Glycaemic Control Among People with Type 1 Diabetes During Lockdown for the SARS-CoV-2 Outbreak in Italy
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ORIGINAL RESEARCH
Glycaemic Control Among People with Type 1 Diabetes During Lockdown for the SARS-CoV-2 Outbreak in Italy Benedetta Maria Bonora . Federico Boscari . Angelo Avogaro . Daniela Bruttomesso . Gian Paolo Fadini
Received: April 3, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: In late February 2020, due to the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the Italian Government closed down all educational and sport activities. In March, it introduced further measures to stop the spread of coronavirus disease (COVID-19), placing the country in a state of almost complete lockdown. We report the impact of these restrictions on glucose control among people with type 1 diabetes (T1D). Methods: Data were collected on 33 individuals with T1D who were monitoring their glucose levels using a flash glucose monitoring device and remotely connected to the diabetes clinic on a cloud platform. We retrieved information on average glucose, standard deviation and percentage time in hypoglycaemia (\ 70 mg/ dl), glucose range (70–180 mg/dl) and hyperglycaemia ([ 180 mg/dl). We compared glycaemic measures collected during lockdown to Benedetta Maria Bonora and Federico Boscari contributed equally to this work.
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12162024. B. M. Bonora F. Boscari A. Avogaro D. Bruttomesso G. P. Fadini (&) Department of Medicine, Unit of Metabolic Disease, University of Padova, 35128 Padova, Italy e-mail: [email protected]
those collected before the SARS-CoV-2 epidemic and to the periods immediately before lockdown. Results: In 20 patients who had stopped working and were at home as a result of the lockdown, overall glycaemic control improved during the first 7 days of the lockdown as compared to the weeks before the spread of SARS-CoV-2. Average glucose declined from 177 ± 45 mg/dl (week before lockdown) to 160 ± 40 mg/dl (lockdown; p = 0.005) and the standard deviation improved significantly. Time in range increased from 54.4 to 65.2% (p = 0.010), and time in hyperglycaemia decreased from 42.3 to 31.6% (p = 0.016). The number of scans per day remained unchanged. In 13 patients who continued working, none of the measures of glycaemic control changed during lockdown. Conclusion: Despite the limited possibility to exercise and the incumbent psychologic stress, glycaemic control improved in patients with T1D who stopped working during the lockdown, suggesting that slowing down routine daily activities can have beneficial effects on T1D management, at least in the short term. Keywords: COVID-19; Education; Epidemic; Sensor; Telemedicine
Diabetes Ther
Key Summary Points Why carry out this study? In March 2020, Italy was placed under lockdown due to the outbreak of the new coronavirus disease. Diabetes management during lockdown was particularly challenging. Using data collected by remote monitoring of glucose sensors, we investigated whether glycaemic control in people with type 1 diabetes (T1D) d
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