Diabetology Unit, Meyer University Children's Hospital, Florence, Italy.
Department of Pediatrics, Meyer University Children's Hospital, University of Florence, Florence, Italy.
Pediatr Diabetes. 2022 Jun;23(4):469-472. doi: 10.1111/pedi.13326. Epub 2022 Mar 2.
Two vaccines against SARS-CoV-2 are approved by the World Health Organization (WHO) for minors aged 12 years and over. Currently, people with both type 1 diabetes (T1D) and type 2 diabetes (T2D) are prioritized for vaccination.
To evaluate possible glycemic control modification, insulin dose adjustment and adverse effects after COVID-19 vaccination in young T1D individuals, users of different technology levels.
Thirty-nine T1D individuals, who received a whole vaccination cycle of either Moderna or Pfizer- BioNTech vaccines, were enrolled, 24 of whom using advanced hybrid closed loop systems (AHCLs) and 15 using intermittently scanned continuous glucose monitoring (isCGM). Symptoms after each dose and the following variables were considered: time in range 70-180 mg/dl (TIR), time in different glucose ranges, mean glucose levels, coefficient of variation (CV), total daily dose (TDD) and bolus proportion RESULTS: No significant differences in TIR, time in different glucose ranges, mean glucose levels, TDD, bolus proportion, were observed before and after any dose nor before and after the whole vaccination cycle. CV was significantly lower after the whole vaccination cycle (CV pre-vaccination 35.1 ± 6.9% vs. CV post-vaccination 33.5 ± 6.3%; p 0.031) in subjects treated by AHCLs. Side effects after the vaccination were mild and more frequent after the second dose. No severe adverse reactions were reported.
COVID-19 vaccination was safe and not associated with significant perturbation of glycemic control in adolescents and young adults with T1D. This information could be of clinical use when counseling families about SARS-CoV-2 vaccination in young people with T1D.
世界卫生组织（WHO）批准了两种针对 SARS-CoV-2 的疫苗，用于 12 岁及以上的未成年人。目前，1 型糖尿病（T1D）和 2 型糖尿病（T2D）患者被优先接种疫苗。
评估不同技术水平的年轻 T1D 个体接种 COVID-19 疫苗后血糖控制的可能变化、胰岛素剂量调整和不良反应。
共纳入 39 名接受 Moderna 或 Pfizer-BioNTech 全疫苗接种周期的 T1D 个体，其中 24 名使用先进的混合闭环系统（AHCLs），15 名使用间歇性扫描连续血糖监测（isCGM）。考虑了每次接种后的症状和以下变量：70-180mg/dl 范围内的时间（TIR）、不同血糖范围内的时间、平均血糖水平、变异系数（CV）、总日剂量（TDD）和推注比例。
未观察到任何剂量前后以及整个疫苗接种周期前后 TIR、不同血糖范围时间、平均血糖水平、TDD、推注比例的显著差异。在接受 AHCL 治疗的患者中，整个疫苗接种周期后 CV 显著降低（接种前 CV 为 35.1±6.9%，接种后 CV 为 33.5±6.3%；p=0.031）。接种后出现的副作用较轻，第二剂后更为常见。未报告严重不良反应。
COVID-19 疫苗接种在 T1D 青少年和年轻成人中是安全的，不会导致血糖控制显著失调。在向 T1D 青少年家庭提供关于 SARS-CoV-2 疫苗接种的咨询时，这些信息可能具有临床应用价值。
