Glycemic control among children and adolescents with type 1 diabetes during COVID-19 pandemic in Egypt: a pilot study

Abstract

Background The COVID-19 pandemic and the consequences of lockdown significantly impacted glycemic control. Aim To evaluate the impact of the pandemic and lockdown on glycemic control among Egyptian children and adolescents with type 1 diabetes. Methods Cross-sectional study conducted through an online questionnaire. The participants were patients with type 1 diabetes and/or their caregivers Results A total of 115 valid responses to the questionnaire were received. During the lockdown, almost 64% of patients showed worsening of their HbA1C with significant increment of HbA1c after the lockdown (p < 0.001). Synchronous simple telemedicine service was initiated through phone calls and social media applications, and 97% of the patients and their families were successfully able to continue follow-up. Almost 76% of the patients/caregivers showed moderate stress which was significantly correlated with HbA1C (p < 0.05). Fear of hospital admission and fear from shortage of medical supplies were the main COVID-19-related worries. Conclusion The lockdown negatively impacted glycemic control and initiated a set of COVID-19 worries and stress among patients and their caregivers in Egypt. Telemedicine service, even simple tools, is effective and important for the continuity of care among patients. The limited availability and the fear of shortage of medical supply forced patients to ration glucose monitoring.

The Impact of the Covid-19 Pandemic on the Well-Being and Diabetes Management of Adolescents With Type 1 Diabetes and Their Caregivers: A Scoping Review

“…On this matter, the majority of the included studies focused on evaluating the impact of Covid-19 on medical indices among adolescents with T1DM. In general, they underlined a stable and even improved TIR and HbA1c pre-, during and post-lockdown (29)(30)(31)34), except for one study that showed a downward trend of glycemic control pre-and post-lockdown (32). Another relevant result that emerged was the reduction in physical CGM, Continuous Glucose Monitoring; GMI, Glucose monitoring Index; LBGI, Low Blood Glucose Index; HBGI, High Blood Glucose Index; SMBG, Self-monitoring of blood glucose; TIR, Time in Range; TAR, Time Above Range; TBR, Time Below Range.…”

“…More specifically, N = 4 studies (29)(30)(31)34) reported the Time in Range (TIR), comprising also the Time Above Range (TAR) and the Time Below Range (TBR) which were reported by N = 3 (30,31,34) studies. Hemoglobin A1c (HbA1c) was instead reported by N=6 studies (29,(31)(32)(33)(34)(35), with N = 2 studies also reporting information about the Glucose Management Indicator (GMI) (30,31) representing the estimates A1c (eA1c). The Low and High Blood Glucose Indices (LBGI and HBGI, respectively) were reported by N = 2 studies (29,31), while the Mean Glucose by N = 3 studies (29,31,34); of these, N = 2 (29, 31) also provided the sample's glucose SD.…”

glycemic control among type 1 diabetes children pre and during COVID-19 pandemic

“…This meta-analysis showed that HbA1c and mean glucose levels were lower before than after the pandemic era. Lockdown in the pandemic era hurts glycemic control in T1DM children (Elhenawy and Eltonbary, 2021), especially 10-13 years of age. 7 However, the severity of T1DM also increases during the pandemic era (Kostopoulou et al, 2021 andMc-Glacken-Bryne et al, 2021).…”

Increased global online interest in diabetes during the COVID-19 pandemic: An infodemiology study

“…The pandemic resulted in fewer number of hospital visits due to the recommendations on social isolation and travel restrictions, loss of the traditional method of communication with the patient, impaired routine diabetic care, and absences of telehealth services. Previous studies have shown that the pandemic resulted in poor glycemic control and increasing incidence of diabetes complications ( Elhenawy and Eltonbary, 2021 ; Kshanti et al, 2021 ; Önmez et al, 2020 ).…”