Improved glucometrics in people with type 1 diabetes 1 year into the COVID-19 pandemic

Namam Ali; Soumia El Hamdaoui; Giesje Nefs; Cornelis J Tack; Bastiaan E De Galan

doi:10.1136/bmjdrc-2022-002789

Improved glucometrics in people with type 1 diabetes 1 year into the COVID-19 pandemic

BMJ Open Diabetes Res Care. 2022 May;10(3):e002789. doi: 10.1136/bmjdrc-2022-002789.

Authors

Namam Ali¹, Soumia El Hamdaoui², Giesje Nefs^{3

4

5}, Cornelis J Tack², Bastiaan E De Galan^{2

6

7}

Affiliations

¹ Department of Internal Medicine, Radboud University Nijmegen, Nijmegen, The Netherlands namam.ali@radboudumc.nl.
² Department of Internal Medicine, Radboud University Nijmegen, Nijmegen, The Netherlands.
³ Department of Medical Psychology, Radboudumc Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
⁴ Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
⁵ Diabeter, National Treatment and Research Center for Children, Adolescents and Adults with Type 1 Diabetes, Rotterdam, Netherlands.
⁶ Internal Medicine/Endocrinology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
⁷ CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, Netherlands.

Abstract

Introduction: Various studies have shown a number of glycemic parameters to improve over several weeks in people with type 1 diabetes during the first surge of the COVID-19 pandemic. Whether and to what extent such improvement is sustained during following COVID-19 surges remains unknown. Therefore, the aim of this study was to investigate glycemic parameters during the first year of the COVID-19 pandemic in people with type 1 diabetes and to determine factors associated with glycemic improvement.

Research design and methods: This was an observational cohort study in people with type 1 diabetes, aged ≥16 years. We compared glycated hemoglobin (HbA_1c) and flash glucose monitoring (FGM) downloads between the prelockdown period and approximately 1 year thereafter. Using logistic regression analysis, we assessed associations between an HbA_1c reduction of at least 0.5% (~5.5 mmol/mol) with baseline clinical characteristics and self-reported changes in psychological well-being and lifestyle behavior related to COVID-19.

Results: A total of 437 participants were included. As compared with prepandemic data, 1 year after the start of the COVID-19 pandemic and associated lockdowns, HbA_1c had decreased from 7.9%±1.1% (63±12 mmol/mol) to 7.5%±1.0% (59±11 mmol/mol) (p<0.001), whereas time in range increased from 55.8%±16.7% to 58.6%±16.7% (p=0.004) and time below (<3.9 mmol/L) and above (>13.9 mmol/L) range and glucose variability all decreased (all p<0.05). FGM use, higher HbA_1c at baseline and current smoking were independently associated with an HbA_1c decrease of at least 0.5%, whereas self-reported changes in psychological well-being and lifestyle behavior related to the first surge of the COVID-19 pandemic and associated lockdowns were not.

Conclusions: The COVID-19 pandemic and related lockdown measures were associated with improvement in glucometrics, including HbA_1c and FGM data, in individuals with type 1 diabetes, particularly in FGM users, those with higher HbA_1c at baseline or current smokers.

Keywords: COVID-19; HbA1c; blood glucose self-monitoring; diabetes mellitus, type 1.

Publication types

Observational Study

MeSH terms

Blood Glucose
Blood Glucose Self-Monitoring
COVID-19* / epidemiology
Communicable Disease Control
Diabetes Mellitus, Type 1* / epidemiology
Glucose
Humans
Pandemics

Substances

Blood Glucose
Glucose