Thomas Danne1, Stefanie Lanzinger2, Martin Isaac de Bock3, Erinn T Rhodes4, Guy Todd Alonso5, Pascal Barat6, Yasmine Elhenawy7, Melanie Kershaw8, Banshi Saboo9, Mauro Scharf10, Agata Chobot11, Klemen Dovc12. 1. Hannover Medical School, 9177, Diabetes Center AUF DER BULT, Janusz-Korczak Allee 12, Hannover, Germany, 30625; danne@hka.de. 2. Ulm University, 9189, Institute of Epidemiology and Medical Biometry, ZIBMT,, Ulm, Baden-Württemberg, Germany; stefanie.lanzinger@uni-ulm.de. 3. University of Otago, Department of Paediatrics , Christchurch, New Zealand; martin.debock@otago.ac.nz. 4. Boston Children's Hospital Department of Pediatrics, 546607, Boston, Massachusetts, United States; Erinn.Rhodes@childrens.harvard.edu. 5. University of Colorado, Pediatrics, Barbara Davis Center, 1775 Aurora Ct, Denver, Colorado, United States, 80045; guy.alonso@cuanschutz.edu. 6. Centre Hospitalier Universitaire de Bordeaux, 36836, Bordeaux, Aquitaine, France; pascal.barat@chu-bordeaux.fr. 7. Ain Shams University, 68791, Pediatric and Adolescent Diabetes Unit (PADU),, Cairo, Egypt; dr_yasmi@yahoo.com. 8. Birmingham Women's and Children's NHS Foundation Trust, 1729, Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland; melaniekershaw1@nhs.net. 9. Dia Care, 1 & 2 gandhi Park, Society, Ahmedabad, India, 380015; banshisaboo@hotmail.com. 10. Centro de Diabetes Curitiba, Pediatric Endocrinology, Alcides Munhoz 433-Mercês-Hospital Nossa Senhora das Graças, Curitiba - PR, 80810-040, Curitiba, Paraná, Brazil, 80810-040; mauroscharf@gmail.com. 11. Opole University, 49576, Department of Pediatrics, Institute of Medical Sciences, , Opole, Poland; agata.chobot@uni.opole.pl. 12. University Medical Centre Ljubljana, 14Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, Ljubljana, Slovenia; klemen.dovc@mf.uni-lj.si.
Abstract
AIMS: To investigate the short-term effects of the first wave of COVID-19 on clinical parameters in children with type 1 diabetes (T1D) from 82 worldwide centres participating in the SWEET registry. METHODS: Aggregated data per person with T1D ≤ 21 years of age were compared between May/June 2020 (first wave), August/September 2020 (after wave) and the same periods in 2019. Hierarchic linear and logistic regression models were applied. Models were adjusted for gender, age- and diabetes duration-groups. To distinguish the added burden of the COVID-19 pandemic, the centres were divided into quartiles of first wave COVID-19 associated mortality in their country. RESULTS: In May/June 2019 and 2020, respectively, there were 16,735 vs. 12,157 persons, 52 vs. 52 % male, median age 13.4 [Q1;Q3: 10,1; 16.2] vs.13.5 [10,2; 16.2] years, T1D duration 4.5 [2.1; 7.8] vs. 4.5 [2.0; 7.8] years and HbA1c 60.7 [53.0; 73.8] vs. 59.6 [50.8; 70.5] mmol/mol (7.8 [7.0; 8.9] vs. 7.6 [6.8; 8.6] %). Across all country quartiles of COVID-19 mortality, HbA1c and rate of severe hypoglycaemia remained comparable to the year prior to the first wave, while DKA rates increased significantly in the centres from countries with the highest mortality rate but returned to baseline after the wave. CGM use decreased slightly during the first wave (53 vs. 51%) and increased significantly thereafter (55 vs. 63%, p<0.001). CONCLUSIONS: Although glycaemic control was maintained, a significant rise in DKA at follow-up was seen during first wave in the quartile of countries with the highest COVID mortality. TRIAL REGISTRATION: NCT04427189.
AIMS: To investigate the short-term effects of the first wave of COVID-19 on clinical parameters in children with type 1 diabetes (T1D) from 82 worldwide centres participating in the SWEET registry. METHODS: Aggregated data per person with T1D ≤ 21 years of age were compared between May/June 2020 (first wave), August/September 2020 (after wave) and the same periods in 2019. Hierarchic linear and logistic regression models were applied. Models were adjusted for gender, age- and diabetes duration-groups. To distinguish the added burden of the COVID-19 pandemic, the centres were divided into quartiles of first wave COVID-19 associated mortality in their country. RESULTS: In May/June 2019 and 2020, respectively, there were 16,735 vs. 12,157 persons, 52 vs. 52 % male, median age 13.4 [Q1;Q3: 10,1; 16.2] vs.13.5 [10,2; 16.2] years, T1D duration 4.5 [2.1; 7.8] vs. 4.5 [2.0; 7.8] years and HbA1c 60.7 [53.0; 73.8] vs. 59.6 [50.8; 70.5] mmol/mol (7.8 [7.0; 8.9] vs. 7.6 [6.8; 8.6] %). Across all country quartiles of COVID-19mortality, HbA1c and rate of severe hypoglycaemia remained comparable to the year prior to the first wave, while DKA rates increased significantly in the centres from countries with the highest mortality rate but returned to baseline after the wave. CGM use decreased slightly during the first wave (53 vs. 51%) and increased significantly thereafter (55 vs. 63%, p<0.001). CONCLUSIONS: Although glycaemic control was maintained, a significant rise in DKA at follow-up was seen during first wave in the quartile of countries with the highest COVIDmortality. TRIAL REGISTRATION: NCT04427189.
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