Abstract
BackgroundWith the onset of the COVID-19 pandemic and state-mandated school closures in the spring of 2020, the management of type 1 diabetes in children underwent significant changes. The aim of our study was to assess the effect of stay-at-home orders on glycemic control in children.MethodsWe conducted a retrospective review of 238 children with type 1 and type 2 diabetes who were seen in the Pediatric Endocrinology Clinic at the University of South Alabama. Average Hemoglobin A1c (A1c) levels in the year prior to stay-at home orders (May 2019–April 2020) were compared with A1c values during the quarantine period (May 2020–July 2020) using a paired t-test. We also analyzed the change of A1c level with respect to sex, race, type of diabetes, type of insurance, and mode of insulin administration, using a 2-sample t-test.ResultsThe average A1c significantly increased from 9.2% during the previous year to 9.5% during the quarantine period (p = 0.0097). The increase of A1c was significantly higher in public insurance patients (0.49% increase) compared to private insurance patients (0.03% increase), (p = 0.0137). We also observed a significant association between the direction of change and type of insurance. Forty-eight percent of public insurance patients had an A1c increase of > 0.5% while 54% of private insurance patients had no change or decrease in A1c (p = 0.0079).ConclusionsThe COVID-19 pandemic resulted in worsening glycemic control in children with type 1 diabetes, with those on public insurance affected in greater proportion than those with private insurance.
Highlights
With the onset of the COVID-19 pandemic and state-mandated school closures in the spring of 2020, the management of type 1 diabetes in children underwent significant changes
Demographic data was collected on each patient from the medical records including sex, age, race, type of insurance, and mode of insulin administration (insulin pump vs multiple daily injections (MDI))
Our study shows that glycemic control in children with Type 1 Diabetes worsened during the initial quarantine period of the COVID-19 pandemic, with children on public insurance affected in greater proportion than those with private insurance
Summary
With the onset of the COVID-19 pandemic and state-mandated school closures in the spring of 2020, the management of type 1 diabetes in children underwent significant changes. The aim of our study was to assess the effect of stay-at-home orders on glycemic control in children. Type 1 Diabetes is a chronic illness that requires constant attention and monitoring. Parents and school nurses play a critical role in helping these children maintain control of their diabetes [1]. If diabetes control is not regulated during the childhood years, these children are at risk of developing complications later in life [2]. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, called COVID-19) was introduced to The United States of America in early 2020, causing widespread illness [3]. State governors started issuing state-wide mandates to
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