Aims: To evaluate the effects of COVID-19 lockdown on blood glucose control in individuals with type 1 diabetes (T1D) and to explore determinants of glucose variability. Methods: Fifty T1D patients undergoing continuous/flash glucose monitoring were recruited. The study's primary outcome was the change of time in range (TIR) from before to lockdown period. Three time-point comparisons of TIR, mean glucose levels (MG), estimated (e)HbA1c, time above (TAR) and below range (TBR), moderate/severe hypoglycemic events between pre-lockdown, lockdown and post-lockdown period were also performed. Information on lockdown-associated perceived stress, changes of work status and physical activity were recorded. Results: TIR significantly decreased (75(63–84)% vs. 69(50–76)%, p < 0.001) whereas MG ( 154 ± 15 mg/dl vs. 165 ± 25 mg/dl, p = 0.027) and eHbA1c (7.3(6.6–7.8)% vs. 7.5(6.7–8.2)%, p = 0.031) increased from pre- to lockdown period; overall glucose control significantly improved when restriction ended. Lockdown-associated work loss/suspension independently predicted impaired TIR after adjustment for potential confounders (Standardized β: −0.29; 95%CΙ: −18.7 to −2.25; p = 0.01). Greater TAR, TBR and hypoglycemic events were also reported during the lockdown. Conclusion: In T1D Italian individuals, blood glucose control significantly worsened during the COVID-19 lockdown; work instability and related issues represented the main determinant of impaired glucose variability in this population.

Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy

Baroni M. G.;
2020-01-01

Abstract

Aims: To evaluate the effects of COVID-19 lockdown on blood glucose control in individuals with type 1 diabetes (T1D) and to explore determinants of glucose variability. Methods: Fifty T1D patients undergoing continuous/flash glucose monitoring were recruited. The study's primary outcome was the change of time in range (TIR) from before to lockdown period. Three time-point comparisons of TIR, mean glucose levels (MG), estimated (e)HbA1c, time above (TAR) and below range (TBR), moderate/severe hypoglycemic events between pre-lockdown, lockdown and post-lockdown period were also performed. Information on lockdown-associated perceived stress, changes of work status and physical activity were recorded. Results: TIR significantly decreased (75(63–84)% vs. 69(50–76)%, p < 0.001) whereas MG ( 154 ± 15 mg/dl vs. 165 ± 25 mg/dl, p = 0.027) and eHbA1c (7.3(6.6–7.8)% vs. 7.5(6.7–8.2)%, p = 0.031) increased from pre- to lockdown period; overall glucose control significantly improved when restriction ended. Lockdown-associated work loss/suspension independently predicted impaired TIR after adjustment for potential confounders (Standardized β: −0.29; 95%CΙ: −18.7 to −2.25; p = 0.01). Greater TAR, TBR and hypoglycemic events were also reported during the lockdown. Conclusion: In T1D Italian individuals, blood glucose control significantly worsened during the COVID-19 lockdown; work instability and related issues represented the main determinant of impaired glucose variability in this population.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11697/151158
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