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The impact of a prolonged lockdown and use of telemedicine on glycemic control in people with type 1 diabetes during the COVID-19 outbreak in Saudi Arabia.
Alharthi, Sahar K; Alyusuf, Ebtihal Y; Alguwaihes, Abdullah M; Alfadda, Assim; Al-Sofiani, Mohammed E.
  • Alharthi SK; Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • Alyusuf EY; Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • Alguwaihes AM; Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • Alfadda A; Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • Al-Sofiani ME; Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, Baltimore, MD, United States; Strategic Center for Diabetes Research, College of Medicine,
Diabetes Res Clin Pract ; 173: 108682, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1062309
ABSTRACT

BACKGROUND:

To minimize the spread of Coronavirus Disease-2019, Saudi Arabia imposed a nationwide lockdown for over 6 weeks. We examined the impact of lockdown on glycemic control in individuals with type 1 diabetes (T1D) using continuous glucose monitoring (CGM); and assessed whether changes in glycemic control differ between those who attended a telemedicine visit during lockdown versus those who did not. MATERIALS AND

METHODS:

Flash CGM data from 101 individuals with T1D were retrospectively evaluated. Participants were categorized into two groups Attended a telemedicine visit during lockdown (n = 61) or did not attend (n = 40). Changes in CGM metrics from the last 2 weeks pre-lockdown period (Feb 25 - March 9, 2020) to the last 2 weeks of complete lockdown period (April 7-20, 2020) were examined in the two groups.

RESULTS:

Those who attended a telemedicine visit during the lockdown period had a significant improvement in the following CGM metrics by the end of lockdown Average glucose (from 180 to 159 mg/dl, p < 0.01), glycemic management indicator (from 7.7 to 7.2%, p = 0.03), time in range (from 46 to 55%, p < 0.01), and time above range (from 48 to 35%, p < 0.01) without significant changes in time below range, number of daily scans or hypoglycemic events, and other indices. In contrast, there were no significant changes in any of the CGM metrics during lockdown in those who did not attend telemedicine.

CONCLUSIONS:

A six-week lockdown did not worsen, nor improve, glycemic control in individuals with T1D who did not attend a telemedicine visit. Whereas those who attended a telemedicine visit had a significant improvement in glycemic metrics; supporting the clinical effectiveness of telemedicine in diabetes care.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Blood Glucose / Communicable Disease Control / Telemedicine / Diabetes Mellitus, Type 1 / Glycemic Control / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Female / Humans / Male / Young adult Country/Region as subject: Asia Language: English Journal: Diabetes Res Clin Pract Journal subject: Endocrinology Year: 2021 Document Type: Article Affiliation country: J.diabres.2021.108682

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Blood Glucose / Communicable Disease Control / Telemedicine / Diabetes Mellitus, Type 1 / Glycemic Control / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Female / Humans / Male / Young adult Country/Region as subject: Asia Language: English Journal: Diabetes Res Clin Pract Journal subject: Endocrinology Year: 2021 Document Type: Article Affiliation country: J.diabres.2021.108682