Abstract
Introduction: Various studies have shown a number of glycemic parameters to improve over several weeks in people with type 1 diabetes during the first surge of the COVID-19 pandemic. Whether and to what extent such improvement is sustained during following COVID-19 surges remains unknown. Therefore, the aim of this study was to investigate glycemic parameters during the first year of the COVID-19 pandemic in people with type 1 diabetes and to determine factors associated with glycemic improvement.
Research design and methods: This was an observational cohort study in people with type 1 diabetes, aged ≥16 years. We compared glycated hemoglobin (HbA 1c ) and flash glucose monitoring (FGM) downloads between the prelockdown period and approximately 1 year thereafter. Using logistic regression analysis, we assessed associations between an HbA 1c reduction of at least 0.5% (~5.5 mmol/mol) with baseline clinical characteristics and self-reported changes in psychological well-being and lifestyle behavior related to COVID-19.
Results: A total of 437 participants were included. As compared with prepandemic data, 1 year after the start of the COVID-19 pandemic and associated lockdowns, HbA 1c had decreased from 7.9%±1.1% (63±12 mmol/mol) to 7.5%±1.0% (59±11 mmol/mol) (p<0.001), whereas time in range increased from 55.8%±16.7% to 58.6%±16.7% (p=0.004) and time below (<3.9 mmol/L) and above (>13.9 mmol/L) range and glucose variability all decreased (all p<0.05). FGM use, higher HbA 1c at baseline and current smoking were independently associated with an HbA 1c decrease of at least 0.5%, whereas self-reported changes in psychological well-being and lifestyle behavior related to the first surge of the COVID-19 pandemic and associated lockdowns were not.
Conclusions: The COVID-19 pandemic and related lockdown measures were associated with improvement in glucometrics, including HbA 1c and FGM data, in individuals with type 1 diabetes, particularly in FGM users, those with higher HbA 1c at baseline or current smokers.
Keywords: COVID-19; HbA1c; blood glucose self-monitoring; diabetes mellitus, type 1.
【저자키워드】 COVID-19, HbA1c, blood glucose self-monitoring, diabetes mellitus, type 1., 【초록키워드】 Clinical characteristics, lockdown, COVID-19 pandemic, Diabetes Mellitus, diabetes, smoking, hemoglobin, Glucose, Smokers, association, Research design, blood glucose, Psychological well-being, reduction, lockdowns, Observational cohort study, Factor, Logistic regression analysis, individual, Variability, measure, participant, parameter, decrease, IMPROVE, shown, determine, changes in, sustained, diabete, baseline, glycemic, 【제목키워드】 COVID-19 pandemic, Improved, diabete,