The challenge of diabetes home control in COVID-19 times: Proof is in the pudding

Cotovad-Bellas, Laura; Tejera-Pérez, Cristina; Prieto-Tenreiro, Alma; Sánchez-Bao, Ana; Guerrero, Diego Bellido

doi:10.1016/j.diabres.2020.108379

Cited by 18 publications

(41 citation statements)

References 13 publications

(15 reference statements)

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“…The increase in food intake (one-third), a higher proportion of less physical activity than usual (two-thirds) and the high prevalence of increased weight may explain the high percentage of people with T1D reporting a worsening of glycaemic control during confinement. Two recent studies in Spain in PLWT1D using FGM reported no deterioration in glycaemic control resulting from the lockdown enforced as a result of the COVID-19 pandemic [8] , [9] . However, this study was conducted using a smaller portion of the population using FGM; therefore, the results may not be applicable to the global population of people with T1D.…”

Section: Discussionmentioning

confidence: 96%

“…Regarding glycaemic control, in T1D, using flash glucose monitoring, glycaemic control improved in those who stopped working during the lockdown in Italy [7] . In Spain [8] , [9] , despite the limitations of lockdown, glycaemic control improved in patients with T1D, suggesting that having more time for self-management may help improve glycaemic control in the short term.…”

Section: Introductionmentioning

confidence: 99%

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People living with type 1 diabetes point of view in COVID-19 times (COVIDT1 study): Disease impact, health system pitfalls and lessons for the future

Tejera¹,

Moreno-Pérez

Ríos

et al. 2021

Diabetes Research and Clinical Practice

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Highlights The COVID-19 pandemic has impacted healthcare worldwide. The consequences of the lockdowns in people with diabetes have not been sufficiently explored. Lockdowns caused significant consequences affecting weight, eating habits, exercise and glycaemic control, negatively impacting the health of people living with type 1 diabetes. Almost all respondents agreed with the concept of telemedicine for their healthcare assistance. We have to learn the lessons regarding healthcare assistance during this pandemic to promote virtual assistance and support in the future.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

People living with type 1 diabetes point of view in COVID-19 times (COVIDT1 study): Disease impact, health system pitfalls and lessons for the future

Tejera¹,

Moreno-Pérez

Ríos

et al. 2021

Diabetes Research and Clinical Practice

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“…Pooled estimate showed no significant differences in RBG level between pre-and during lockdown period (MD=0.91 mg/dL [95%CI -4.52 to 6.34], I 2 =88%, random-effects). RBG sub-group analysis presented no significant differences on cohort studies (MD=-0.71 mg/dL [95%CI -7.64 to 6.22], I 2 =0.64%, random-effects) [9,22,[30][31][32], case-control studies (MD=-2.47 mg/dL [95%CI -8.91 to 3.98], I 2 =75%, random-effects) [24,26,27,33], and cross-sectional studies (MD=23.61 mg/dL (95%CI -15.32 to 62.54, I 2 =93%, random-effects) [28,29,34].…”

Section: Random Blood Glucose (Rbg)mentioning

confidence: 99%

“…A total of eleven studies [21][22][23][24][25][26][27][28][29][30][31] with 1357 pre-lockdown and 1325 lockdown total participants, consisting of T1D and T2D patients, reported the mean level of HbA1c and estimated A1c which obtained either from CGM or FGM (Figure 2). A pooled estimate showed that lockdown did not significantly give rise to changes in HbA1c parameter (MD=0.06% [95%CI -0.10 to 0.23], I 2 =77%, random-effects).…”

Section: Primary Outcomes Glycated Hemoglobin A1c (Hba1c)mentioning

confidence: 99%

“…Twelve studies [22,24,26,[28][29][30][31][32][33][34][35][36] on T1D patients reported mean difference of RBG with a total of 2162 pre-lockdown and 2210 lockdown participants (Figure 2). Pooled estimate showed no significant differences in RBG level between pre-and during lockdown period (MD=0.91 mg/dL [95%CI -4.52 to 6.34], I 2 =88%, random-effects).…”

Section: Random Blood Glucose (Rbg)mentioning

confidence: 99%

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Impact of COVID-19 Lockdown on the Metabolic Control Parameters in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis

Ia¹,

Nr²,

Sofia³

et al. 2021

Preprint

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Background: The abrupt implementation of COVID-19 lockdown had impacted the management of diabetes mellitus. Limited access to health facilities and alterations in daily lifestyle put metabolic control among patients at risk. Thus, we observed the differences in metabolic control parameters in diabetic patients before and during the lockdown. Methods: We performed searches from five databases. Meta-analyses were done using random or fixed-effect approaches with glycemic control parameters (HbA1c, RBG, FBG, TIR, TAR, TBR) as primary outcomes. Mean difference (MD), Confidence Interval (CI), and p-value were calculated. Lipid profile presented as secondary outcome. Results: 21 studies with 3992 diabetic patients were included in the study. Meta-analysis presented an increase on HbA1c of T1D and T2D patients [MD=+0.06% (95%CI -0.10–0.23), I2=77%, p=0.45], TBR of T1D patients [MD=-0.05% (95%CI -0.38–0.28), I2=0%, p=0.77], FBG of T2D patients [MD=+3,47 mg/dL (95%CI 1.22–5.73), I2=0%, p=0.002], and lipid profile on qualitative analysis. However, TIR, TAR, and RBG of T1D patients were improved [MD=+3.52% (95%CI 0.29–6.74), I2=76%, p=0.03; MD=-3.36% (95%CI -6.48–-0.25), I2=75%, p=0.03; MD=-0.91 mg/dL (95%CI -4.52–6.34), I2=88%, p=0.74]. Conclusion: Lockdown enforcement did not worsen the glycemic control parameter in diabetic patients. Particular parameters inclined to improve during the lockdown.

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Glucose control in diabetes during home confinement for the first pandemic wave of COVID-19: a meta-analysis of observational studies

et al. 2021

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Aim To assess the effect on glycaemic control of confinement due to lockdown measures, during COVID-19 pandemic, in people with type 1 (T1DM) and type 2 (T2DM) diabetes. Methods Meta-analysis of observational studies reporting measures of glucose control and variability before and during and/or after periods of confinement caused by COVID-19 in 2020 and/or 2021. Results We included 27 studies on T1DM. No significant change in Hba1c was observed after lockdown (WMD − 1.474 [− 3.26; 0.31] mmol/mol, I2 = 93.9). TIR significantly increased during and after lockdown (WMD: 2.73 1.47; 4.23 %, I2 = 81% and 3.73 [1.13; 5.33] %, I2 = 85%, respectively).We retrieved nine studies on T2DM patients. No significant variation in HbA1c was detected (WMD − 1.257 − 3.91; 1.39 mmol/mol, I2 = 98.3%). HbA1c had a more favourable trend in studies performed in Asia than in Europe (p = 0.022 between groups). Conclusion Lockdown showed no significant detrimental effect on HbA1c in either T1DM or T2DM. Conversely, home confinement led to a reduction in mean glucose and glucose variability in T1DM, although with a high heterogeneity of results.

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The challenge of diabetes home control in COVID-19 times: Proof is in the pudding

Abstract: Highlights COVID-19 pandemic had affected to healthcare assistance for people with diabetes. Data about effect of lockdown in glycemic control in people with diabetes at tome are scarce. Use of glucose monitoring system help people with to diabetes to improve their self-care.

Cited by 18 publications

References 13 publications

People living with type 1 diabetes point of view in COVID-19 times (COVIDT1 study): Disease impact, health system pitfalls and lessons for the future

People living with type 1 diabetes point of view in COVID-19 times (COVIDT1 study): Disease impact, health system pitfalls and lessons for the future

Impact of COVID-19 Lockdown on the Metabolic Control Parameters in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis

Glucose control in diabetes during home confinement for the first pandemic wave of COVID-19: a meta-analysis of observational studies

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