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?:abstract
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BACKGROUND The aim of this study was to evaluate the impact on glycemic control during lockdown due to the COVID-19 pandemic in adults with type 1 diabetes (T1D). MATERIAL AND METHODS Continuous glucose monitoring (CGM) metrics were obtained from adults with T1D and compared during three periods: before lockdown (Period 1), lockdown (Period 2) and de-escalation after the end of lockdown (Period 3). In addition, patients who presented clinically meaningful glycemic improvement during Period 2 (defined by a glucose management indicator [GMI] reduction ≥ 0.5%) were compared with those who did not present it, and a logistic regression analysis was used to select predictive variables. RESULTS The study included 138 subjects. During Period 2, there was a decrease in mean glucose, GMI, time above range and an increase in time in range, compared with Period 1. During Period 3 these findings were maintained, in addition to a reduction in glycemic variability and an increase in sensor use and scans per day. Twenty-four patients (17.4%) presented clinically meaningful glycemic improvement during lockdown. No differences were detected between patients, except for the last laboratory A1c value. In the logistic regression analysis, continuous subcutaneous insulin infusion (CSII) therapy and last laboratory A1c increased the probability of glycemic improvement, while duration of diabetes decreased that probability. CONCLUSIONS Most adults with T1D using CGM improved their glycemic control during the COVID-19 pandemic, not only during lockdown but also after it ended. A shorter duration of diabetes, CSII therapy and a higher last laboratory A1c value predicted glycemic improvement during lockdown.
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