Youth with Type 1 Diabetes Had Improvement in Continuous Glucose Monitoring Metrics During the COVID-19 Pandemic

Abstract

Background:

The impact of the coronavirus disease-2019 (COVID-19) pandemic on glycemic metrics in children is uncertain. This study evaluates the effect of the shelter-in-place (SIP) mandate on glycemic metrics in youth with type 1 diabetes (T1D) using continuous glucose monitoring (CGM) in Northern California, United States.

Methods:

CGM and insulin pump metrics in youth 3–21 years old with T1D at an academic pediatric diabetes center were analyzed retrospectively. Data 2–4 months before (distant pre-SIP), 1 month before (immediate pre-SIP), 1 month after (immediate post-SIP), and 2–4 months after (distant post-SIP) the SIP mandate were compared using paired t-tests, linear regression, and longitudinal analysis using a mixed effects model.

Results:

Participants (n = 85) had reduced mean glucose (−10.3 ± 4.4 mg/dL, P = 0.009), standard deviation (SD) (−5.0 ± 1.3 mg/dL, P = 0.003), glucose management indicator (−0.2% ± 0.03%, P = 0.004), time above range (TAR) >250 mg/dL (−3.5% ± 1.7%, P = 0.01), and increased time in range (TIR) (+4.7% ± 1.7%, P = 0.0025) between the distant pre-SIP and distant post-SIP periods. Relationships were maintained using a mixed effects model, when controlling for other demographic variables. There was improvement in SD, TAR 180–250 mg/dL, and TIR for participants with private insurance, but changes in the opposite direction for participants with public insurance.

Conclusions:

Improvement in CGM metrics in youth with T1D during the COVID-19 pandemic suggests that diabetes management can be maintained in the face of sudden changes to daily living. Youth with public insurance deserve more attention in research and clinical practice.