Centre for Diabetes in Children and Adolescents, Department of Woman and Child Health, Parma University Hospital, Parma, Italy.
Post-graduate School of Pediatrics, University of Parma, Parma, Italy.
Acta Biomed. 2021 Nov 3;92(5):e2021399. doi: 10.23750/abm.v92i5.11911.
COVID-19 pandemic determined a profound impact in everyday life and in routine follow-up of patients with type 1 diabetes (T1D). In this context, telemedicine represented an important tool to guarantee a regular care for these patients. Aim of our work was to assess metabolic control before and after lockdown in the cohort of T1D patients followed-up by our Service, to evaluate the impact of restrictive measures and of disease management through telemedicine.
This is a retrospective observational study. Subjects were enrolled among children, adolescents and young adults affected by T1D and followed at the Regional Paediatric Diabetology Centre of the University-Hospital of Parma, Italy. We collected data about age, gender, ethnicity, anthropometric measurements, duration of disease, type of blood glucose monitoring used, type of insulin administration, daily insulin requirement and metabolic control, assessed using capillary HbA1c.
We enrolled 139 patients, mean age 13.9 years. During lockdown, we reported significantly more contacts through telemedicine between patients and medical team. Global glycol-metabolic control significantly improved, without differences in daily insulin requirement. Patients with a previous poor-controlled diabetes showed a greater improvement. Finally, mean weekly hours of physical activity decreased significantly, without worsening in BMI z-score.
Our results show a global improvement in mean HbA1c, with a stronger result for patients with a previous non satisfactory control. In our setting, despite regulatory rules and physical and logistic limitations related to pandemic, no worsening of metabolic control has been shown for patients with type 1 diabetes.
COVID-19 大流行对 1 型糖尿病（T1D）患者的日常生活和常规随访产生了深远影响。在这种情况下，远程医疗成为为这些患者提供常规护理的重要手段。我们的研究目的是评估在我们的服务中接受随访的 T1D 患者在封锁前后的代谢控制情况，评估限制措施和通过远程医疗进行疾病管理的影响。
这是一项回顾性观察性研究。研究对象为意大利帕尔马大学医院的区域儿科糖尿病中心随访的 T1D 儿童、青少年和年轻成人患者。我们收集了年龄、性别、种族、人体测量数据、疾病持续时间、血糖监测类型、胰岛素给药类型、每日胰岛素需求和代谢控制等数据，使用毛细血管 HbA1c 评估。
我们共纳入了 139 名患者，平均年龄为 13.9 岁。在封锁期间，我们报告称患者与医疗团队之间通过远程医疗进行的联系明显增多。总体糖代谢控制显著改善，而每日胰岛素需求无差异。既往血糖控制不佳的患者改善更为显著。最后，平均每周的体力活动时间显著减少，但 BMI z 评分无恶化。
我们的研究结果显示平均 HbA1c 整体改善，既往控制不佳的患者改善更为显著。在我们的环境中，尽管存在与大流行相关的监管规则以及物理和后勤限制，但 1 型糖尿病患者的代谢控制并未恶化。
