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Observational Study
. 2020 Dec;57(12):1511-1517.
doi: 10.1007/s00592-020-01596-4. Epub 2020 Oct 7.

Lessons learned from the continuous glucose monitoring metrics in pediatric patients with type 1 diabetes under COVID-19 lockdown

Avivit Brener  1   2 , Kineret Mazor-Aronovitch  3   4   5 , Marianna Rachmiel  3   6 , Noa Levek  5 , Galia Barash  3   6 , Orit Pinhas-Hamiel  3   4   5 , Yael Lebenthal  7   3 , Zohar Landau  5   8   9
Affiliations
Observational Study

Lessons learned from the continuous glucose monitoring metrics in pediatric patients with type 1 diabetes under COVID-19 lockdown

Avivit Brener et al. Acta Diabetol. 2020 Dec.

Abstract

Aims: Billions of people have been under lockdown in an attempt to prevent COVID-19 spread. Lifestyle changes during lockdown could lead to deterioration of glycemic control in type 1 diabetes (T1D). We aimed to assess the impact of COVID-19 lockdown on the glycemic control of pediatric patients with T1D.

Methods: This observational real-life study from the AWeSoMe Group assessed continuous glucose monitoring (CGM) metrics of 102 T1D patients (52.9% males, mean age 11.2 ± 3.8 years, mean diabetes duration 4.2 ± 3.8 years) who used Dexcom G5. The data were accessed without any interface between patients, caregivers, and the diabetes team. Study variables from CGM metrics were: mean glucose level, time-in-range (TIR, 70-180 mg/dL; 3.9-10 mmol/L), hypoglycemia (< 54 mg/dL; < 3 mmol/L), hyperglycemia (> 250 mg/dL; > 13.3 mmol/L), coefficient of variation (CV), and time CGM active before and during lockdown. Delta-variable = lockdown variable minus before-lockdown variable.

Results: The mean TIR was 60.9 ± 14.3% before lockdown, with no significant change during lockdown (delta-TIR was 0.9 ± 7.9%). TIR during lockdown was significantly correlated with TIR before lockdown (r = 0.855, P < 0.001). Patients with improved TIR (delta-TIR > 3%) were significantly older than patients with stable or worse TIR (P = 0.028). Children aged < 10 years had a significantly higher CV before lockdown and during lockdown than children aged ≥ 10 years (P = 0.02 and P = 0.005, respectively). Among children aged < 10 years, a multiple linear regression model revealed associations of age and lower socioeconomic cluster with delta-TIR (F = 4.416, P = 0.019) and with delta-mean glucose (F = 4.459, P = 0.018).

Conclusions: CGM metrics in pediatric patients with T1D were relatively stable during a nationwide lockdown. Intervention plans should focus on younger patients with lower socioeconomic position.

Keywords: Ambulatory glucose profile; COVID-19 lockdown; Children and adolescents; Continuous glucose monitoring (CGM) metrics; Type 1 diabetes.

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Conflict of interest statement

The Authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
The association between time-in-range (TIR) before and during lockdown. A significant positive correlation was observed between TIR before lockdown and TIR during lockdown (r = 0.855, P < 0.001)
See this image and copyright information in PMC

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