Auxological parameters and metabolic control in children and young patients with type 1 diabetes 1-year after COVID-19 pandemic

ABSTRACT

Introduction: COVID-19 pandemic, by restricting outside activities, encouraged a sedentary lifestyle due to social distancing and, alongside, an increase in the consumption of canned food and industrialized foods, resulting in a negative impact on the growth of children and young people (CYP). Concerns for consequences in CYP with type 1 diabetes (T1D) rose. Objective(s) To investigate 1-year effects of the COVID-19 pandemic on auxological parameters and metabolic control in CYP with T1D. Method(s) Anthropometric [BMI (SDS), waist circumference/ height (WHt) ratio] and glycemic control data of CYP with T1D were collected during the annual routine outpatient visit between December 2020-February 2021 (T1, 1-year after the pandemic) and were compared with the ones of the same period in 2019-20 (T0, before lockdown). Data on number of visit (outpatient and telemedicine), diabetic ketoacidosis (DKA) and severe hypoglycemic events, insulin dose (IU/kg/day), glucose monitoring (SBGM/ isCGM/rtCGM), glycosylate hemoglobin (HbA1c), physical activity (h/week), and SARS-CoV-2 infection were collected. Result(s) Seventy-eight CYP with T1D (males 61.5%;age 13.7 [5.7-17.8] years;T1D duration 5.96 [2.1-15.4] years) were enrolled. The interval between visits was 1.06 years. Clinical and average annual HbA1c data at T1 were comparable to T0 (see Table). Physical activity decreased, while insulin TDD increased. The prevalence of patients with last HbA1c value <=53 mmol/mol increased (24 vs 28%, p<0.0001). The SARS-CoV-2 infection was recorded in 12 patients (15.4%). At T1, CGM use increased (67.9 vs 71.8%, p<0.001). The telemedicine visits increased because 56.4% of patients had at least one telemedicine. Rate of secondary DKA remained comparable and no severe hypoglycemic event was recorder. Conclusion(s) In our patients with T1D, both the BMI z-score and the glycemic control were maintained during the 1-year COVID-19 pandemic period, despite the decrease of regular physical activity. Our data may be possibly related to the increase of telemedicine visits that allowed us to adjust patients' insulin TDD, to avoid acute complications, and also to continue educational training to start CGM, complying with safety rules to avoid COVID-19 spread.