Auxological data and glycemic control in children and adolescents with type 1 diabetes 2-years after the COVID-19 pandemic

ABSTRACT

Introduction: Since the beginning of the coronavirus disease 2019, (COVID-19) pandemic concerns for consequences on auxological data and glycemic control in patients with type 1 diabetes (T1D) were raised. Objective(s) To investigate the 2-years effects of the COVID-19 pandemic on body mass index (BMI) and glycemic control in children and adolescents with T1D. Method(s) Data on type and number of annual visit, auxological parameters [height (Ht), weight, and waist circumference (W)], insulin total daily dose (TDD), glycemic control (HbA1c), and weekly physical activity were collected during the annual routine outpatient visit between Dec 2021-Feb 2022 (T2) and were compared with those during the same period in 2019-20 (T0;before lockdown) and in 2020-21 (T1). Result(s) A 83 children and adolescents with T1D [65% male;median age 14.3 years (range 6.3-18.5);T1D duration 7.09 years (range 2.9-16.3)] were enrolled. The annual number of outpatient visits decreased (4 vs. 3 vs. 3;chi2 = 74.2;p < 0.0001), while frequency of patient using telemedicine increased (0 vs. 55.4 vs. 33.7%;chi2 = 48.1;p < 0.0001). BMI z-score significantly changed between periods, remaining within normal range values (0.19 vs. 0.08 vs. 0.23 SDS;chi2 = 15.9;p < 0.001). Height and WHt ratio were comparable. Physical activity was significantly different between periods (4 vs. 0 vs. 5 h/week;chi2 = 128.4;p < 0.0001) as well as insulin TDD (0.84 vs. 0.92 vs. 0.92 IU/kg/day;chi2 = 8.19;p = 0.017). Average of annual HbA1c values significantly improved (62.1 vs. 60.5 vs. 60.6 mmol/mol;X2 = 12.8;p = 0.002). Rate of secondary DKA remained comparable and no severe hypoglycemic event was recorder during follow-up. Conclusion(s) In our patients, BMI z-score was unchanged and glycemic control remained improved in the 2-years after COVID-19 pandemic spread. Our data may be possibly related to both the resuming of regular exercise and the increased use of sensor during T1 that allowed to continue with telemedicine visits in T2, adjusting patients' insulin TDD and avoiding acute complications.