Impact of COVID-19 lockdown on glucemic control in children and adolescents with type 1 diabetes mellitus

Background and aims: To face the rapid spread of SARS-CoV2 coronavirus pandemic, home lockdown in Spain was decreed on 15th March 2020. The main objective of this study is to evaluate the impact of this constraint on glycemic control in children and adolescents with type 1 diabetes mellitus (T1D). Patients and methods: Observational, retrospective study in children and adolescents with T1D users of interstitial glucose monitoring systems. The following information corresponding to the last 2 weeks of lockdown was collected for subsequent comparison with data of 2 weeks prior to quarantine: daily insulin needs, mean interstitial glucose, estimated HbA1c, coefficient of variation (CV), time in range (70–180 mg/dl), hypoglycemia (180 and> 250 mg/dl), sensor use and number of blood glucose measurements. Data about meal routines, physical exercise, need for adjustments in therapy, acute complications and lockdown of caregivers were assessed via a survey. Results: 80 patients were studied (mean age 12.61 ± 3.32 years, mean time of evolution of the disease 5.85 ± 3.92 years), 66.2% treated with an insulin pump, users of following glucose monitoring systems: Guardian 3 (65%), FreeStyle Libre (18.8%) and Dexcom G6 (16.2%). Time in range in the cohort increased significantly during confinement (72.1 ± 10.5 vs 74.8 ± 10.5%; P = 0.011) with lower time in hypoglycemia both 250 mg/dl (4.6 ± 3.9 vs 3.7 ± 3.7%; P = 0.038). CV also decreased (35.8 ± 6.3 vs 33.1 ± 6.1%; P 180 y >250 mg/dl), uso del sensor y número de glucemias capilares. Mediante encuesta se obtuvo información acerca de rutinas de ingesta, ejercicio físico, necesidad de ajustes en la terapia, complicaciones agudas surgidas y acompañamiento de los pacientes por sus cuidadores durante el confinamiento. Resultados: Se incluyeron 80 pacientes (edad media 12,61 ± 3,32 años, tiempo medio de evolución de la enfermedad 5,85 ± 3,92 años), 66,2% tratados con bomba de insulina, usuarios de los siguientes sistemas de monitorización: Guardian 3 (65%), FreeStyle Libre (18,8%) y Dexcom G6 (16,2%). El tiempo en rango en la cohorte se incrementó de forma significativa durante el confinamiento (72,1 ± 10,5 vs 74,8 ± 10,5%; p = 0,011) a expensas de una disminución del tiempo en hipoglucemia tanto 250 mg/dl (4,6 ± 3,9 vs 3,7 ± 3,7%; p = 0,038), reduciéndose también el CV (35,8 ± 6,3 vs 33,1 ± 6,1%; p