Abstract
AimsMalaysia implemented nationwide lockdown from 18th March till 3rd May 2020 to mitigate the spread of coronavirus disease (COVID-19). This study aimed to examine the impact of the lockdown on glycaemic control and lifestyle changes in children and adolescents with type 1 (T1DM) and 2 diabetes mellitus (T2DM) aged less than 18 years old.MethodsIn this cross-sectional study, interviews and a standardised questionnaire comparing lifestyle changes before and during the lockdown were performed in follow-up clinic visits after the lockdown. Anthropometry measurements and glycated haemoglobin (HbA1c) values were compared 3 months prior and after the lockdown.ResultsParticipants were 93 patients with T1DM (11.08 ± 3.47 years) and 30 patients with T2DM (13.81 ± 2.03 years). Male gender, T2DM and pubertal adolescents were found to have a significant deterioration in glycaemic control. A significant increment of HbA1c was observed in patients with T2DM (8.5 ± 0.40 vs 9.9 ± 0.46%), but not in patients with T1DM (8.6 ± 0.28 vs 8.7 ± 0.33%). Contrarily, there was an improved glycaemic control in pre-pubertal T1DM children likely due to parental supervision during home confinement. Weight and BMI SDS increased in T1DM patients but surprisingly reduced in T2DM patients possibly due to worsening diabetes control. Reduced meal frequency mainly due to skipping breakfast, reduced physical activity level scores, increased screen time and sleep duration were observed in both groups.ConclusionsAdverse impact on glycaemic control and lifestyle were seen mostly in patients with T2DM and pubertal adolescent boys.
Highlights
The catastrophic outbreak of novel severe acute respiratory syndrome coronavirus 2 in Wuhan City, China in December 2019, has spread globally within months and was declared a pandemic since March 2020 by the World Health Organization
In the effort to increase social distancing and to mitigate the spread of COVID-19, the total nationwide lockdown known as the Movement Control Order (MCO) was implemented in Malaysia from 18th March until 3rd May 2020
All participants with T1DM was on multiple daily insulin injections, except for six patients (6.5%) who were on continuous subcutaneous infusion insulin pump therapy
Summary
The catastrophic outbreak of novel severe acute respiratory syndrome coronavirus 2 in Wuhan City, China in December 2019, has spread globally within months and was declared a pandemic since March 2020 by the World Health Organization. In the effort to increase social distancing and to mitigate the spread of COVID-19, the total nationwide lockdown known as the Movement Control Order (MCO) was implemented in Malaysia from 18th March until 3rd May 2020. Schools were closed and all non-essential businesses, outdoor sports, leisure activities, travel between states and districts were restricted. This was followed by a partial lockdown with gradual lifting of restrictions in phases, known as the Conditional Movement Control Order (CMCO) from 4th May until 9th. June 2020 and Recovery Movement Control (RMCO) from 10th June until 31st March 2021. During the CMCO and RMCO, more shops were allowed to open, travel restriction and schools closure remained
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