The effects of large-scale social restriction during the covid-19 pandemic on glycemic control and occurrence of complications in children with type-1 diabetes mellitus

  • Sahara Effendy Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Central Java
  • Setya Wandita Department of Child Health, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada/Dr. Sardjito Hospital Yogyakarta, Central Java
  • Madarina Julia Department of Child Health, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Central Java
Keywords: large social scale restriction; LSSR; type 1 diabetes mellitus; HbA1c; complication

Abstract

Background The global pandemic of severe acute respiratory syndrome caused by the coronavirus-2 (SARS-CoV-2) infection has resulted in a national large-scale social restriction (LSSR) to limit the spread of the virus.

Objective To determine the impacts of LSSR on glycemic controls and the occurrence of complications in type-1 diabetes mellitus (T1DM) children.   

Methods A retrospective longitudinal study was carried out in Dr. Sardjito Hospital, Yogyakarta. Subjects were 0-18 years old T1DM patients diagnosed before the LSSR with at least six months of disease. Data on demographics, T1DM status, HbA1c level, and complications pre-LSSR, and during LSSR were taken from medical records. Paired T-tests were used to assess the difference in HbA1c level between the two-time points

Results: We included information on 21 children based on the inclusion and exclusion criteria. Their median (range) age was 13.9 (1.42-17.3) years, with a median (range) diabetes duration of 2.6 (0.0-10.92) years. Glycemic control improved in 76% of the children. The mean  HbA1c before and during LSSR was 10.9 (SD 2.7) and. 9.7 (SD 2.3), respectively; P<0.05. The glycemic control was not associated with sex, age, duration of diabetes, travel time to the clinic, or a total daily insulin dose. There was also no significant difference in the occurrence of complications.

Conclusion Despite limitations during LSSR, glycemic control improved in most patients with T1DM. This might be related to improved health awareness during the pandemic, more regular meals, and better parental control.  

References

Badan Penelitian dan Pengembangan Kementrian Kesehatan RI. Riskesdas. Riset Kesehatan Dasar. Jakarta: Kemenkes RI; 2013.
2. Ikatan Dokter Anak Indonesia. Tridjaja B, Yati NP, Faizi M, Marzuki N, Moelyo AG, Soesanti F, editors. Konsensus nasional pengelolaan diabetes mellitus tipe 1. Jakarta: Badan Penerbit IDAI; 2015.
3. Eiselein L, Schwartz HJ, Rutledge JC. The challenge of type 1 diabetes mellitus. ILAR 2004;45:231–6. DOI: https://doi.org/10.1093/ilar.45.3.231.
4. Macmillan F, Kirk A, Mutrie N, Matthews L, Robertson K, Saunders DH. A systematic review of physical activity and sedentary behavior intervention studies in youth with type 1 diabetes: Study characteristics, intervention design, and efficacy. Pediatr Diabetes. 2014;15:175–89. DOI: https://doi.org/10.1111/pedi.12060.
5. Wang G, Zhang Y, Zhao J, Zhang J, Jiang F. Mitigate the effects of home confinement on children during the COVID-19 outbreak. Lancet. 2020; 395: 945-7. DOI: https://doi.org/10.1016/S0140-6736(20)30547-X.
6. Kshanti IA, Epriliawati M, Mokoagow MI, Nasarudin J, Magfira N. The impact of COVID-19 lockdown on diabetes complication and diabetes management in people with diabetes in Indonesia. J Prim Care Community Health. 2021;12:21501327211044888. DOI: https://doi.org/10.1177/21501327211044888.
7. Nwosu BU, Al-Halbouni L, Parajuli S, Jasmin G, Zitek-Morrison E, Barton BA. COVID-19 pandemic and pediatric type 1 diabetes: No significant change in glycemic control during the pandemic lockdown of 2020. Front. Endocrinol. 2021;12. DOI: https://doi.org/10.3389/fendo.2021.703905.
8. Shah N, Karguppikar M, Bhor S, Ladkat D, Khadilkar V, Khadilkar A. Impact of lockdown for COVID-19 pandemic in Indian children and youth with type 1 diabetes from different socio-economic classes. J Pediatr Endocrinol Metab. 2020;34:217-23. DOI: https://doi.org/10.1515/jpem-2020-0460.
9. Elhenawy YI, Eltonbary KY. Glycemic control among children and adolescents with type 1 diabetes during COVID-19 pandemic in Egypt: a pilot study. International Journal of Diabetes in Developing Countries [Internet]. 2021;41:389–95. DOI: https://doi.org/10.1007/s13410-021-00968-y.
10. Lawrence N, Natarajan A, Petkar R, Joseph L. Impact of COVID-19 lockdown on glycaemic control in young people with type 1 diabetes: a retrospective review at a large hospital. Diabetes Care for Children & Young People2021;10:1–7.
11. Predieri B, Leo F, Candia F, Lucaccioni L, Madeo SF, Pugliese M, et al. Glycemic Control improvement in Italian Children and Adolescents with Type 1 Diabetes followed through Telemedicine during Lockdown due to the COVID-19 Pandemic. Front Endocrinol (Lausanne). 2020;11: 595735. DOI: https://doi.org/10.3389/fendo.2020.595735.
12. Huang X, Wei F, Hu L, Wen L, Chen K. Epidemiology and clinical characteristics of COVID-19. Arch Iran Med. 2020;23:268-71. DOI: https://doi.org/10.34172/aim.2020.09.
13. Ruissen MM, Regeer H, Landstra CP, Schroijen M, Jazet I, Nijhoff MF, et al. Increased stress, weight gain and less exercise in relation to glycemic control in people with type 1 and type 2 diabetes during the COVID-19 pandemic. BMJ Open Diabetes Research and Care. 2021;9:e002035. DOI: https://doi.org/10.1136/bmjdrc-2020-002035.
14. Wright RJ, Kelnar CJH, Frier BM. Factors influencing glycaemic control in children with type 1 diabetes. Diabetic Medicine. 2008;25:375–6. DOI: https://doi.org/ DOI: 10.1111/j.1464-5491.2007.02367.x.
15. Donaghue KC, Marcovecchio ML, Wadwa RP, Chew EY, Wong TY, Calliari LE, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Microvascular and macrovascular complications in children and adolescents. Pediatric Diabetes. 2018;19:262–74. DOI: https://doi.org/10.1111/pedi.12742.
16. American Diabetes Association. Children and adolescents: Standards of medical care in diabetes—2021. Diabetes Care. 2021;44 (Suppl.1) :S180–99. DOI: https://doi.org/10.2337/dc21-S013.
Published
2023-08-16
How to Cite
1.
Effendy S, Wandita S, Julia M. The effects of large-scale social restriction during the covid-19 pandemic on glycemic control and occurrence of complications in children with type-1 diabetes mellitus. PI [Internet]. 16Aug.2023 [cited 10Nov.2024];63(4):298-03. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3062
Section
Pediatric Endocrinology
Received 2022-08-09
Accepted 2023-08-16
Published 2023-08-16