Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK.
Edinburgh Centre for Endocrinology and Diabetes, Western General Hospital, Edinburgh, UK.
Diabet Med. 2021 Jan;38(1):e14374. doi: 10.1111/dme.14374. Epub 2020 Sep 28.
To describe the effect of the stringent lockdown measures, introduced in the UK on 23 March 2020 to curtail the transmission of COVID-19, on glycaemic control in people with type 1 diabetes using flash glucose monitoring.
We undertook an observational study of 572 individuals with type 1 diabetes for whom paired flash glucose monitoring data were available between early March and May 2020. The primary outcome was change in flash glucose monitoring variables. We also assessed clinical variables associated with change in glycaemic control.
Percentage of time in range increased between March and May 2020 [median (interquartile range) 53 (41-64)% vs 56 (45-68)%; P < 0.001], with associated improvements in standard deviation of glucose (P <0.001) and estimated HbA (P <0.001). There was a small reduction in the number of individuals meeting the hypoglycaemia target of <5% per day (64% vs 58%; P = 0.004). Comparing changes in flash glucose monitoring data from March to May in 2019 with the same period in 2020 confirmed that these differences were confined to 2020. Socio-economic deprivation was an independent predictor of a ≥5% reduction in time in range during lockdown (odds ratio 0.45 for people in the two most affluent Scottish Index of Multiple Deprivation quintiles; P <0.001).
Lockdown was not associated with a significant deterioration in glycaemic control in people with type 1 diabetes using flash glucose monitoring. However, socio-economic deprivation appeared to increase the risk of decline in glycaemic control, which has implications for how support is focused in challenging times.
描述英国于 2020 年 3 月 23 日实施的严格封锁措施对使用实时动态血糖监测的 1 型糖尿病患者血糖控制的影响。
我们对 572 名 1 型糖尿病患者进行了一项观察性研究，这些患者在 2020 年 3 月至 5 月期间有配对的实时动态血糖监测数据。主要结局是实时动态血糖监测变量的变化。我们还评估了与血糖控制变化相关的临床变量。
2020 年 3 月至 5 月期间，范围内的时间百分比增加[中位数（四分位间距）为 53（41-64）%比 56（45-68）%；P <0.001]，同时血糖标准差（P <0.001）和估计的糖化血红蛋白（HbA）（P <0.001）也有所改善。每天有<5%的时间处于低血糖目标的人数略有减少（64%比 58%；P = 0.004）。将 2019 年 3 月至 5 月与 2020 年同期的实时动态血糖监测数据进行比较，证实这些差异仅局限于 2020 年。社会经济贫困程度是封锁期间范围内时间减少≥5%的独立预测因素（在苏格兰多因素剥夺指数的前两个最富裕五分位数中，比值比为 0.45；P <0.001）。
使用实时动态血糖监测的 1 型糖尿病患者的血糖控制在封锁期间没有明显恶化。然而，社会经济贫困程度似乎增加了血糖控制恶化的风险，这对困难时期如何集中支持具有影响。
