Impact of COVID-19 lockdown on flash and real-time glucose sensor users with type 1 diabetes in England

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Joshi Prabhu Navis
  • Lalantha Leelarathna
  • Womba Musumadi Mubita
  • Andrea Urwin
  • Jonathan Schofield
  • Hood Thabit

Abstract

Aims People with type 1 diabetes (T1D) face the daily task of implementing self-management strategies to achieve their glycaemic goals. The UK COVID-19 lockdown has had an impact on day-to-day behaviour, which may affect diabetes self-management and outcomes. We assessed whether sensor-based outcomes pre- and during lockdown periods were different in a cohort of glucose sensor users with T1D. Methods Data were collected from Freestyle Libre (FSL) or Dexcom G6 sensor users who remotely shared their data with the diabetes clinic web-platform. Sensor metrics according to international consensus were analysed and compared between pre-lockdown period, and two and six weeks into lockdown (Period 1 and 2). Results Two hundred and sixty-nine T1D patients (baseline HbA1c 57±14mmol/mol) were identified as FSL (n=190) or Dexcom G6 (n=79) users. In patients with sensor use>70% (N=223), compared to prelockdown period percentage TIR 3.9 to 10mM (TIR) significantly increased during Period 1 (59.6±18.2 vs. 57.5±17.2%, p=0.002) and Period 2 (59.3±18.3 vs. 57.5±17.2%, p=0.035). The proportion of patients achieving TIR ≥70% increased from 23.3% pre-lockdown, to 27.8% in Period 1 and 30.5% in Period 2. A higher proportion also achieved the recommended time below and above range, and coefficient of variation in Period 1 and 2. Dexcom G6 users had significantly lower % time below range (<3.9mM) compared to FSL users during both lockdown periods (Period 1: Dexcom G6 vs. FSL: 1.8% vs. 4%; Period 2: 1.4% vs. 4%, P< 0.005 for both periods). Conclusion Sensor-based glycaemic outcomes in people with T1D in the current cohort improved during COVID19 lockdown, which may be associated with positive changes in self-management strategies. Further work is required to evaluate long term sustainability and support.

Bibliographical metadata

Original languageEnglish
JournalActa Diabetologica
Publication statusAccepted/In press - 29 Sep 2020