The impact of strict COVID-19 lockdown in Spain on glycemic profiles in patients with type 1 Diabetes prone to hypoglycemia using standalone continuous glucose monitoring (original) (raw)
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Diabetes Research and Clinical Practice, 2021
To assess the effects of lockdown due to COVID-19 pandemic on glucose metrics, measured by glucose monitoring systems, in adult individuals with type 1 diabetes. Methods: We conducted a systematic literature search for English language articles from MEDLINE, Scopus and Web of Science up to February 28, 2021, using ''diabetes", ''lockdown", and ''glucose" as key search terms. Time in range (TIR) was the main outcome; other metrics were time above range (TAR), time below range (TBR), mean blood glucose (MBG) and its variability (%CV), estimated HbA1c (eA1c) or glucose management indicator (GMI). Results: Seventeen studies for a total of 3,441 individuals with type 1 diabetes were included in the analysis. In the lockdown period, TIR 70-180 mg/dl increased by 3.05% (95% CI 1.67-4.43%; p < 0.0001) while TAR (>180 mg/dL and > 250 mg/dL) declined by 3.39% (À5.14 to À1.63%) and 1.96% (À2.51 to À1.42%), respectively (p < 0.0001 for both). Both TBR < 70 and <54 mg/dL remained unchanged. MBG slightly decreased by 5.40 mg/dL (À7.29 to À3.51 mg/dL; p < 0.0001) along with a reduction in %CV. Pooled eA1c and GMI decreased by 0.18% (À0.24 to À0.11%; p < 0.0001) and a similar reduction was observed when GMI alone was considered (0.15%, À0.23 to À0.07%; p < 0.0001). Sensor use was only slightly but not significantly reduced during lockdown. Conclusions: This meta-analysis shows that well-controlled people with type 1 diabetes on both MDI and CSII with continuous or flash glucose monitoring did not experience a deterioration in glucose control throughout the COVID-19 lockdown, showing a modest, though statistically significant improvement in many glucose control parameters.
The impact of lockdown caused by the COVID-19 pandemic on glycemic control in patients with diabetes
Endocrine
Purpose The aim the study was to assess the impact of the lockdown due to COVID-19 on diabetes control. Methods The HbA1c value from a pre-lockdown visit (V1) from patients with diabetes was compared to the lockdown visit one (V2) after 3–5 months of its duration. Additional information on how the HbA1c changed and which variables can modify HbA1c during lockdown was also studied. Results Records from 65 patients (type 2 diabetes −96,9%) were eligible and revealed that: HbA1c was at the target in 60% of the patients at V2 compared to 40% at V1; HbA1c decreased and normalized in 19, but worsened in 4 participants during the lockdown. No impact on HbA1c of: sex, age, diabetes duration, therapy type and modification before the pandemic, abandonment of the treatment, previous problems with glycemic control, or change in body weight and physical activity during the lockdown, was found. The previous macrovascular complications were the only variable that affected the increase in HbA1c (p ...
Diabetes, Obesity and Metabolism, 2021
Aim: To assess the effect of the coronavirus disease 2019 (COVID-19) lockdown on glycaemic control in subjects with type 2 diabetes (T2D). Materials and Methods: In this observational, multicentre, retrospective study conducted in the Lazio region, Italy, we compared the differences in the HbA1c levels of 141 subjects with T2D exposed to lockdown with 123 matched controls with T2D who attended the study centres 1 year before. Basal data were collected from 9 December to 9 March and follow-up data from 3 June to 10 July in 2020 for the lockdown group, and during the same timeframes in 2019 for the control groups. Changes in HbA1c (ΔHbA1c) and body mass index (ΔBMI) during lockdown were compared among patients with different psychological wellbeing, as evaluated by tertiles of the Psychological General Well-Being Index (PGWBS). Results: No difference in ΔHbA1c was found between the lockdown and control groups (lockdown group −0.1% [−0.5%−0.3%] vs. control group −0.1% [−0.4% −0.2%]; p = .482). Also, no difference was found in ΔBMI (p = .316) or ΔGlucose (p = .538). In the lockdown group, subjects with worse PGWBS showed a worsening of HbA1c (p = .041 for the trend among PGWBS tertiles) and BMI (p = .022). Conclusions: The COVID-19 lockdown did not significantly impact glycaemic control in people with T2D. People with poor psychological well-being may experience a worsening a glycaemic control because of restrictions resulting from lockdown. These findings may aid healthcare providers in diabetes management once the second wave of COVID-19 has ended.
Journal of Nepal Medical Association
Introduction: Lockdown enforced to control the rapid transmission of novel coronavirus has resulted in the confinement of people in the home and restrictions of movement. This may have altered the lifestyle and glycemic control of type 2 diabetes mellitus patients. This study aimed to find the prevalence of poor glycemic control in type 2 diabetes mellitus patients in two tertiary care centres during COVID-19 lockdown. Methods: A descriptive cross-sectional study was conducted among 259 type 2 diabetes mellitus patients in selected hospitals from 1st September to 30th September 2020 after receiving ethical approval from the Departmental Research Unit, Biochemistry under Institutional Review Committee (Reference number: DRU/01/2020). A convenience sampling method was used. Data analysis was done by using Statistical Package for the Social Sciences version 26.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among...
Impact of lockdown in COVID 19 on glycemic control in patients with type 1 Diabetes Mellitus
Diabetes & Metabolic Syndrome: Clinical Research & Reviews
Background and aims: COVID 19 is a novel pandemic affecting globally. Although no reliable data suggests that patients of well controlled Type 1 Diabetes Mellitus (T1DM) being at increased risk of becoming severely ill with SARS-CoV2, but lockdown may impact patients with T1DM requiring regular medications and follow up. Hence this study was planned to see the impact of lockdown on glycemic control in patients with T1DM. Methods: A cross sectional study was done in T1DM patients in whom a structured questionnaire was administered on follow up within 15 days after lockdown. Data regarding hypoglycemic and hyperglycemic episodes, Diabetic ketoacidosis (DKA), insulin dose missed, regular glucose monitoring, dietary compliance, physical activity, hospitalization during the phase of lockdown was taken. Average blood glucose and HbA1C of lockdown phase was compared with the readings of prelockdown phase. Results: Out of 52 patients, 36.5% had hyperglycemic and 15.3% had hypoglycemic episodes. Insulin dose was missed in 26.9%, glucose monitoring not done routinely in 36.5% and 17.4% were not diet compliant during lockdown. Average blood glucose during lockdown phase was 276.9 ± 64.7 mg/dl as compared to 212.3 ± 57.9 mg/dl during prelockdown phase. Mean HbA1c value of lockdown (10 ± 1.5%) which was much higher that of pre lockdown (8.8 ± 1.3%) and the difference was statistically significant (p < 0.05). Conclusion: Glycemic control of T1DM patients has worsened mainly due to non availability of insulin/ glucostrips during lockdown period. There is a need for preparedness in future so that complications can be minimised.
Diabetologia, 2020
To the Editor: We welcome the letters by Sardu et al [1] and Lepper et al [2] on our paper entitled 'Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study' [3]. Sardu et al found that the change in blood glucose concentration between admission and 24 h was associated with coronavirus disease-2019 (COVID-19) outcome in 132 Italian hyperglycaemic (i.e. blood glucose >7.7 mmol/l on admission) patients hospitalised for both severe and non-severe disease [1]. In addition, Lepper et al reported data on an impressive cohort of nearly 7000 patients with community-acquired pneumonia (CAP) and A complete list of the CORONADO trial investigators is provided in the Electronic supplementary material (ESM).
Frontiers in Endocrinology, 2021
ImportanceThere is no consensus on the impact of the 2020 COVID-19 pandemic lockdown on glycemic control in children and adolescents with type 1 diabetes (T1D) in the US.AimTo determine the impact of the pandemic lockdown of March 15th through July 6th, 2020 on glycemic control after controlling for confounders.Subjects and MethodsAn observational study of 110 subjects of mean age 14.8 ± 4.9 years(y), [male 15.4 ± 4.0y, (n=57); female 14.1 ± 3.8y, (n=53), p=0.07] with T1D of 6.31 ± 4.3y (95% CI 1.0-19.7y). Data were collected at 1-4 months before the lockdown and 1-4 months following the lifting of the lockdown at their first post-lockdown clinic visit.ResultsThere was no significant change in A1c between the pre- and post-pandemic lockdown periods, 0.18 ± 1.2%, (95% CI -0.05 to 0.41), p=0.13. There were equally no significant differences in A1c between the male and female subjects, -0.16 ± 1.2 vs -0.19 ± 1.2%, p=0.8; insulin pump users and non-pump users, -0.25 ± 1.0 vs -0.12 ± 1.4...
Int J DiabetesDevCtriesOct , 2020
Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. However, the effect of COVID- 19 lockdown on physical activity and glycemic control in such individuals is not known. We studied the physical activity and glycemic control during lockdown in comparison to pre-lockdown parameters in individuals with long-standing type 2 diabetes. Methods This prospective, observational study includes 2240 people with T2DM regularly attending diabetes clinic prior to lockdown. Glycemic record, HbA1c, and physical activity assessed with Global Physical Activity Questionnaire (GPAQ) as metabolic equivalents (MetS min/week) were obtained during lockdown (minimum duration of 3 months). Results A total of 422 out of 750 participants (nest) responded. The median (IQR) for age was 58 (52 to 64) years, duration of diabetes 11 (6 to 16) years, prevalent foot complications in 59.7%, and atherosclerotic cardiovascular disease in 21.3% of participants. There was a decrease in HbA1c from 7.8% (6.9 to 9.4) prior lockdown to 7.4% (6.6 to8.7) during lockdown [ΔHbA1c − 0.41 ± 0.27% (p = 0.005)] and postprandial blood glucose 200.0 mg/dl (152.0 to 252.0) to 158.0 (140.0 to 200.0) mg/dl (p < 0.001). The physical activity increased during lockdown from a GPAQ score 140 (0.0 to 1260) MetS to 840 (0.0 to 1680)MetS (p = 0.014). The improvement of glycemic control was observed in either gender and independent of the presence of foot complications or increase in physical activity. Conclusions There is an overall improvement of glycemic control during COVID-19 lockdown independent of increase in physical activity in people with long duration of diabetes. Keywords COVID-19 . Glycemic control . HbA1c . Global Physical Activity Questionnaire (GPAQ) . Physical activity
Type 1 diabetes and COVID-19: The “lockdown effect”
Diabetes Research and Clinical Practice, 2020
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, P 0), 2 weeks immediately after the lockdown (period 1, P 1), in mid-lockdown (Period 2, P 2) and immediately after end of lockdown (Period 3, P 3) 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 P 1 (62%), P 2 (61%) and P 3 (62%) as compared to P 0 (58%, all p < 0.05 or less) with concomitant reduction in the Time Above Range (P 0 : 38%; P 1 : 34%, P 2 : 34%, P 3 : 32%, all p < 0.05 or less vs. P 0). Average glucose and GMI improved achieving statistical difference in P 3 (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 workrelated distress.
Impact of the Covid-19 Pandemic on Blood Glucose Management in Diabetes Mellitus Patients
2021
The COVID-19 pandemic increases the risk of mortality and morbidity in patients with diabetes mellitus. This is due to the implementation of social restriction policies that can change patterns of physical activity, food consumption, psychological pressure, and medical history which will affect blood glucose management compliance in patients with DM. The purpose of this study was to determine the impact of the COVID-19 pandemic on blood glucose management in patients with DM. This study was literature review by searching four databases (Pubmed, Science direct, Microsoft Academic, and Wiley) for searches of past research on the same theme published in 2020-2021. The prism checklist is used as a protocol and evaluation, and critical appraisal is used to test the feasibility of the study results to be used. 12 articles were found that met the inclusion criteria. The results of the study consisted of case control, cohort, and cross sectional research with the total number of participant...