This new investigation compared outcomes among pediatric patients with type 1 diabetes (T1D) before and after COVID-19 restrictions were imposed in Dallas County on March 15, 2020.
Adverse changes were not seen in depression screening via Patient Health Questionnaire-9 (PHQ-9), hospitalization frequency, and glycemic control among pediatric patients receiving care for type 1 diabetes (T1D) before and after COVID-19 restrictions were imposed in Dallas County on March 15, 2020, according to new findings published in BMC Pediatrics.
Outcomes were compared among 1600 patients of Children’s Medical Center Dallas for 2 periods: Those in the baseline 2019 (pre-COVID) group received care between March 15, 2019, and March 14, 2020, and those in the 2020 (post-COVID) group received care between March 15, 2020, and March 14, 2021. In addition to the above, all were evaluated for disease characteristics, in-person and virtual outpatient encounters, and continuous glucose monitor (CGM) utilization; had to have at least 1 patient encounter; and were considered CGM users if data were available for their study group year.
The COVID-19 pandemic has greatly impacted glycemic control among patients with diabetes, the authors noted. This—coupled with the fact that pediatric patients with T1D tend to have higher rates of diabetic ketoacidosis (DKA) if they have noncommercial insurance coverage, are of a minority race or ethnicity, and have higher glycated hemoglobin (A1C)—stresses the importance of good glycemic control to prevent severe cases of COVID-19 or death.
The mean (SD) patient age in the study was 13.8 (3.6) years and most were male (52.8%) or White (53.5%) with commercial insurance (60.3%). The virtual visit platform was put in place on April 1, 2020, following stoppage of in-person clinic visits on March 16, 2020.
Their analysis determined the following:
“In our large urban hospital setting, the COVID pandemic had no effect on glycemic control,” the authors concluded. “Rapid adoption of telemedicine, improved access to CGM and, perhaps, increased parental oversight of diabetes care likely helped maintain glycemic control and hospitalization frequencies at prepandemic levels.”
Generalization of their findings, however, may be limited because the patients in their analysis came from just 1 medical center and lived in urban areas, and similar results may not be seen among rural populations with lack of reliable access to internet and cellular phone connectivity. In addition, they used insurance status as a stand-in for socioeconomic status.
Choudhary A, Adhikari S, White PC. Impact of the COVID-19 pandemic on management of children and adolescents with type 1 diabetes. BMC Pediatr. Published online March 10, 2022. doi:10.1186/s12887-022-03189-2