ESPE Abstracts

Objectives: The SARS-CoV-2 pandemic has resulted in major cutbacks in service provision to patients. This could be detrimental to children with diabetes mellitus (DM), whose condition could deteriorate from poor access to healthcare. The lockdown has also potentially caused changes in diet, sedentary behavior and psychological burden due to the stress associated with the pandemic, which can have negative effects on glycemic control. Thus, this study compares clinical processes and patient care markers for paediatric patients with DM pre- and post- pandemic.

Study Design: A clinical audit of diabetes care provided to paediatric patients was conducted in a tertiary children’s hospital in London. The indicators of care were based on the 9 care processes recommended by the National Institute for Health and Care Excellence. Data was collected retrospectively for 270 patients and compared between the pre-pandemic (October 2019 to March 2020) and post pandemic (October 2020 to March 2021) periods. Newly diagnosed, transitioned, permanently discharged patients were excluded. Paired sample t-tests were used for data analysis.

Results: There were 207 patients with T1DM, 18 with T2DM, 11 with MODY and 34 with others. The mean BMI and HbA1c values of patients who had data for both periods, are as follows: Expectedly, the mean number of BMI and HbA1c measurements taken for the entire cohort dropped drastically over the 2 time periods, from 1.40 (95%CI 1.32-1.48) to 0.70 (95%CI 0.62-0.77) and 1.46 (95%CI 1.39-1.53) to 0.93 (95%CI 0.87-0.99) respectively (P < 0.001). Of the patients assessed during both periods, 55.9% required psychological support pre-pandemic versus 57.7% post. Of those receiving input, mental health staging declined for 38.6%, remained unchanged for 42.1% and improved for 19.3% (P = 0.092). Of those who declined, 52.4% were primarily due to the lockdown.

Conclusions: During the pandemic, the BMI of patients with T1DM and the HbA1c of patients with T2DM increased significantly. It also impacted the percentage of patients with completed care processes, the frequency of monitoring of key indicators and the patient’s mental wellbeing.