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E-ISSN: 1308-6308 ISSN: 1304-9054
COVID-19 Pandemisi ve Kısıtlamalarının Tip 1 Diabetes Mellitus Hastalarında Glisemik Kontrol Üzerine Etkisi
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Original Article
VOLUME: 20 ISSUE: 2
P: 141-146
August 2022

COVID-19 Pandemisi ve Kısıtlamalarının Tip 1 Diabetes Mellitus Hastalarında Glisemik Kontrol Üzerine Etkisi

J Curr Pediatr 2022;20(2):141-146
DOI: 10.4274/jcp.2022.79663
Ebru Barsal Çetiner
Aynur Bedel
Zeynep Donbaloğlu
Berna Singin
Bilge Aydın Behram
Hale Tuhan
Mesut Parlak
1. Akdeniz Üniversitesi Tıp Fakültesi, Çocuk Endokrinoloji Anabilim Dalı, Antalya, Türkiye
No information available.
No information available
Received Date: 19.01.2022
Accepted Date: 25.05.2022
Publish Date: 31.08.2022
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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.

References

1
Ozougwu JC, Obimba KC, Belonwu CD, Unakalamba CB. The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus. J. Physiol. Pathophysiol 2013;4:46-57.
2
Mayer-Davis EJ, Kahkoska AR, Jefferies C, Dabelea D, Balde N, Gong CX, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of Diabetes in children and adolescents. Pediatric diabetes 2018;19(Suppl27)7-19.
3
d’Annunzio G, Maffeis C, Cherubini V, Rabbone I, Scaramuzza A, Schiaffini R, et al. Caring for children and adolescents with type 1 diabetes mellitus: Italian Society for Pediatric Endocrinology and Diabetology (ISPED) statements during COVID-19 pandemia. Diabetes Res Clin Pract 2020;168:108372.
4
Cefalu WT, Berg EG, Saraco M, Petersen MP, Uelmen S, Robinson S. Children and Adolescents: Standards of Medical Care in Diabetes-2019. Diabetes Care 2019;42:S148-64.
5
DiMeglio LA, Acerini CL, Codner E, Craig ME, Hofer SE, Pillay K, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes 2018;19(Suppl 27):105-14.
6
Mader JK. Personal experiences with coronavirus disease 2019 and diabetes: The time for telemedicine is now. J Diabetes Sci Technol 2020;14:752-3.
7
Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, Darendeliler F, et al. Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol 2015;7:280-93.
8
International Society of Pediatric and Adolescent Diabetes (ISPAD). Summary of recommendations regarding COVID-19 in children with diabetes: Keep Calm and Mind your Diabetes Care and Public Health Advice. Pediatr Diabetes 2020;21:413-4. 
9
Verma A, Rajput R, Verma S, Balania VK, Jangra B. Impact of lockdown in COVID 19 on glycemic control in patients with type 1 Diabetes Mellitus. Diabetes Metab Syndr 2020;14:1213-6.
10
Turan H, Güneş DK, Tarçın G, Evliyaoğlu SO. Effect of the COVID-19 quarantine on metabolic control in children and adolescents with type 1 diabetes. Endocrinol Diabetes Nutr 2021;69:201-8.
11
Ruissen MM, Regeer H, Landstra CP, Schroijen M, Jazet I, Nijhoff MF, et al. Increased stress, weight gain and less exercise in relation to glycemic control in people with type 1 and type 2 diabetes during the COVID-19 pandemic. BMJ Open Diabetes Res Care 2021;9:e002035.
12
Garg SK, Rodbard D, Hirsch IB, Forlenza GP. Managing new-onset type 1 diabetes during the COVID-19 pandemic: challenges and opportunities. Diabetes Technol Ther 2020;22:431-9.
13
Ceconi V, Barbi E, Tornese G. Glycemic control in type 1 diabetes mellitus and COVID-19 lockdown: What comes after a “quarantine”? J Diabetes 2020;12:946-8.
14
Predieri B, Leo F, Candia F, Lucaccioni L, Madeo SF, Pugliese M, et al. Glycemic control improvement in Italian children and adolescents with type 1 diabetes followed through telemedicine during lockdown due to the COVID-19 pandemic. Front Endocrinol (Lausanne) 2020;11:595735.