Lockdown-related lifestyle changes do not disrupt glycaemic control in young T1D patients

Lockdowns due to the novel coronavirus disease (COVID-19) pandemic do not seem to adversely affect glycaemic control among children and teenagers with type 1 diabetes (T1D), a new study has found.

Researchers conducted an observational study of 43 young T1D patients (mean age, 7.45 years; 20 girls) who had had diabetes for a median of 1.05 years at enrolment. All participants were on continuous glucose monitoring (CGM). Data before, during, and after the lockdown were collected. Questionnaires were used to describe changes in lifestyle due to the lockdown.

Over 40,000 hours of CGM data were collected. Analysis showed that hypoglycaemia significantly improved during lockdown, as indicated by drops in the number of hypoglycaemic episodes, prolonged hypoglycaemic events, and median time below range (TBR) <3.9 and <3.0 mmol/L.

A rebound effect was observed after lockdowns were lifted. For example, median TBR <3.9 mmol/L dropped from 3.70 percent at baseline to 2.91 percent under lockdown, and jumped back to 4.95 percent after the lockdown (p=0.004). Similar patterns were observed for other measures of hypoglycaemia.

In terms of lifestyle behaviours, the lockdown encouraged a significant increase in the number of snacks and sleep duration among participants, as well as giving them significantly more time for diabetes management. Almost half (44.1 percent) of the children reported reduced exercise time, and most switched primary exercise type to indoor activities, such as rope skipping.

In line with CGM data, most patients reported a drop in self-perceived hypoglycaemia during the lockdown.

Medical access also changed during lockdown, though only a small minority of the participants (n=3) said they experienced temporary insulin shortage. Outpatient consultations were disrupted in majority of the participants, forcing a switch to online medical services.