Impact of COVID-19 lockdown on glycemic control in patients with type 1 diabetes

Abstract

Introduction: The COVID-19 pandemic has forced governments to take exceptional measures to minimize its spread, imposing lockdown policies. The aim of this study was to evaluate the impact of lockdown on type 1 diabetes (T1D) glycemic control. Material and methods: People with T1D using flash glucose monitoring were included. Data from the 14 days before lockdown were compared with data from the last 14 days after 8 weeks of lockdown. Results: A total of 307 patients were included (age 45.8 ± 12.6 years, 50.2% male, diabetes duration 21.1 ± 12.3 years). Only one patient had COVID-19 infection. Mean glucose decreased from 166.89 ± 29.4 to 158.0 ± 29.0 mg/dL and estimated HbA1c declined from 7.4 ± 1.0 to 7.1 ± 1.0% (54 ± 10.9 vs 57 ± 10.9 mmol/mol; p < 0.001). Time in range increased from 57.8 ± 15.8 to 62.46 ± 16.1%. Time in hyperglycemia > 180 mg/dL and >250 mg/dL decreased from 37.3 ± 1.9% to 32.0 ± 17.1% and from 13.0 ± 11.3 to 10.3 ± 10.6%, respectively; (p < 0.001). Time in hypoglycaemia <70 mg/dL increased from 4.9 ± 4.0% to 5.5 ± 4.4% (p < 0.001). No differences in time <54 mg/dl, coefficient of variation (CV%) or number of scans per day were found. Conclusion: Despite the limitations of lockdown, glycemic control improved in patients with T1D. These results suggest that having more time for self-management may help improve glycemic control in the short term.

COVID-19 associated with diabetes and other noncommunicable diseases led to a global health crisis

“…Authors reported BG worsening in Brazil, India, China and African countries [16,31,33,35,36], while the opposite situation was observed in T1D groups in high income countries (HIC). With access to advanced technology, treatment, specialized services and HCPs used to digital health tools, PwD in HIC maintained or even improved their BG level during the pandemic [59,61,72,73,74]. In a study in Spain, time in range of individuals with T1D using glucose sensors increased, in comparison with the pre-pandemic period, from 57.8% to 62.5% [73], and from 55.8% to 58.2%, in Italy [61].…”

“…With access to advanced technology, treatment, specialized services and HCPs used to digital health tools, PwD in HIC maintained or even improved their BG level during the pandemic [59,61,72,73,74]. In a study in Spain, time in range of individuals with T1D using glucose sensors increased, in comparison with the pre-pandemic period, from 57.8% to 62.5% [73], and from 55.8% to 58.2%, in Italy [61]. However, negative consequences of inequalities were also present in HIC [17,51].…”

Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy

“…Other studies investigated changes of glucose control in relation to COVID-19 lockdown in children [7] and adults [8][9][10][11][12] with T1D, overall finding either comparable [7,12] or improved [8][9][10][11] glucose variability in these populations. However, unlike other study cohorts, our patients had prelockdown TIR above the optimal range (TIR> 70%).…”

Impact of COVID-19 lockdown on glycemic control in children and adolescents

“…Recently, new approaches are being studied to provide new treatments to diabetic patients. Some studies have been conducted to explore COVID-19 lockdown and glycemic control ... Al Agha et al how diabetic patients are dealing with their diabetes during the COVID-19 lockdown; [7][8][9] however, few have been conducted in Saudi Arabia. We aimed to assess how children and adolescents with T1D were coping with their diabetes during the lockdown, and more broadly, to offer the diabetic community better strategies for healthy living in lockdown.…”