The Effect of the COVID-19 Pandemic and its Restrictions on Glycemic Control in Patients with Type 1 Diabetes Mellitus


Barsal Çetiner E., Bedel A., Donbaloğlu Z., Singin B., Aydın Behram B., Ünver Tuhan H., ...More

The Journal of Current Pediatrics, vol.20, pp.141-146, 2022 (ESCI)

Abstract

Abstract Introduction: Mandatory sedentary life due to quarantine, disruption of exercise programs, excessive caloric intake and worsening of glycemic control in patients diagnosed with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection type 1 diabetes mellitus (DM). In our study, we planned to evaluate the changes in glycemic control and daily insulin needs during the Coronavirus disease-19 (COVID-19) pandemic of the cases followed up with the diagnosis of type 1 DM in our clinic. Materials and Methods: The 1-year follow-up data of the cases followed up in the pediatric endocrinology clinic with the diagnosis of type 1 DM, before and after March 2020, when the first COVID-19 case in Turkey was seen, were analyzed. The data of 350 patients who were followed up were retrospectively analyzed. After the patients who did not meet the study criteria were excluded, 36 of the remaining 167 cases were evaluated separately because of the insertion of an insulin pump during this period. As a result, files of 131 patients, glycosylated hemoglobin A1c (HbA1c) values and daily insulin doses were evaluated. Results: No significant difference was found in the subjects’ height, standard deviation score (SDS), body weight, body weight SDS, body mass index (BMI), and BMI SDS values compared to the pre-pandemic period. There was no worsening in glycemic control (HbA1c value) (p=0.16). The mean daily insulin dose of the cases increased significantly compared to the pre-pandemic period (p<0.001). While no worsening was observed in glycemic control in the groups younger than 12 years of age and older, an increase was observed in daily insulin doses (respectively; p=0.620/0.180, p=0.003/0.004). Conclusion: In our study, no significant increase was found in the HbA1c levels of the cases compared to the pre-pandemic period. This has been attributed to the provision of telemedicine services to these patients even during the full closure period. However, due to the inactivity of the patients, insulin doses had to be increased in order to achieve good glycemic control. In conclusion, our study has shown that glycemic control will not be impaired if standard diabetes care is maintained during the pandemic period.