patients with T1D. A healthier and stressless lifestyle changes in association with the maintenance of physical activity resulted in a significant age-proportional improvement in glycemic control.

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“…Prior studies have shown that adults and children had increased sensor usage and glucose scans during lockdown periods, 5 suggesting that increased CGM use may be related to optimal glycemic metrics. In other studies, children using either MDI or insulin pump therapy had no changes in total daily dose of insulin in the immediate 7 or distant time periods (3 months) 9 surrounding the SIP mandate, which was confirmed in our study.…”

Section: Discussionmentioning

confidence: 99%

Youth with Type 1 Diabetes Had Improvement in Continuous Glucose Monitoring Metrics During the COVID-19 Pandemic

Abdulhussein

Chesser

Boscardin

et al. 2021

Diabetes Technology & Therapeutics

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Factors Related to Improvement of Glycemic Control Among Adults with Type 1 Diabetes During Lockdown Due to COVID-19

Cited by 15 publications

References 6 publications

Improved glycaemia during the Covid-19 pandemic lockdown is sustained post-lockdown and during the “Eat Out to Help Out” Government Scheme, in adults with Type 1 diabetes in the United Kingdom

Improved glycaemia during the Covid-19 pandemic lockdown is sustained post-lockdown and during the “Eat Out to Help Out” Government Scheme, in adults with Type 1 diabetes in the United Kingdom

The Effect of Lockdown and Physical Activity on Glycemic Control in Italian Children and Young Patients With Type 1 Diabetes

Youth with Type 1 Diabetes Had Improvement in Continuous Glucose Monitoring Metrics During the COVID-19 Pandemic

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