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Glycaemic Control Assessment of Paediatric T1dm Patients Throughout the Covid-19 Pandemic between 2019 and 2021 in a District General Hospital
Archives of Disease in Childhood ; 107(Supplement 2):A272-A273, 2022.
Article in English | EMBASE | ID: covidwho-2064034
ABSTRACT
Aims Our aim is to assess whether Covid-19 had an overall impact on diabetic control within the paediatric type 1 diabetic population who attend Causeway Hospital. We retrospectively compared baseline HbA1cs of patients between the years 2019 - 2021 to assess for change in the mean HbA1c throughout all paediatric T1DM patients as well as to compare patients with and without an insulin pump. We planned to retrospectively assess the percentage of newly diagnosed diabetic patients who were in DKA on initial presentation. Finally, we wanted to assess HbA1c control of patients with a libre 2 sensor to assess whether patients who scanned more frequently have better overall HbA1c and/or time in target glucose range. Methods NIECR, TWINKLE and LIBREVIEW systems were used to collect data from all Causeway diabetic patients from 2019-2021 to compare HbA1c, number of libre scans and data including whether patients presented in DKA. For data collected on patients with a libre sensor - this was analysed using an unpaired t-test and a p-value subsequently calculated to assess statistical significance. Results In total data was collected from 92 patients throughout the years 2019 - 2021. The median HbA1c of all T1DM patients increased from 65.2 in 2019 to 65.7 in 2020 then improved in 2021 to 64.07mmol/mol. In 2020, there were fewer overall patients with a new diagnosis of T1DM (n=8) compared with 2019 (n=11) and 2021 (n=11). In 2020 37.5% of newly diagnosed patients were in DKA on initial presentation compared with 18% in 2019 and 27% in 2021. Total number of T1DM patients with an HbA1c <48 was 5.6% in 2019, 3.8% in 2020 and 11.8% in 2021. Mean HbA1c from all T1DM patients increased from 65.24mmol/mol in 2019 to 65.72mmol/mol in 2020 and improved to 64.08mmol/mol in 2021. Mean HbA1c in T1DM patients with an insulin pump also increased from 57.76mmol/ mol in 2019 to 59.63mmol/mol in 2020 and improved to 57.56mmol/mol in 2021. In patients with a libre 2 sensor, percentage time within target glucose range (3.9-10mmol/L) increased from 31.25% in those who scanned <4 times/day(n=12) to 59.44% in those who scanned >12 times/day(n=18) resulting in a pvalue of 0.0001. In patients with a libre 2 sensor, mean HbA1c values in those who scanned <4 times per day was 76.5 compared to 55mmol/mol for patients who scanned >12/day resulting in a p-value of 0.0003. Conclusion Throughout all T1DM paediatric patients, we noted an increased HbA1c in 2020 and an improvement in 2021. There was also an increase in incidence of DKA at presentation in newly diagnosed patients who presented in 2020 compared to 2019/2021. Our patients with an insulin pump had better overall HbA1c control than those who self-inject. Patients with a libre 2 sensor who scan more frequently are more likely to have an increased amount of time within the target glucose range of 3.9-10mmol/L and are more likely to have a lower HbA1c.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study Language: English Journal: Archives of Disease in Childhood Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study Language: English Journal: Archives of Disease in Childhood Year: 2022 Document Type: Article