Garofolo, M. et al | 2021| Glycaemic control during the lockdown for COVID-19 in adults with type 1 diabetes: A meta-analysis of observational studies | Diabetes Research and Clinical Practice | doi: https://doi.org/10.1016/j.diabres.
This review is available online ahead of print. It updates an earlier systematic systematic review and meta-analysis of studies assessing the effects of lockdown during COVID-19 pandemic on glucose metrics in adult subjects
with type 1 diabetes using continuous glucose monitoring (CGM) and flash glucose monitoring (FGM).
The reviewers report that in their meta-analysis of aggregate data shows that well-controlled people with type 1
diabetes on both MDI and CSII with continuous or flash glucose monitoring did not experience a 14 deterioration in glucose control throughout the COVID-19 lockdown, showing a modest, though statistically significant improvement in many glucose control parameters (Garofolo et al, 2021).
To assess the effects of lockdown due to COVID-19 pandemic on glucose metrics, measured by glucose monitoring systems, in adult individuals with type 1 diabetes.
Methods: We conducted a systematic literature search for English language articles from MEDLINE, Scopus and Web of Science up to February 28, 2021, using “diabetes”, “lockdown”, and “glucose” as key search terms. Time in range (TIR) was the main outcome; other metrics were time above range (TAR), time below range (TBR), mean blood glucose (MBG) and its variability ( per cent CV), estimated HbA1c (eA1c) or glucose management indicator (GMI).
Results: Seventeen studies for a total of 3,441 individuals with type 1 diabetes were included in the analysis. In the lockdown period, TIR 70-180 mg/dl increased by 3.05 per cent declined by 3.39 per cent (-5.14 to -1.63 per cent ) and 1.96 per cent (-2.51 to -1.42 per cent ), respectively (p less than 0.0001 for both). Both TBR less than 70 and less than 54 mg/dL remained unchanged. MBG slightly decreased by 5.40 mg/dL (-7.29 to – 3.51 mg/dL; p less than 0.0001) along with a reduction in per centCV. Pooled eA1c and GMI decreased by 0.18 per cent (-0.24 to -0.11 per cent ; p less than 0.0001) and a similar reduction was observed when GMI alone was considered (0.15 per cent, -0.23 to – 0.07 per cent; p less than 0.0001). Sensor use was only slightly but not significantly reduced during lockdown.
Conclusions: This meta-analysis shows that well-controlled people with type 1 diabetes on both MDI and CSII with continuous or flash glucose monitoring did not experience a deterioration in glucose control throughout the COVID-19 lockdown, showing a modest, though statistically significant improvement in many glucose control parameters.
Glycaemic control during the lockdown for COVID-19 in adults with type 1 diabetes: A meta-analysis of observational studies [paper ahead of print]