Has COVID-19 lockdown improved glycaemic control in pediatric patients with type 1 diabetes? An analysis of continuous glucose monitoring metrics

• Published in: Diabetes research and clinical practice 2021-08, Vol.178, p.108988-108988, Article 108988
• Main Authors: Lombardo, Fortunato, Salzano, Giuseppina, Bombaci, Bruno, Basile, Pietro, Lucania, Giovanni, Alibrandi, Angela, Passanisi, Stefano
• Format: Article
• Language: English
• Subjects: Adolescence; Adolescent; Ambulatory glucose profile; Benchmarking; Blood Glucose; Blood Glucose Self-Monitoring; Child; Child, Preschool; Children; Communicable Disease Control; COVID-19; Diabetes Mellitus, Type 1 - drug therapy; Female; Glycemic Control; Humans; Hybrid closed loop; Hypoglycemic Agents - therapeutic use; Male; Pandemic; Time in range
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2021.108988

Our observational study aimed to evaluate the impact of the lockdown period due to 2019 Coronavirus disease pandemic on glycaemic control in a cohort of paediatric patients with type 1 diabetes (T1D). Eighty-five patients with T1D aged 5–18 years using continuous glucose monitoring (CGM) systems were enrolled. Demographic and clinical data, including glucose metrics generated by CGM-specific web-based cloud platforms, were collected in three different periods (pre-lockdown phase, lockdown phase, and post-lockdown phase) of 90 days each and were statistically analysed. During the lockdown period, a clear improvement in almost all CGM metrics (time in range, time above range, coefficient of variation, and glucose management indicator) was observed in our study population, regardless of age and insulin type treatment. In the months following lockdown, maintaining satisfactory diabetes outcomes was confirmed only in younger patients (aged 5–9 years) and in those individuals on hybrid closed loop therapy. The increasing use of innovative technological devices together with data sharing systems and interaction with multidisciplinary diabetes team through telemedicine allowed paediatric patients with T1D to improve glucose metrics during the lockdown period. However, our findings showed that the achievement of better glycaemic control was transient for most patients.