Pediatrics, Hospital Universitario Miguel Servet, Zaragoza, Aragón, Spain.
J Pediatr Endocrinol Metab. 2022 May 30;35(7):867-873. doi: 10.1515/jpem-2022-0222. Print 2022 Jul 26.
Lockdown during the SARS-CoV-2 pandemic generated uncertainty regarding its effects on the control of type 1 diabetes (DM1). Our study aims to evaluate the influence of the pandemic on the control of paediatric patients with DM1.
Longitudinal, retrospective, observational study in patients with DM1 attended between 15/10/2019 and 15/03/2020. Data were collected at that visit and at the three subsequent visits. The second was remote in 50% of cases. The variables analysed were: type of insulin therapy, time in range (TIR), time in hypoglycaemia (THypo), time in hyperglycaemia (THyper), coefficient of variation (CV), glycosylated haemoglobin, insulin requirements and anthropometric data.
157 patients were recruited. At the post-lockdown visit, the TIR increased and the THyper decreased with respect to the first (p<0.00) and second (p<0.00) visits. Patients treated with subcutaneous infusion showed a higher TIR at the third visit (p=0.03) and lower insulin requirements at the fourth visit (p=0.03) compared to patients treated with multiple doses. Patients with a remote visit presented a higher TIR (p<0.00), a lower THyper (p=0.00) and lower insulin requirements (p=0.01) at the next visit. Patients aged less than 6 years presented a lower glycosylated haemoglobin (p=0.01) and insulin requirements at the third (p=0.03) and fourth (p=0.01) visits, and a lower increase in body mass index (p=0.03) over the year.
Metabolic control improved at the post-lockdown visit. Patients treated with subcutaneous infusion, those who had a remote visit during strict lockdown and those aged less than 6 years had a better evolution.
在 SARS-CoV-2 大流行期间实施封锁,这给 1 型糖尿病(DM1)的控制效果带来了不确定性。我们的研究旨在评估大流行对儿科 DM1 患者控制情况的影响。
这是一项在 2019 年 10 月 15 日至 2020 年 3 月 15 日期间就诊的 1 型糖尿病患者中进行的纵向、回顾性、观察性研究。在就诊时以及随后的 3 次就诊时收集数据。第二次就诊有 50%是远程就诊。分析的变量包括:胰岛素治疗类型、血糖控制达标时间(TIR)、低血糖时间(THypo)、高血糖时间(THyper)、变异系数(CV)、糖化血红蛋白、胰岛素需求和人体测量数据。
共纳入 157 例患者。与首次(p<0.00)和第二次就诊(p<0.00)相比,封锁后就诊时 TIR 增加,THyper 降低。与多次皮下注射胰岛素治疗的患者相比,接受皮下输注胰岛素治疗的患者在第三次就诊时 TIR 更高(p=0.03),第四次就诊时胰岛素需求更低(p=0.03)。进行远程就诊的患者,在随后的就诊时 TIR 更高(p<0.00)、THyper 更低(p=0.00)和胰岛素需求更低(p=0.01)。年龄小于 6 岁的患者,第三次(p=0.03)和第四次就诊(p=0.01)时糖化血红蛋白和胰岛素需求更低,且一年内体重指数增加幅度更低(p=0.03)。
封锁后就诊时代谢控制得到改善。接受皮下输注胰岛素治疗的患者、在严格封锁期间进行远程就诊的患者以及年龄小于 6 岁的患者,病情改善更好。