Lessons Learned From the Continuous Glucose Monitoring Metrics in Pediatric Patients With Type 1 Diabetes Under COVID-19 Lockdown

אורן קסנר ^1,2 Kineret Mazor-Aronovitch ^2,3,4 Marianna Rachmiel ^2,5 Noa Levek ⁴ Galia Barash ^2,5 Orit Pinhas-Hamiel ^2,3,4 Yael Lebenthal ^1,2 Zohar Landau ^4,6,7

¹Pediatric Endocrinology and Diabetes Unit, Dana Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center
²Sackler Faculty of Medicine, Tel Aviv University
³Pediatric Endocrine and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center
⁴National Juvenile Diabetes Center, Maccabi Health Care Services, Ra'anana
⁵Pediatric Endocrinology Unit, Shamir (Assaf Harofeh) Medical Center
⁶Pediatrics Department, Barzilai Medical Center, Ashkelon
⁷Faculty of Health Sciences, Ben-Gurion University of the Negev

Aims: Billions of people have been under lockdown in an attempt to prevent COVID-19 spread. Lifestyle changes during lockdown could lead to deterioration of glycemic control in type 1 diabetes (T1D). We aimed to assess the impact of COVID-19 lockdown on the glycemic control of pediatric patients with T1D.

Methods: This observational real-life study from the AWeSoMe Group assessed continuous glucose monitoring (CGM) metrics of 102 T1D patients (52.9% males, mean age 11.2±3.8years, mean diabetes duration 4.2±3.8years) who used DEXCOM G5. The data were accessed without any interface between patients, caregivers and the diabetes team. Study variables from CGM metrics were: mean glucose level, time-in-range (TIR, 70-180mg/dL;3.9-10mmol/L), hypoglycemia (< 54mg/dL;< 3mmol/L), hyperglycemia (> 250mg/dL;>13.3mmol/L), coefficient of variation (CV), and time CGM active before- and during-lockdown. Delta-variable=lockdown variable minus before-lockdown variable.

Results: The mean TIR was 60.9±14.3% before-lockdown, with no significant change during lockdown (delta-TIR was 0.9±7.9%). TIR during-lockdown was significantly correlated with TIR before-lockdown (r=0.855, P<0.001). Patients with improved TIR (delta-TIR>3%) were significantly older than patients with stable or worse TIR (P=0.028). Children aged

Conclusions: CGM metrics in pediatric patients with T1D were relatively stable during a nationwide lockdown. Intervention plans should focus on younger patients with lower socioeconomic position.