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DOI: 10.1055/a-1743-2537
COVID-19 Lockdown Periods in 2020: Good Maintenance of Metabolic Control in Adults with Type 1 and Type 2 Diabetes
Funding This work was supported by the German Centre of Diabetes Research (DZD) funded by the Federal Ministry of Education and Research (FKZ 82DZD14A02). The German Diabetes Association (DDG), and the Robert Koch Institute (RKI) provided additional financial support for the DPV registry. The work described in this paper was also supported by the German Diabetes Foundation (grant number FP-0438-2021).Abstract
During the COVID-19 pandemic, there were increased concerns about glycemic control in patients with diabetes. Therefore, we aimed to assess changes in diabetes management during the COVID-19 lockdown for patients with type 1 or type 2 diabetes mellitus (T1DM, T2DM) in Germany. We included data from 24,623 patients (age>18 years) with T1DM (N=6,975) or T2DM (N=17,648) with documented data in 2019 and 2020 from the multicenter Diabetes-Prospective Follow-up registry (DPV). We conducted a groupwise comparison of identical patients in 2019 and 2020 for different time periods of pandemia. Pairwise differences of continuous parameters of treatment modalities and metabolic outcome between 2019 and 2020 were adjusted for seasonality, age, and diabetes duration. We presented these outcomes as adjusted medians with 95% confidence intervals. Rates were compared using negative-binomial models, dichotomous outcomes were compared using logistic models. Models were additionally adjusted for age and diabetes duration. These outcomes were presented as least-square means with 95% confidence intervals, p-values of<.05 were considered significant.
In participants with T1DM, CGI (combined glucose indicator) increased only by 0.11–0.12% in all time periods of 2020 compared to 2019 (all p<0.001) while BMI decreased slightly by −(0.09–0.10) kg/m² (p<0.0001). In participants with T2DM, HbA1c increased by 0.12%, while BMI decreased slightly by −(0.05–0.06) kg/m² (p<0.0001).
During the COVID-19 lockdown period, patients with T1DM and T2DM experienced only clinically insignificant changes in glucose control or body weight. Despite lockdown restrictions, patients were able to maintain metabolic control.
* Hartmann B and Tittel SR contributed equally to the study.
Publication History
Received: 19 October 2021
Received: 05 December 2021
Accepted: 07 January 2022
Article published online:
18 February 2022
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References
- 1 Pellegrini M, Ponzo V, Rosato R. et al. Changes in weight and nutritional habits in adults with obesity during the “Lockdown” period caused by the COVID-19 virus emergency. Nutrients 2020; 12: 2016
- 2 Maddaloni E, Coraggio L, Pieralice S. et al. Effects of COVID-19 lockdown on glucose control: Continuous glucose monitoring data from people with diabetes on intensive insulin therapy. Diabetes Care 2020; 43: e86-e87
- 3 Bonora BM, Morieri ML, Avogaro A. et al. The toll of lockdown against COVID-19 on diabetes outpatient care: Analysis from an outbreak area in Northeast Italy. Diabetes Care 2021; 44: e18-e21
- 4 Bohn B, Kerner W, Seufert J. et al. Trend of antihyperglycaemic therapy and glycaemic control in 184,864 adults with type 1 or 2 diabetes between 2002 and 2014: Analysis of real-life data from the DPV registry from Germany and Austria. Diabetes Res Clin Pract 2016; 115: 31-38
- 5 Hermann JM, Miller KM, Hofer SE. et al. The Transatlantic HbA1c gap: Differences in glycaemic control across the lifespan between people included in the US T1D Exchange Registry and those included in the German/Austrian DPV registry. Diabet Med 2020; 37: 848-855
- 6 Hofer SE, Heidtmann B, Raile K. et al. Discontinuation of insulin pump treatment in children, adolescents, and young adults. A multicenter analysis based on the DPV database in Germany and Austria. Pediatr Diabetes 2010; 11: 116-121
- 7 Welters A, Tittel SR, Laubner K. et al. Long-term trends of BMI and cardiometabolic risk factors among adults with type 1 diabetes: An observational study from the German/Austrian DPV registry. Diabetes Res Clin Pract 2021; 178: 108973
- 8 Takeishi S, Tsuboi H. 866-P: Estimated HbA1c discordance: Should estimated HbA1c be derived from time-in-range or mean glucose levels?. Diabetes 2020; 69: 866-86
- 9 Vigersky RA, McMahon C. The relationship of hemoglobin A1C to time-in-range in patients with diabetes. Diabetes Technol Ther 2019; 21: 81-85
- 10 Eberle C, Stichling S. Impact of COVID-19 lockdown on glycemic control in patients with type 1 and type 2 diabetes mellitus: A systematic review. Diabetol Metab Syndr 2021; 13: 95
- 11 Garofolo M, Aragona M, Rodia C. et al. Glycaemic control during the lockdown for COVID-19 in adults with type 1 diabetes: A meta-analysis of observational studies. Diabetes Res Clin Pract 2021; 180: 109066
- 12 Hosomi Y, Munekawa C, Hashimoto Y. et al. The effect of COVID-19 pandemic on the lifestyle and glycemic control in patients with type 1 diabetes: A retrospective cohort study. Diabetol Int 2021; 1-6
- 13 Potier L, Hansel B, Larger E. et al. Stay-at-home orders during the COVID-19 pandemic, an opportunity to improve glucose control through behavioral changes in type 1 diabetes. Diabetes Care 2021; 44: 839-843
- 14 Capaldo B, Annuzzi G, Creanza A. et al. Blood glucose control during lockdown for COVID-19: CGM metrics in Italian adults with type 1 diabetes. Diabetes Care 2020; 43: e88-e89
- 15 D'Onofrio L, Pieralice S, Maddaloni E. et al. Effects of the COVID-19 lockdown on glycaemic control in subjects with type 2 diabetes: The glycalock study. Diabetes Obes Metab 2021; 23: 1624-1630