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Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy

AIMS: To evaluate the effects of COVID-19 lockdown on blood glucose control in individuals with type 1 diabetes (T1D) and to explore determinants of glucose variability. METHODS: Fifty T1D patients undergoing continuous/flash glucose monitoring were recruited. The study’s primary outcome was the cha...

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Autores principales: Barchetta, Ilaria, Cimini, Flavia Agata, Bertoccini, Laura, Ceccarelli, Valentina, Spaccarotella, Michele, Baroni, Marco Giorgio, Cavallo, Maria Gisella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier B.V. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566668/
https://www.ncbi.nlm.nih.gov/pubmed/33075424
http://dx.doi.org/10.1016/j.diabres.2020.108513
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author Barchetta, Ilaria
Cimini, Flavia Agata
Bertoccini, Laura
Ceccarelli, Valentina
Spaccarotella, Michele
Baroni, Marco Giorgio
Cavallo, Maria Gisella
author_facet Barchetta, Ilaria
Cimini, Flavia Agata
Bertoccini, Laura
Ceccarelli, Valentina
Spaccarotella, Michele
Baroni, Marco Giorgio
Cavallo, Maria Gisella
author_sort Barchetta, Ilaria
collection PubMed
description AIMS: To evaluate the effects of COVID-19 lockdown on blood glucose control in individuals with type 1 diabetes (T1D) and to explore determinants of glucose variability. METHODS: Fifty T1D patients undergoing continuous/flash glucose monitoring were recruited. The study’s primary outcome was the change of time in range (TIR) from before to lockdown period. Three time-point comparisons of TIR, mean glucose levels (MG), estimated (e)HbA1c, time above (TAR) and below range (TBR), moderate/severe hypoglycemic events between pre-lockdown, lockdown and post-lockdown period were also performed. Information on lockdown-associated perceived stress, changes of work status and physical activity were recorded. RESULTS: TIR significantly decreased (75(63–84)% vs. 69(50–76)%, p < 0.001) whereas MG ( 154 ± 15 mg/dl vs. 165 ± 25 mg/dl, p = 0.027) and eHbA1c (7.3(6.6–7.8)% vs. 7.5(6.7–8.2)%, p = 0.031) increased from pre- to lockdown period; overall glucose control significantly improved when restriction ended. Lockdown-associated work loss/suspension independently predicted impaired TIR after adjustment for potential confounders (Standardized β: −0.29; 95%CΙ: −18.7 to −2.25; p = 0.01). Greater TAR, TBR and hypoglycemic events were also reported during the lockdown. CONCLUSION: In T1D Italian individuals, blood glucose control significantly worsened during the COVID-19 lockdown; work instability and related issues represented the main determinant of impaired glucose variability in this population.
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spelling pubmed-75666682020-10-19 Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy Barchetta, Ilaria Cimini, Flavia Agata Bertoccini, Laura Ceccarelli, Valentina Spaccarotella, Michele Baroni, Marco Giorgio Cavallo, Maria Gisella Diabetes Res Clin Pract Article AIMS: To evaluate the effects of COVID-19 lockdown on blood glucose control in individuals with type 1 diabetes (T1D) and to explore determinants of glucose variability. METHODS: Fifty T1D patients undergoing continuous/flash glucose monitoring were recruited. The study’s primary outcome was the change of time in range (TIR) from before to lockdown period. Three time-point comparisons of TIR, mean glucose levels (MG), estimated (e)HbA1c, time above (TAR) and below range (TBR), moderate/severe hypoglycemic events between pre-lockdown, lockdown and post-lockdown period were also performed. Information on lockdown-associated perceived stress, changes of work status and physical activity were recorded. RESULTS: TIR significantly decreased (75(63–84)% vs. 69(50–76)%, p < 0.001) whereas MG ( 154 ± 15 mg/dl vs. 165 ± 25 mg/dl, p = 0.027) and eHbA1c (7.3(6.6–7.8)% vs. 7.5(6.7–8.2)%, p = 0.031) increased from pre- to lockdown period; overall glucose control significantly improved when restriction ended. Lockdown-associated work loss/suspension independently predicted impaired TIR after adjustment for potential confounders (Standardized β: −0.29; 95%CΙ: −18.7 to −2.25; p = 0.01). Greater TAR, TBR and hypoglycemic events were also reported during the lockdown. CONCLUSION: In T1D Italian individuals, blood glucose control significantly worsened during the COVID-19 lockdown; work instability and related issues represented the main determinant of impaired glucose variability in this population. Elsevier B.V. 2020-12 2020-10-16 /pmc/articles/PMC7566668/ /pubmed/33075424 http://dx.doi.org/10.1016/j.diabres.2020.108513 Text en © 2020 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Barchetta, Ilaria
Cimini, Flavia Agata
Bertoccini, Laura
Ceccarelli, Valentina
Spaccarotella, Michele
Baroni, Marco Giorgio
Cavallo, Maria Gisella
Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy
title Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy
title_full Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy
title_fullStr Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy
title_full_unstemmed Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy
title_short Effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during COVID-19 lockdown in Italy
title_sort effects of work status changes and perceived stress on glycaemic control in individuals with type 1 diabetes during covid-19 lockdown in italy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566668/
https://www.ncbi.nlm.nih.gov/pubmed/33075424
http://dx.doi.org/10.1016/j.diabres.2020.108513
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