Diabetes care practices and outcomes in 40.000 children and adolescents with type 1 diabetes from the SWEET registry during the COVID-19 pandemic

•The COVID-19 pandemic led to significant changes in global care for pediatric type 1 diabetes.•We present diabetes outcomes in >40,000 youths with T1D from the international SWEET registry before and during the pandemic.•We evaluated trends in HbA1c and severe adverse events across a 4-year obse...

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Published in:Diabetes research and clinical practice 2023-08, Vol.202, p.110809-110809, Article 110809
Main Authors: Chobot, Agata, Lanzinger, Stefanie, Alkandari, Hessa, Todd Alonso, G., Blauensteiner, Nicole, Coles, Nicole, De Sanctis, Luisa, Mul, Dick, Saboo, Banshi, Smart, Carmel, Tsai, Meng-Che, Zabeen, Bedowra, Dovc, Klemen
Format: Article
Language:English
Subjects:
Children
Covid-19
Diabetes care
Diabetes ketoacidosis
HbA1c
Type 1 diabetes
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Summary:•The COVID-19 pandemic led to significant changes in global care for pediatric type 1 diabetes.•We present diabetes outcomes in >40,000 youths with T1D from the international SWEET registry before and during the pandemic.•We evaluated trends in HbA1c and severe adverse events across a 4-year observation period.•Changes in HbA1c and acute diabetes complications were consistent with shifts in provision of diabetes care.•There was a positive impact of transition to telemedicine on glycemic outcomes regardless of the increase in technology use. This study aimed to provide a global insight into initiatives in type 1 diabetes care driven by the COVID-19 pandemic and associations with glycemic outcomes. An online questionnaire regarding diabetes care before and during the pandemic was sent to all centers (n = 97, 66,985 youth with type 1 diabetes) active in the SWEET registry. Eighty-two responded, and 70 (42,798 youth with type 1 diabetes) had available data (from individuals with type 1 diabetes duration >3 months, aged ≤21 years) for all 4 years from 2018 to 2021. Statistical models were adjusted, among others, for technology use. Sixty-five centers provided telemedicine during COVID-19. Among those centers naive to telemedicine before the pandemic (n = 22), four continued only face-to-face visits. Centers that transitioned partially to telemedicine (n = 32) showed a steady increase in HbA1c between 2018 and 2021 (p 
ISSN:0168-8227
1872-8227
DOI:10.1016/j.diabres.2023.110809