Impact of Coronavirus Disease ۲۰۱۹ Outbreak on Children and Adolescents with Type ۱ Diabetes Mellitus

Background: This study aimed to investigate the impact of the Coronavirus Disease ۲۰۱۹ (COVID-۱۹) pandemic on daily routines and health of patients with type ۱ diabetes mellitus (T۱DM).Study design: A cross-sectional study.Methods: This study included ۹۸ children and adolescents with type ۱ diabetes who were regularlyfollowed up in the Endocrinology outpatient clinic of Besat Hospital, Hamadan, Iran, in ۲۰۲۰. Theprimary measurements included body mass index, glycemic control, number of hypoglycemicevents, number of hospitalizations, as well as bedtime and availability of insulin six months pre andpost COVID-۱۹ outbreak. The obtained data were analyzed in SPSS software (version ۱۶). A pvalueless than ۰.۰۵ was considered statistically significant.Results: Out of ۹۸ participants (mean ±SD age: ۱۳.۵±۴۹), ۵۱% of the cases were male, and %۸۱.۶of the patients were urban residents. Furthermore, most participants (۴۳.۹%) were in the age groupof ۱۱-۱۵ years, and the mean ±SD duration of diabetes was ۴.۶۴±۳.۳۱ years. In addition, ۲.۰۴% ofthe participants developed COVID-۱۹. There was a statistically significant difference amongaverage duration of night sleep (P<۰.۰۰۱), bedtime (P<۰.۰۰۱), time of waking up (P<۰.۰۰۱),amount of insulin intake (P=۰.۰۰۳), daily exercise (P<۰.۰۰۱), and availability of the insulin(P<۰.۰۰۱) before and during COVID-۱۹ crisis. The frequencies of hospitalizations andhypoglycemic events were lower after the COVID-۱۹ outbreak (P=۰.۰۰۵ and P=۰.۰۳۴,respectively). Morning insulin dose was omitted in ۲۲.۲% of participants. No differences were foundbetween hemoglobin A۱c and daytime sleep pre and post COVID-۱۹ outbreak.Conclusions: The key challenges due to COVID-۱۹ pandemic restrictions for Iranian T۱DMpatients were the need to take more insulin, lower physical activity, non-availability of insulin, andmissed morning insulin dose. However, it is worth mentioning that the patients' blood glucosecontrol did not worsen in this period.

Keywords:

COVID-۱۹ , Diabetic Ketoacidosis , Glycemic Control , Type ۱ Diabetes Mellitus