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The effect of COVID-19 lockdown on the glycemic control of children with type 1 diabetes.
Hakonen, Elina; Varimo, Tero; Tuomaala, Anna-Kaisa; Miettinen, Päivi J; Pulkkinen, Mari-Anne.
  • Hakonen E; Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Stenbäckinkatu 9, HUS 00029, PO Box 347, Helsinki, Finland. elina.hakonen@helsinki.fi.
  • Varimo T; Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Stenbäckinkatu 9, HUS 00029, PO Box 347, Helsinki, Finland.
  • Tuomaala AK; Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Stenbäckinkatu 9, HUS 00029, PO Box 347, Helsinki, Finland.
  • Miettinen PJ; Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Stenbäckinkatu 9, HUS 00029, PO Box 347, Helsinki, Finland.
  • Pulkkinen MA; Pediatric Research Center, New Children's Hospital, Helsinki University Hospital, Stenbäckinkatu 9, HUS 00029, PO Box 347, Helsinki, Finland.
BMC Pediatr ; 22(1): 48, 2022 01 19.
Article in English | MEDLINE | ID: covidwho-1633014
ABSTRACT

BACKGROUND:

Between March 18th and May 13th 2020, the COVID-19 pandemic outbreak in Finland resulted in the closure of schools and the limitation of daycare (i.e. lockdown). Social distancing changed the daily routines of children with type 1 diabetes (T1D). Healthcare professionals were forced to adapt to the pandemic by replacing physical outpatient visits with virtual visits. However, the influence of the lockdown on glycemic control in these patients remained unknown.

METHODS:

In this retrospective register study from a pediatric diabetes outpatient clinic, we analyzed the glycemic data of T1D patients (n = 245; aged 4 to 16 years) before and under the lockdown. All the participants used continuous glucose monitoring (rtCGM or iCGM), two-thirds were on insulin pumps (CSII), and one-third on multiple daily insulin injections (MDI) therapy.

RESULTS:

In our patient cohort, time in range (TIR, n = 209) and mean glucose levels (n = 214) were similar prior to and under the lockdown (mean change 0.44% [95%CI -1.1-2.0], p = 0.56 and -0.13 mmol/mol [95%CI -0.3-0.1], p = 0.17, respectively). However, children treated with CSII improved their glycemic control significantly during the lockdown TIR improved on average 2.4% [0.6-4.2] (p = 0.010) and mean blood glucose level decreased -0.3 mmol/mol [-0.6-(-0.1)] (p = 0.008). The difference was more pronounced in girls, adolescents and patients using conventional insulin pumps.

CONCLUSIONS:

The glycemic control in T1D children did not deteriorate under the lockdown, and patients on CSII even improved their control, which suggests that social distancing might have allowed families to use the insulin pump more accurately as out-of-home activities were on hold.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 1 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Child / Female / Humans Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03115-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 1 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Child / Female / Humans Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03115-6