Visual Abstract
To slow the spread of COVID-19, a shelter in place (SIP) order was imposed in California between 03/16/2020 - 05/31/2020. We assessed the impact of SIP on glycemic control in a pediatric population with T1D using a continuous glucose monitor (CGM). We hypothesized that glucose control would improve due to increased supervision at home. The retrospective study included 96 patients between the ages of 3-22 years who were diagnosed with T1D at least one year earlier. We analyzed CGM data during three time periods: baseline, SIP, and post SIP (06/01/2020 - 07/30/2020) and compared standard CGM metrics controlling for gender (56% male), race (55% White), ethnicity (70% non-Hispanic), age (mean 11 yrs ± 3.9), and insurance type (8.4% public). The mean time in range (70-180 mg/dL: TIR) increased across the three time periods: from 59.9% ± 15.1 at baseline to 62.8% ± 15.9 during SIP (p<0.001) and maintained at 63.5% ± 16.6 during post-SIP period (p=0.23) compared with SIP. Increases in TIR were seen in both privately insured (2.9% ± 6.0) and publicly insured (3.7% ± 6.2) individuals during SIP vs. baseline with no increase in time with hypoglycemia (<70 mg/dl) in privately insured (0.1% ± 1.4) and publicly insured (-0.08%±1.3). Our analyses highlight the impact of the SIP order on glycemic control. Better understanding of the factors associated with improved TIR could translate to better glycemic control post-COVID.
L. Ekhlaspour: Consultant; Self; Tandem Diabetes Care, Ypsomed Group. J. J. Vallon: None. J. Ngo: None. P. Prahalad: None. D. Scheinker: Advisory Panel; Self; Carta Healthcare. D. M. Maahs: Advisory Panel; Self; Abbott Diabetes, Dompe, Eli Lilly and Company, Medtronic, Novo Nordisk, Consultant; Self; aditxt.
Stanford Diabetes Research Center (P30DK116074); National Institutes of Health (K23121942)
