Glycemic control in people with type 1 diabetes using a hybrid closed loop system and followed by telemedicine during the COVID-19 pandemic in Italy

Abstract

This study aims at evaluating the metrics of glycemic control in people with type 1 diabetes using the hybrid closed loop (HCL) system during the COVID-19 lockdown. Methods: This is a retrospective study of thirty adults with type 1 diabetes using HCL and followed with telemedicine at an Italian University Hospital. Data on metrics of glucose control were collected at different times: two weeks before the lockdown (Time 0), first two weeks of lockdown (Time 1), last two weeks of lockdown (Time 2) and first two weeks after the lockdown (Time 3). The primary endpoint was the change in glucose management indicator (GMI) across the different time points. Results: GMI did not worsen over time (Time 1 vs Time 3, 7% vs 6.9%, P < 0.05), whereas a reduction of mean glucose (P = 0.004) and indices of glucose variability was observed. Time in range (TIR) significantly increased (68.5% vs 73.5%, P = 0.012), and time above range (TAR) level 2 (251-400 mg/dL) significantly decreased (P = 0.002). The improvement of TIR and glucose variability was mainly observed in participants < 35 years. Conclusions: Adults with type 1 diabetes using HCL showed a significant improvement of most of the metrics of glucose control during the COVID-19 lockdown.

Weight change and glycemic control in type 2 diabetes patients during COVID-19 pandemic: the lockdown effect

“…If we indeed consider type 1 diabetes mellitus, several recent studies on young and normal-weight patients using continuous glucose monitoring (CGM) systems found an unexpected improvement in glycemic control during the lockdown [ 12 , 15 , 16 ]. This can be explained by a more regular lifestyle during quarantine: the rhythm of daily activities slowed down, they were able to eat at more reproducible mealtimes, they were allowed to have a more controlled composition of meals [ 22 ].…”

Effectiveness of diabetes education including insulin injection technique and dose adjustment through telemedicine in hospitalized patients with COVID-19

“…The study concludes that a structured telephonic visit appears to be an effective way to replace or integrate routine visits in special situations, such as COVID-19 pandemic [ 7 ]. In another Italian study, adults with type 1 diabetes using hybrid closed loop system and followed by telemedicine showed improvements in most of the metrics of glucose control during the COVID-19 lockdown [ 8 ].…”

Effect of COVID-19 on management of type 1 diabetes: Pushing the boundaries of telemedical healthcare

“…This was clearly shown in a study performed in Italy during the COVID-19 lockdown including people with type 1 diabetes using the hybrid closed loop demonstrating improved glycemic control probably due to the availability of telemedicine and more active engagement of patients in glycemic management[ 10 ].…”