Glycemic Control Improvement in Italian Children and Adolescents With Type 1 Diabetes Followed Through Telemedicine During Lockdown Due to the COVID-19 Pandemic.
Background/Objective
To minimize the wide spread of coronavirus disease (COVID-19) pandemic, Italy was placed in an almost complete lockdown state that forced people to "stay at home". Aim of this study was to evaluate the effects of lockdown on glycemic control in children and adolescents with type 1 diabetes (T1D) followed through telemedicine.


Subjects/Methods
This observational study involved patients with T1D using the real-time continuous glucose monitoring (CGM) Dexcom G6®. Ambulatory glucose profile data from the 3-months before schools closure (November 26, 2019-February 23, 2020; T0) and from the 3-months of consecutive lockdown (February 24-May 18, 2020; T1) were compared.


Results
Sixty-two children and adolescents (11.1 ± 4.37 years, 50% males) with T1D (median time disease 3.67 years) were enrolled in the study. Insulin total daily dose was unchanged, while time spent on physical activities was decreased (p<0.0001). Despite the lack of statistical significance, median value of the glucose management indicator decreased from 7.4% to 7.25%. Glucose standard deviation (p<0.0001) and coefficient of variation (p=0.001) improved across the study. Median time in range increased from 60.5% to 63.5% (p=0.008), time above range decreased from 37.3% to 34.1% (p=0.048), and time below range decreased from 1.85% to 1.45% (p=0.001).


Conclusions
Overall, in our children and adolescents with T1D glycemic control improved during lockdown. Despite patients were confined to their homes and limited to exercise, our data suggest that the use of real-time CGM, the continuous parental management, and the telemedicine can display beneficial effects on T1D care.
['Predieri|Barbara|B|', 'Leo|Francesco|F|', 'Candia|Francesco|F|', 'Lucaccioni|Laura|L|', 'Madeo|Simona F|SF|', 'Pugliese|Marisa|M|', 'Vivaccia|Valentina|V|', 'Bruzzi|Patrizia|P|', 'Iughetti|Lorenzo|L|']
D000293:Adolescent D015415:Biomarkers D001786:Blood Glucose D015190:Blood Glucose Self-Monitoring D000086382:COVID-19 D002648:Child D003922:Diabetes Mellitus, Type 1 D005260:Female D005500:Follow-Up Studies D000085002:Glycemic Control D006801:Humans D007004:Hypoglycemic Agents D007558:Italy D008137:Longitudinal Studies D008297:Male D011379:Prognosis D012189:Retrospective Studies D000086402:SARS-CoV-2 D017216:Telemedicine
glycemic control children and adolescents type 1 diabetes COVID-19 continuous glucose monitoring system telemedicine—utilization