Turan Hande, Güneş Kaya Didem, Tarçın Gürkan, Evliyaoğlu Saadet Olcay
Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey.
Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric, Istanbul, Turkey.
Endocrinol Diabetes Nutr (Engl Ed). 2021 Jun 8;69(3):201-8. doi: 10.1016/j.endinu.2021.05.003.
Metabolic control in type 1 diabetes (T1D) depends on many factors such as eating habits, exercise and lifestyle. The objective of this study was to investigate how these factors were affected during the coronavirus disease 2019 (COVID-19) lockdown and impacted metabolic control in children with T1D.
One hundred children with T1D were enrolled in the study. Anthropometric measurements, snack and meal frequency, carbohydrate consumption, HbA1c levels, and exercise patterns were recorded and compared before and after the lockdown. Subjects were divided into two subgroups-patients with decreased and patients with increased HbA1c levels after the lockdown-and comparisons of the same parameters were also made between these two subgroups.
In the overall group, the mean HbA1c level was significantly higher after the lockdown compared to before (p=0.035). Meal schedules changed due to delayed sleep and waking times, and total daily carbohydrate consumption increased in the subgroup with increased HbA1c while it decreased in the subgroup with decreased HbA1c (p<0.001 for both).
Our study supports the notion that blood sugar management in children with T1D worsened during the COVID-19 pandemic. Although it is not possible to explain this with any one factor, some behavioral changes observed in our study, such as inactivity, irregular meal frequency and timing, and irregular sleep and waking patterns appeared to be associated with blood sugar management.
1型糖尿病（T1D）的代谢控制取决于许多因素，如饮食习惯、运动和生活方式。本研究的目的是调查在2019冠状病毒病（COVID-19）封锁期间这些因素是如何受到影响的，以及对T1D儿童的代谢控制产生了怎样的影响。
100名T1D儿童参与了本研究。记录并比较了封锁前后的人体测量数据、零食和进餐频率、碳水化合物摄入量、糖化血红蛋白（HbA1c）水平以及运动模式。将受试者分为两个亚组——封锁后HbA1c水平降低的患者和升高的患者——并对这两个亚组的相同参数进行了比较。
在整个研究组中，封锁后的平均HbA1c水平显著高于封锁前（p = 0.035）。进餐时间表因睡眠时间和起床时间推迟而改变，HbA1c升高的亚组每日碳水化合物总摄入量增加，而HbA1c降低的亚组则减少（两者p均<0.001）。
我们的研究支持这样一种观点，即在COVID-19大流行期间，T1D儿童的血糖管理恶化。虽然无法用任何一个因素来解释这一现象，但我们在研究中观察到的一些行为变化，如缺乏运动、进餐频率和时间不规律以及睡眠和起床模式不规律，似乎与血糖管理有关。
