Dataset Information

Glycemic fluctuations caused by COVID-19: Results from continuous glucose monitoring.

ABSTRACT:

Aim

We aimed to address the potential impact of COVID-19 on glycemic patterns in a small pilot study.

Method

13 patients with mild COVID-19 who were confirmed without diabetes and another group of 18 healthy individuals with available CGM data were well matched and enrolled into the final analysis.

Results

We noticed significantly higher TARs of >140 mg/dL (median 13.9% vs. 2.3%, P = 0.006), >160 mg/dL (median 4.7% vs. 0.0%, P = 0.011) and >180 mg/dL (median 1.9% vs. 0.0%, P = 0.007) among non-diabetic patients with COVID-19 than those among healthy individuals. There was no significant difference in TBR of <70 mg/dL or <54 mg/dL (all P > 0.1). Consequently, the TIR of 70 mg/dL to 140 mg/dL was significantly lower in non-diabetic patients with COVID-19 than that in healthy individuals (median 80.1% vs. 93.1%, P = 0.001). Significant postprandial glycemic fluctuations were observed among patients with COVID-19. There was a remarkable difference in CV in non-diabetic patients with COVID-19 compared to healthy individuals (median 25.6% vs. 15.7%, P < 0.001).

Conclusion

Significant higher glycemic fluctuation and exposure to hyperglycemia was associated with COVID-19 among previously normoglycemic individuals, characterized with potentially impaired glucose tolerance.

SUBMITTER: Shen Y

PROVIDER: S-EPMC7884232 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Glycemic fluctuations caused by COVID-19: Results from continuous glucose monitoring.

Shen Yun Y Zhang Lei L Fan Xiaohong X Zhou Jian J

Obesity medicine 20210216

<h4>Aim</h4>We aimed to address the potential impact of COVID-19 on glycemic patterns in a small pilot study.<h4>Method</h4>13 patients with mild COVID-19 who were confirmed without diabetes and another group of 18 healthy individuals with available CGM data were well matched and enrolled into the final analysis.<h4>Results</h4>We noticed significantly higher TARs of >140 mg/dL (median 13.9% vs. 2.3%, <i>P</i> = 0.006), >160 mg/dL (median 4.7% vs. 0.0%, <i>P</i> = 0.011) and >180 mg/dL (median 1 ...[more]

PMID: 33615034

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Project description:Aims/introductionThe coronavirus disease 2019 (COVID-19) pandemic urged authorities to impose rigorous quarantines and brought considerable changes to people's lifestyles. The impact of these changes on glycemic control has remained unclear, especially the long-term effect. We aimed to investigate the impact of COVID-19 lockdown on glycemic control in children and adolescents with type 1 diabetes.Materials and methodsThis observational study enrolled children with type 1 diabetes using continuous glucose monitoring. Continuous glucose monitoring data were extracted from the cloud-based platform before, during and after lockdown. Demographics and lifestyle change-related information were collected from the database or questionnaires. We compared these data before, during and after lockdown.ResultsA total of 43 children with type 1 diabetes were recruited (20 girls; mean age 7.45 years; median diabetes duration 1.05 years). We collected 41,784 h of continuous glucose monitoring data. Although time in range (3.9-10.0 mmol/L) was similar before, during and after lockdown, the median time below range <3.9 mmol/L decreased from 3.70% (interquartile range [IQR] 2.25-9.53%) before lockdown to 2.91% (IQR 1.43-5.95%) during lockdown, but reversed to 4.95% (IQR 2.11-9.42%) after lockdown (P = 0.004). Time below range <3.0 mmol/L was 0.59% (IQR 0.14-2.21%), 0.38% (IQR 0.05-1.35%) and 0.82% (IQR 0.22-1.69%), respectively (P = 0.008). The amelioration of hypoglycemia during lockdown was more prominent among those who had less time spent <3.9 mmol/L at baseline. During lockdown, individuals reduced their physical activity, received longer sleep duration and spent more time on diabetes management. In addition, they attended outpatient clinics less and turned to telemedicine more frequently.ConclusionGlycemic control did not deteriorate in children and teenagers with type 1 diabetes around the COVID-19 pandemic. Hypoglycemia declined during lockdown, but reversed after lockdown, and the changes related to lifestyle might not provide a long-term effect.

Project description:Tight glycemic control can potentially reduce morbidity and mortality in the intensive care unit but increases the risk of hypoglycemia. The most effective means to avoid hypoglycemia is to obtain frequent blood glucose samples, but this increases the burden to nursing staff. The objective of this study was to assess the ability of a real-time continuous glucose monitor to reduce hypoglycemia (blood glucose <60 mg/dL [3.3 mmol/L]) during standard care or tight glycemic control effected with a proportional integral derivative insulin titration algorithm.Real-time continuous glucose monitor profiles obtained from an ongoing prospective randomized trial of tight glycemic control were retrospectively analyzed to determine whether the continuous glucose measure had prevented instances of hypoglycemia.Cardiac intensive care unit.Children 3 yrs of age or younger undergoing cardiac surgery were studied.Intravenous insulin infusion and rescue glucose guided by the real-time continuous glucose monitor and the proportional integral derivative algorithm in the tight glycemic control arm (n = 155; target glucose 80-110 mg/dL [4.4-6.1 mmol/L]) and the real-time continuous glucose monitor in the standard care arm (n = 156).No reduction in hypoglycemia was observed with real-time continuous glucose monitor alarms set at 60 mg/dL (3.3 mmol/L) (zero of 19 occurrences of blood glucose <60 mg/dL [3.3 mmol/L] detected); 18 of 40 subsequent incidences of hypoglycemia were detected after the alarm threshold was increased to 70 mg/dL (3.9 mmol/L). In the tight glycemic control arm, eight incidences were reduced in duration and an additional eight events were prevented with intravenous glucose. In the standard care arm, three of nine occurrences of hypoglycemia were detected with the duration reduced in all cases. On average, one to two false hypoglycemia alarms were observed in each patient.The real-time continuous glucose monitor in combination with proportional integral derivative control can reduce hypoglycemia during tight glycemic control. The real-time continuous glucose monitor can also reduce hypoglycemia during standard care. However, false alarms increase the overall nursing workload.

Dataset Information

Glycemic fluctuations caused by COVID-19: Results from continuous glucose monitoring.

Aim

Method

Results

Conclusion

Publications

Glycemic fluctuations caused by COVID-19: Results from continuous glucose monitoring.

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