844-P: Impact of Hypoglycemic Awareness on Diabetes Care during the SARS CoV Pandemic

Abstract

A recent report by Potier et al found that patients with T1DM had improved glycemic control during the pandemic, possibly due to changes in behavioral and lifestyle patterns. However, very little is known regarding how patients with normal hypoglycemia unawareness (NAH) or impaired awareness (IAH) have responded to changes in diabetes management during the pandemic. Fifteen participants with T1DM from the Greater New Haven area participated in this study, which is part of a larger ongoing clinical study. Participants completed questionnaires measuring awareness (Clarke Score), current quality of diabetes care (Diabetes Treatment Satisfaction), and symptom severity (Hypo AQ) twice, pre-pandemic (prior to March 2020) and during pandemic (September to November 2020). Nine individuals had NAH (3F/6M, Clarke mean 1.00 ± SEM 0.4, age 32 ± 12 yrs, A1C 8.2 ± 1.3%, BMI 24.7 ± 4.7) and six had IAH, (4F/2M, Clarke 4.33 ± .3, age 39 ± 14, A1C 7.3 ± 0.9%, BMI 30.1 ± 7.4). There were no significant demographic differences between groups except for Clarke score. Among IAH patients, symptom severity (pre: 13.8 ± 0.910, during: 11.50 ± 0.957, p = 0.04) and treatment satisfaction (pre: 26.17 ± 1.99, during: 31.33 ± 1.542, p = 0.013) were significantly improved during the pandemic. Self-reported frequency of hypoglycemic episodes was unchanged (p = 0.741). In contrast, among NAH participants, there were no changes in severity of symptoms (p = 0.822), satisfaction of treatment (p = 0.407), or frequency of hypoglycemic episodes (p = 1.000). Our results indicate that pandemic associated changes in diabetes care and management had differential effects on patients with and without hypoglycemic unawareness. Further studies to identify the specific factors driving these differences will be beneficial to improving the clinical care of patients with IAH. Disclosure C. Watt: None. M. Knight: None. E. Sanchez rangel: None. F. Gunawan: None. J. J. Hwang: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (DK020495)