Data are expressed as mean 6 SD. *Paired sample t test.

In this retrospective analysis, we examine the impact of the lockdown of the coronavirus pandemic (COVID-19) on eating habits in individuals with type 1 diabetes (T1D) on a hybrid artificial pancreas (HAP). Dietary composition before and during lockdown was assessed by 7-day food records of 12 participants with T1D on HAP (three men and nine women, ages 38 ± 13 years, HbA1c 6.8 ± 0.3%, M ± SD). Continuous glucose monitoring (CGM) metrics and lifestyle changes (online questionnaire) were also assessed. Compared to prelockdown, reported body weight tended to increase during lockdown with no changes in total energy intake. Participants significantly decreased animal protein intake (−2.1 ± 3.7% of total energy intake, p = 0.048), but tended to increase carbohydrate intake (+17 ± 28 g/day, p = 0.052). These changes were induced by modifications of eating habits at breakfast and lunch during weekdays. Patients consumed more cereals (+21 ± 33 g/day, p = 0.038), whole grain (+22 ± 32 g/day, p = 0.044), and sweets (+13 ± 17 g/day, p = 0.021), and less animal protein sources (−42 ± 67 g/day, p = 0.054). Participants showed a more regular meal timing and decreased physical activity. Blood glucose control remained optimal (time-in-range 76 ± 8 vs. 75 ± 7% before lockdown), and daily total insulin infusion increased (42 ± 10 vs. 39 ± 12 I.U., p = 0.045). During the lockdown, patients with T1D on HAP modified dietary habits by decreasing animal protein and increasing carbohydrate intake. This increase, mainly concerning whole grain and low-glycemic-index products, did not influence blood glucose control.

New technologies for managing type 1 diabetes (T1D) offer health care providers (HCPs) a means to minimize face-toface visits and, consequently, COVID-19 exposure and missed time from work and school. 1 To align with COVID-19 pandemic restrictions, a remote training program was implemented in March 2020 at the Federico II University Hospital diabetes center, to onboard T1D patients to a hybrid closed-loop system (MiniMed 670G). The training program was performed by a Medtronic Training Therapy Specialist along with a diabetologist and a registered dietitian conducting a remote nutritional educational course. 2 Technical training was delivered in three steps: (1) Pump and Continuous Glucose Monitoring (CGM) components of the system, (2) Sensor Augmented Pump (SAP) function (Manual Mode), and (3) hybrid closed-loop Auto-mode function. Two-to-four remote individual training sessions (median duration 60 minutes, range 50-90 minutes) were completed using the Zoom video-conferencing platform. Follow-up remote visits with the diabetes team were scheduled one week, one month, and every second month after Auto-mode initiation.In the remote trained patients, we evaluated the changes in CGM metrics 3 between before training and one month after initiation of Auto-mode. These changes were compared with those observed in patients trained face-to-face. Participants signed an informed consent for the treatment of their data.One-month follow-up after Auto-mode initiation was available for 16 patients attending remote training and 28 trained face-to-face (44 and 46% men, age 42 ± 14 and 39 ± 11 years, duration of diabetes 25 ± 12 and 23 ± 9 years, respectively). Time in range (TIR) significantly improved by shifting to Auto-mode to a mean value >70% in both groups. Accordingly, statistically significant decreases in Glucose Management Indicator (GMI) and time above range (TAR > 180 mg/dL)

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Rationale and aims Outpatient group visits in diabetes care have several potential advantages and can be simplified by the new technologies. The aim of this study was to assess feasibility and effectiveness of group visits vs individual visits in adults with type 1 diabetes on insulin pump therapy (continuous subcutaneous insulin infusion, CSII) and continuous glucose monitoring (CGM). Methods Outpatient setting for group visits (2‐hour duration, quarterly, 6‐8 patients) was the projection on giant screen of each patient's CGM and insulin pump data, with interactive discussion moderated by a diabetologist. Anthropometric measures and glycemic control (HbA1c) were assessed before and after a mean observation period of 4.4 ± 1.2 years (mean ± standard deviation, M ± SD) in CSII patients followed by group visits (GROUP) or individual visits (INDIVIDUAL) between 2013 and 2019. Results At the beginning of the observation, GROUP and INDIVIDUAL cohorts were strictly matched for gender (M/F = 37/35 and 37/35), age, diabetes duration, body mass index (BMI), CSII duration, and HbA1c level. HbA1c levels did not change significantly between beginning and end of observation in either cohort (GROUP 7.54 ± 0.80% and 7.60 ± 0.79%, P = .585; INDIVIDUAL 7.73 ± 1.27% and 7.60 ± 1.08%, P = .281) (time*visit effect P = .232, two‐way repeated measures analysis of variance [ANOVA]). Body weight remained unchanged in the GROUP cohort (73.2 ± 14.0 vs 73.8 ± 14.8 kg, P = .361), while it increased in the INDIVIDUAL cohort (70.3 ± 13.5 vs 73.0 ± 13.7 kg, P < 0.001) (time*visit effect P = .009). Conclusions Group care is feasible in adult patients with type 1 diabetes using new technologies. Group visits can be beneficial in inducing lifestyle changes, as indicated by the favorable effects observed on body weight trend.