Impact of COVID-19 lockdown on glycemic control in patients with type 1 diabetes

Abstract

Introduction: The COVID-19 pandemic has forced governments to take exceptional measures to minimize its spread, imposing lockdown policies. The aim of this study was to evaluate the impact of lockdown on type 1 diabetes (T1D) glycemic control.

Material and methods: People with T1D using flash glucose monitoring were included. Data from the 14 days before lockdown were compared with data from the last 14 days after 8 weeks of lockdown.

Results: A total of 307 patients were included (age 45.8 ± 12.6 years, 50.2% male, diabetes duration 21.1 ± 12.3 years). Only one patient had COVID-19 infection. Mean glucose decreased from 166.89 ± 29.4 to 158.0 ± 29.0 mg/dL and estimated HbA1c declined from 7.4 ± 1.0 to 7.1 ± 1.0% (54 ± 10.9 vs 57 ± 10.9 mmol/mol; p < 0.001). Time in range increased from 57.8 ± 15.8 to 62.46 ± 16.1%. Time in hyperglycemia > 180 mg/dL and >250 mg/dL decreased from 37.3 ± 1.9% to 32.0 ± 17.1% and from 13.0 ± 11.3 to 10.3 ± 10.6%, respectively; (p < 0.001). Time in hypoglycaemia <70 mg/dL increased from 4.9 ± 4.0% to 5.5 ± 4.4% (p < 0.001). No differences in time <54 mg/dl, coefficient of variation (CV%) or number of scans per day were found.

Conclusion: Despite the limitations of lockdown, glycemic control improved in patients with T1D. These results suggest that having more time for self-management may help improve glycemic control in the short term.

Keywords: COVID-19; Continuous glucose monitoring; Flash glucose monitoring; Hypoglycemia; Time in range; Type 1 diabetes.

Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘Elsa Fernandez has served as a consultant for, or received research support or lecture fees from Novo Nordisk. Alicia Cortazar has served as a consultant for, or received research support or lecture fees from Eli Lilly. Virginia Bellido has served as a consultant for, or received research support, lecture fees from Abbott, Sanofi Aventis, Novo Nordisk, Eli Lilly, MSD, Boehringer Ingelheim, Esteve, Novartis, and Astra Zeneca’.

Copyright © 2020 Elsevier B.V. All rights reserved.

Figures

Fig. 1

Comparison of times in ranges, eHbA1c and CV baseline (14 days before lockdown: PRE) and after 8 weeks of lockdown (the last 14 days: POST), according to baseline eHbA1c.