Type 1 diabetes and COVID-19: The "lockdown effect". (December 2020)

• Record Type: Journal Article
• Authors: Aragona, Michele; Rodia, Cosimo; Bertolotto, Alessandra; Campi, Fabrizio; Coppelli, Alberto; Giannarelli, Rosa; Bianchi, Cristina; Dardano, Angela; Del Prato, Stefano
• Is Part Of: Diabetes research and clinical practice. Volume 170(2020)
• Publication Date: 2020-12
• Subjects: COVID-19 -- Type 1 diabetes -- Flash glucose monitoring, continuous glucose monitoring -- Lockdown -- Time in range -- Time above range -- Time below range; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108468
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: The aim of this study was to evaluate the effect the lockdown imposed during COVID-19 outbreak on the glycemic control of people with Type 1 diabetes (T1D) using Continuous (CGM) or Flash Glucose Monitoring (FGM). Materials and methods: We retrospectively analyzed glucose reading obtained by FGM or CGM in T1D subjects. Sensor data from 2 weeks before the lockdown (Period 0, P0 ), 2 weeks immediately after the lockdown (period 1, P1 ), in mid-lockdown (Period 2, P2 ) and immediately after end of lockdown (Period 3, P3 ) were analyzed. Results: The study included 63 T1D patients, (FGM: 52, 82%; CGM:11, 18%). Sensor use (91%) were slightly reduced. Despite this reduction, Time in Range increased in P1 (62%), P2 (61%) and P3 (62%) as compared to P0 (58%, all p < 0.05 or less) with concomitant reduction in the Time Above Range (P0 : 38%; P1 : 34%, P2 : 34%, P3 : 32%, all p < 0.05 or less vs. P0 ). Average glucose and GMI improved achieving statistical difference in P3 (165 vs . 158 mg/dl, p = 0.040 and 7.2% (55 mmol/mol) vs . 7.0% (53 mmol/mol), p = 0.016) compared to P0. Time Below Range (TBR) and overall glucose variability remained unchanged. Bi-hourly analysis of glucose profile showed an improvement particularly in the early morning hours. Conclusions: In T1D subjects with good glycemic control on CGM or FGM, the lockdown had no negative impact. Rather a modest but significant improvement in glycemic control has been recorded, most likely reflecting more regular daily life activities and reduces work-related distress.