The impact of COVID-19 lockdown on glycaemic control in young adults with type 1 diabetes mellitus

Abstract

Background In December 2019, a novel coronavirus strain, COVID-19, was identified in Wuhan, China. The first case was reported in the Republic of Ireland that month. Since then, along with many other countries worldwide, Ireland has imposed intermittent strict lockdowns to mitigate the spread of the virus. Aims To investigate the impact of lockdown on glycaemic control in young adult patients with type 1 diabetes mellitus. Methods Pre-and post-lockdown HbA1c levels were recorded for 118 patients attending the Young Adult Diabetes clinic in Beaumont Hospital, Dublin, and the results were compared. Changes in weight, insulin requirements and incidence of DKA/severe hypoglycaemia were also assessed. Results HbA1c results were 3.81 mmol/mol lower post-lockdown. Weight increased by 1.8 kg. Both of these results were statistically significant. Conclusions Lockdown was associated with improved glycaemic control in young adult diabetic patients, and also with an increase in body weight. Changes in lifestyle factors associated with lockdown may explain this finding.

Glycemic Control in Type 1 Diabetes Mellitus and COVID-19: What We Learned From the Lockdown Experience

“…Opposite to what would be expected during a period with difficult access to health services, increased levels of anxiety and reduced physical activity [5,12], we found an improvement in glycemic control in our sample. We documented a significant decrease of 0.28% in HbA1c after the lockdown period which is consistent with other international studies [5][6][7][8][9][10][11]13,14]. We further determined a relevant reduction in HbA1c (≥0.5%) in more than one-third (35.3%) of our population.…”

“…This might explain the results seen in our study since many of our patients were working or studying from home. This theory was also supported by other authors [5][6][7]10,14,16].…”

“…In our unit, all scheduled appointments were postponed, but diabetic patients could contact our team, by phone call, to clarify any doubts or to request a medical evaluation. We considered that this support was essential to obtain these good results and many studies suggest the importance of telemedicine in glycemic control during the lockdown period [7,13,17].…”

“…However, in contrast to what would be expected, the implementation of lockdown during the COVID-19 pandemic did not appear to worsen glycemic control in patients with T1D. Some studies on the impact of confinement on glycemic control suggest a reduction of 0.1 to 0.5% in the value of glycated hemoglobin (HbA1c) [6][7][8][9][10][11]. The aim of this study was to assess the impact of the lockdown due to COVID-19 on glycemic control in adult patients with T1D followed in our Unit.…”

“…Coronavirus disease 2019 (COVID-19) forced governments and public health authorities, in many countries, to impose exceptional measures to prevent the spread of this disease [5]. Restrictions to circulation, social distancing, school closure and mandatory remote working whenever possible, were some of the adopted measures, which drastically changed people's personal and professional lives [3,[5][6][7]. In Portugal, a state of emergency was declared on March 18th, 2020, and stringent containment and mitigation measures were imposed, until May 2nd, 2020.…”