Impact of COVID-19 Lockdown on Glycemic Control in Adults with Type 1 Diabetes Mellitus

Abstract

Aim: To examine the impact of the lockdown caused by the COVID-19 pandemic on both the glycemic control and the daily habits of a group of patients with type 1 diabetes mellitus (T1DM) using flash continuous glucose monitoring devices (flash CGMs).

Methods: Retrospective analysis based on all the information gathered in virtual consultations from a cohort of 50 adult patients with T1DM with follow-up at our site. We compared their CGM metrics during lockdown with their own previous data before the pandemic occurred, as well as the potential psychological and therapeutic changes.

Results: We observed a reduction of average glucose values: 160.26 ± 22.55 mg/dL vs 150 ± 20.96 mg/dL, P = .0009; estimated glycosylated hemoglobin: 7.21 ± 0.78% vs 6.83 ± 0.71%, P = .0005; glucose management indicator 7.15 ± 0.57% vs 6.88 ± 0.49%; P = .0003, and glycemic variability: 40.74 ± 6.66 vs 36.43 ± 6.09 P < .0001. Time in range showed an improvement: 57.46 ± 11.85% vs a 65.76 ± 12.09%, P < .0001, without an increase in percentage of time in hypoglycemia.

Conclusions: COVID-19 lockdown was associated with an improvement in glycemic control in patients with T1DM using CGMs.

Keywords: COVID-19; ambulatory glucose profile; continuous glucose monitoring (GCM); lockdown; type 1 diabetes mellitus.

Figure 1.

Glucose ambulatory profile improvement during lockdown. Box plots of CGM metrics from Ambulatory Glucose Profile forms before and during lockdown (*P < .001, **P < 0.01, ***P < .001). The dots are outliers, which are defined as those values that are outside the range. This is calculated by multiplying 1.5 by the interquartile range.

Figure 2.

Exploratory [analysis of clinical predictors of COVID-19 impact in glycemic control. (A) Box plots of mean glucose difference values before and during lockdown in 3 different groups of age (<35, ≥35–50, and ≥50 years old). (B) Box plots of mean glucose difference values before and during lockdown regarding gender. (C) Correlation map of clinical predictors of glycemic control. Values represent the Pearson’s correlation coefficient (r). Significant negative correlations are shown in orange and significant positive correlations in blue. Color intensity increases with the magnitude of correlation. The white ones indicate a coefficient with non-significant correlation.