Real life experience 2 years after lockdown: coronavirus triggers video game addiction and worsen glycemic control in youth with type 1 diabetes

ABSTRACT

Introduction: COVID-19 pandemic and eventual lockdown gave a major boost to online heavy action gaming like PUBG. Adolescents are finding gaming the best avenue to connect and socialize with friends addressing their needs of human interaction and coping with the pandemic. Objective(s) This pilot study aimed to evaluate changes in glycemic control and the role of online gaming during the exceptional time of COVID-19 complete lockdown in a cohort of children with T1DM and 2 years after. Method(s) We evaluated children with T1DM on basal bolus regimen who were monitored using the FreeStyle Libre glucose monitoring system. Analysis were extracted from downloads and compared to timing after lockdown. Result(s) A 47 patients (39 males) with mean age 13.6 +/- 2.8 years and duration of diabetes (5.2 +/- 1.3 years) were followed up. The glycemic control was worse during than after lockdown mean glucose management indicator of 8.3% versus 7.2% (p = 0.001). There was higher time above range of 44%, lower time in range of 39% and time below range of 6% during quarantine than after (p < 0.001 for all). A significantly higher coefficient of variation (CV) indicating an increased glucose variability in the lockdown period compared to postlockdown was observed (42.6% vs. 37.2%, p = 0.011).Time spent playing online games occupied>=8 h daily in 73% together with decreased sleep duration. They had more snacking leading to increase insulin bolus by 32% (p = 0.002) and weight gain by 12% (p = 0.006). Conclusion(s) Glycemic controlin T1DM adolescents addicted to online gaming worsened during restrictions of COVID-19 pandemics. Maintaining regular physical activity in a safe home environment with dietary and insulin dose recommendations is an essential strategy for young individuals to better control glycemic excursusions. As we mark 2 years of the COVID-19 pandemic, a central pillar of building more attention to sedentary behavior and lifestyle factor management in patients with T1DM if unprecedented waves of the global pandemic hit and beyond.