Effect of the COVID-19 quarantine on metabolic control in children and adolescents with type 1 diabetes

INTRODUCTION: Metabolic control in type 1 diabetes (T1D) depends on many factors such as eating habits, exercise and lifestyle. The objective of this study was to investigate how these factors were affected during the coronavirus disease 2019 (COVID-19) lockdown and impacted metabolic control in children with T1D. MATERIALS AND METHOD: One hundred children with T1D were enrolled in the study. Anthropometric measurements, snack and meal frequency, carbohydrate consumption, HbA1c levels, and exercise patterns were recorded and compared before and after the lockdown. Subjects were divided into two subgroups—patients with decreased and patients with increased HbA1c levels after the lockdown—and comparisons of the same parameters were also made between these two subgroups. RESULTS: In the overall group, the mean HbA1c level was significantly higher after the lockdown compared to before (p = 0.035). Meal schedules changed due to delayed sleep and waking times, and total daily carbohydrate consumption increased in the subgroup with increased HbA1c while it decreased in the subgroup with decreased HbA1c (p < 0.001 for both). CONCLUSION: Our study supports the notion that blood sugar management in children with T1D worsened during the COVID-19 pandemic. Although it is not possible to explain this with any one factor, some behavioral changes observed in our study, such as inactivity, irregular meal frequency and timing, and irregular sleep and waking patterns appeared to be associated with blood sugar management.