Glycemic Control in Type 1 Diabetes Mellitus During COVID-19 Quarantine and the Role of In-Home Physical Activity
Glycemic Control in Type 1 Diabetes Mellitus During COVID-19 Quarantine and the Role of In-Home Physical Activity
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DOI：
10.1089/dia.2020.0169
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发表时间：
2020-05-21
影响因子：
5.4
通讯作者：
Barbi, Egidio
中科院分区：
文献类型：
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作者：
Tornese, Gianluca;Ceconi, Viola;Barbi, Egidio
背景：为了限制 2019 冠状病毒病 (COVID-19) 的传播，各国政府下令采取一系列可能影响 1 型糖尿病 (T1DM) 患者血糖控制的限制措施，因为不允许在户外进行体力活动 (PA)。方法：我们回顾性评估了意大利 SARS-CoV-2 爆发之前（2 月 10 日至 2 月 23 日）期间使用混合闭环 (HCL) 系统对 T1DM 患者的血糖控制情况。 2020年-时间1)，仅减少活动时(2020年2月24日至3月8日-时间2)和完全封锁期间(2020年3月9日-22日-时间3)。收集有关隔离前和隔离期间定期 PA（每周至少 3 小时）的信息。 结果：该研究包括 13 名中位年龄为 14.2 岁且基线时血糖控制良好的个体（血糖管理指标为 7%，范围内时间 [TIR] 为 68%，低于范围 [TBR] 的时间为 2%）。在整个研究期间，所有个体均继续表现出良好的血糖控制。研究期间 TIR 有所增加 (+3%)，并且时间 3 期间的 TIR (72%) 显着高于时间 2 期间 (66%)。与时间 1 和时间 2 (2%) 相比，时间 3 期间的 TBR 显着降低 (1%)。发现在隔离期间进行或不进行 PA 的个体之间在时间 3 的 TIR 存在有意义的差异，并且在基线和隔离期间均进行 PA 的个体在时间 2 和时间 3 之间的 TIR 显着增加。在逻辑回归中，只有隔离期间 PA 的存在才能显着预测 TIR >70%。结论：使用 HCL 系统的青少年 T1DM 的血糖控制在因 COVID-19 大流行而受到限制期间没有恶化，并且在隔离期间继续 PA 的患者中进一步改善。在 COVID-19 危机期间，在安全的家庭环境中保持定期 PA 是患有 T1DM 的年轻人的一项重要策略。
Background: To limit the spread of coronavirus disease 2019 (COVID-19), governments have ordered a series of restrictions that may affect glycemic control in individuals with type 1 diabetes mellitus (T1DM), since physical activity (PA) was not allowed outside home.Methods: We retrospectively evaluated glycemic control of individuals with T1DM using hybrid closed loop (HCL) system in the period before the SARS-CoV-2 outbreak in Italy (February 10-23, 2020-Time 1), when movements were only reduced (February 24-March 8, 2020-Time 2) and during complete lockdown (March 9-22, 2020-Time 3). Information about regular PA (at least 3 h per week) prior and during the quarantine was collected.Results: The study included 13 individuals with a median age of 14.2 years and a good glycemic control at baseline (glucose management indicator of 7%, time in range [TIR] of 68%, time below range [TBR] of 2%). All individuals continued to show good glycemic control throughout the study period. There was an increase in TIR during the study period (+3%) and TIR was significantly higher during Time 3 (72%) than during Time 2 (66%). TBR was significantly lower during Time 3 (1%) both compared with Time 1 and Time 2 (2%). A meaningful variance in TIR at Time 3 between individuals who performed or not PA during quarantine and a significant increase in TIR between Time 2 and Time 3 in individuals both doing PA at baseline and during quarantine was found. At logistic regression, only the presence of PA during quarantine significantly predicted a TIR >70%.Conclusions: Glycemic control of T1DM in adolescents using HCL system did not worsen during the restrictions due to COVID-19 pandemics and further improved in those who continued PA during the quarantine. Maintaining regular PA in a safe home environment is an essential strategy for young individuals with T1DM during the COVID-19 crisis.