Coronavirus disease (Covid-19): How does the exercise practice in active people with type 1 diabetes change? A preliminary survey

Abstract

Aims: Coronavirus disease (Covid-19) could lead persons with pre-existing medical conditions to severe respiratory infections. The Italian Government introduced quarantine to limit viral transmission. This measure could lead people with type 1 diabetes (PWT1D) to disrupt daily care routine including PA practice with difficulties in glycemia management.This study aims to explore PA level in PWT1D before and during quarantine and to describe variation in glycemia values.Methods: An online survey investigating medical factors and the perceived and PA level in pre-established period before and after the introduction of quarantine was developed.Comparison between pre and post quarantine was assessed by Wilcoxon Signed Ranks test for continuous variables.Results: A total of 154 subjects satisfied the eligibility criteria (54.5% males, 44.8 ± 12.5 years). We found a decrease of PA level (Godin Scale Score 25 ± 1.7vs38.6 ± 1.7 points), steps number and minutes of exercise (respectively 12.606 ± 5026vs4.760 ± 3.145 and 66±4 vs 38 ±3) and an increase of glycemia values (142.1 ± 25.4 mg/dLvs150.8 ± 29.4 mg/dL).Conclusions: PWT1D reported a decrease in exercise and worst glycemia. Although PWT1D tried to remain active, their PA level was inadequate to prevent glycemia rising. The difficult to maintain a glycemic control could expose patients to diabetes complications and to an higher risk to counteract infections.

Glycemic Control Improvement in Italian Children and Adolescents With Type 1 Diabetes Followed Through Telemedicine During Lockdown Due to the COVID-19 Pandemic

“…The beneficial effect of physical activity on glycosylated hemoglobin (HbA1c) has been extensively investigated and a meta-analysis showed an overall effect on HbA1c of -0.85% (14). Data we found in our children and adolescents disagree with that obtained in adults with T1D in which it was reported a decrease in exercise and a worst in glucose values (15,41). Again, glycemic control in adolescents with T1D using hybrid closed loop system did not worsen during the restrictions due to COVID-19 pandemic and further improved in those who continued physical activity during the first 2-week of quarantine, confirming the importance of maintaining a regular physical activity also at home (19).…”

“…However, due to the suspension of outside structured physical and leisure activities, housebound children and adolescents with T1D needed to change their disease care, so concerns about possible harmful effects on glycemic control were arisen (14). To the best of our knowledge, studies on how the change in daily activities and lifestyles during lockdown has affected glycemic control in subjects with T1D are few and have small samples or short observation times (15)(16)(17)(18)(19).…”

COVID-19 and diabetes mellitus: from pathophysiology to clinical management

“…Several groups from Italy, Spain and the UK have reported that patients with T1DM and without COVID-19 have shown no deteriorations in glycaemic control, and often even show improvements in control, during the pandemic compared with a control period before the pandemic 131 – 133 . During lockdown, self-reported physical activity was found to be reduced 133 , 134 and more consistent patterns of nutrient intake and sleep were found 133 ; these findings might reflect conditions under which glycaemic control is easier to achieve. This effect might differ from the situation in developing countries with reduced access to food, medications, blood glucose test strips and medical services 135 , 136 .…”

Is It Important to Perform Physical Activity During Coronavirus Pandemic (COVID-19)? Driving Action for a Correct Exercise Plan

“…To limit viral transmission, most governments introduced national quarantine reducing movements and social interaction with the imperative "stay at home." Lockdown is considered the extreme option to protect health and in particularly most vulnerable people (those aged ≥65 years, and those with pathologies such as chronic heart, lung kidney and liver diseases, diabetes, and obesity), but it caused considerable disruption to the routine of the general population (2,3). The closure of gyms, stadiums, pools, dance and fitness studios, physiotherapy centers, parks, playgrounds reduced the possibility to practice Physical Activity (PA) in outdoor setting and, in general, the exercise options (4,5).…”