93-LB: Comparison of Glycemic Control between Multiple Daily Injections and Hybrid Closed-Loop System in Children and Adolescents during the Restrictions Due to COVID-19

Abstract

Introduction: The COVID-19 pandemic forced health authorities to issue restrictive measures on daily activities from March 12th to June 15th, 2020 (‘lockdown’) in Qatar, which may have influenced the glycemic control in patients with type 1 diabetes (T1D). The aims of the study was to evaluate glycemic control between Multiple Daily Injections (MDI) and Hybrid Closed Loop (HCL) system in children and adolescent with T1D during the lockdown. Methods: This single-center analysis included 168 patients with T1D, using MDI or HCL system MiniMed 670G (Medtronic, Northridge, USA) at least 3 months before the study. Glycemic control from face-to-face visits, three months before lockdown were analyzed and compared to face to face or remote visits during the lockdown of 3 months. Data was collected through the electronic medical record system and reports generated by Carelink Therapy Management Software. HbA1c, glucose and insulin data were analyzed before and 3 months after restrictions. Results: Patients were analyzed in two groups: 1) 92 patients (age 12.4±3.1 years, female:51) on MDI and 2) 76 patients (age 11.2±2.6 years, female:36) HCL system. HbA1c in patients on MDI increased from 8.3±1.5% (67±16.4 mmol/mol) before lockdown to 8.9±1.7% (74±18.6 mmol/mol) during the lockdown, compared to patients on HCL system, where HbA1c remained stable (7.0±0.9% (53±9.8 mmol/mol) to 7.1±1.2% (54±13.1mmol/mol) respectively). No significant difference on DKA events were found in MDI group, before and after lockdown, while no DKA was noted in HCL group during the study. No severe hypoglycemia was observed in both groups. Remote visits were 54% in patients on HCL system, compared to 38% in patients on MDI during the lockdown. Conclusion: Children and adolescents using HCL system maintained stabile glycemic control during the lockdown compared to patient on MDI, where the glycemic control deteriorated. Disclosure G. Petrovski: None. J. Campbell: None. K. Hussain: None. Alkhalaf and consultants/educators: n/a.