Abstract
Background/ObjectiveTo minimize the wide spread of coronavirus disease (COVID-19) pandemic, Italy was placed in an almost complete lockdown state that forced people to “stay at home”. Aim of this study was to evaluate the effects of lockdown on glycemic control in children and adolescents with type 1 diabetes (T1D) followed through telemedicine.Subjects/MethodsThis observational study involved patients with T1D using the real-time continuous glucose monitoring (CGM) Dexcom G6®. Ambulatory glucose profile data from the 3-months before schools closure (November 26, 2019–February 23, 2020; T0) and from the 3-months of consecutive lockdown (February 24–May 18, 2020; T1) were compared.ResultsSixty-two children and adolescents (11.1 ± 4.37 years, 50% males) with T1D (median time disease 3.67 years) were enrolled in the study. Insulin total daily dose was unchanged, while time spent on physical activities was decreased (p<0.0001). Despite the lack of statistical significance, median value of the glucose management indicator decreased from 7.4% to 7.25%. Glucose standard deviation (p<0.0001) and coefficient of variation (p=0.001) improved across the study. Median time in range increased from 60.5% to 63.5% (p=0.008), time above range decreased from 37.3% to 34.1% (p=0.048), and time below range decreased from 1.85% to 1.45% (p=0.001).ConclusionsOverall, in our children and adolescents with T1D glycemic control improved during lockdown. Despite patients were confined to their homes and limited to exercise, our data suggest that the use of real-time CGM, the continuous parental management, and the telemedicine can display beneficial effects on T1D care.
Highlights
On January 9, 2019, the Chinese Center for Disease Control and Prevention reported the new strain of coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), as the causative agent of the coronavirus disease-2019 (COVID-19) that from China spread worldwide in few months [1]
Subjects were enrolled among children and adolescents with type 1 diabetes (T1D) followed at the Pediatric Diabetes Clinic of the University of Modena and Reggio Emilia that belongs to the public National Health System (NHS) and is the only provincial referral Center for the diabetes care of patients aged ≤18 years
Aspart insulin was used in all durable devices, while lispro was used in patch pumps
Summary
On January 9, 2019, the Chinese Center for Disease Control and Prevention reported the new strain of coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), as the causative agent of the coronavirus disease-2019 (COVID-19) that from China spread worldwide in few months [1]. The World Health Organization (WHO) on March 11, 2020 declared COVID-19 a pandemic health emergency [2]. At time of this paper submission, 21.516.760 cases of COVID-19 have been confirmed all over the world, including 766.663 deaths, as reported by the WHO [3]. Was the first EU country to be affected by the COVID-19 outbreak and the first autochthonous case was confirmed on February 21, 2020 in Codogno (Lodi, Lombardia). 253.915 total cases of COVID-19 with 35.396 (13.9%) deaths have been confirmed in Italy [4] and in our Region (Emilia-Romagna), one of the most affected by COVID-19, the latest data update reported 29.575 cases, including 4.286 deaths. One thousand and nine (3.4%) of confirmed cases were in young people (≤19 years old) and among these no death was recorded [5]
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