911-P: Changes in Metrics of Continuous Glucose Monitoring during COVID-19 in Children and Adolescents with Type 1 Diabetes

Background: Data on the changes in glucose control in pediatric patients with type 1 diabetes (T1D) affected by COVID-19 is lacking. We aimed to evaluate changes in metrics of continuous glucose monitoring (CGM) system during COVID-19 infection in children and adolescents with T1D.

Methods: We included 21 children and adolescents with T1D, aged younger than 20 years, with at least 70% of CGM readings during COVID-19. Symptoms of COVID-19 infection were investigated through a questionnaire. The effects of COVID-19 on metrics of CGM were assessed at five different time points [2 weeks before-COVID-19 (Time 1), 1 week before-COVID-19 (Time 2), 1 week during COVID-19 (Time 3), 1 week after COVID-19 (Time 4), and 2 weeks after COVID-19 (Time 5)].

Results: Of 21 patients (6 males and 15 females), mean age was 11.4 ± 4.7 years, and mean disease duration was 5.1 ± 4.8 years. All had at least one related symptoms (mean duration of symptoms of 5.2 ± 3.7 days); no one required hospitalization. Glucose management indicator (GMI) and the percentage of time spent above range (> 250 mg/dL) were significantly higher at Time 3 compared to Time 5 (7.8 ± 1.4 % vs 7.2 ± 1.4 %; P = 0.001 and 18.3 ± 18.5 % vs 13.0 ± 15.7 %; P = 0.016, respectively). According to the insulin delivery methods, GMI at Time 2 was significantly higher compared to Time 5 in patients treated with multiple daily injection (MDI) (n = 13) but not in those using continuous subcutaneous insulin infusion (CSII) (n = 6).

Conclusion: Pediatric patients with T1D experience mild COVID-19 infection with worsening glycemic control during COVID-19. The use of CSII is more effective in maintaining stable glycemic control during COVID-19 infection compared to MDI therapy.