ESPE2021 ePoster Category 2 Diabetes and insulin (72 abstracts)
The Impact of COVID 19 Pandemic on Type 1 Diabetes Mellitus: An experience of a Tertiary Care Hospital in a resource limited country
Aqeela Ayub 1,2 , Sadaf Ijaz 2 , Syeda Mamoona Qudrat 2 , Tanzeela Rani 2 , Abdur Raziq 1 , Muhammad Ali 3 & Taeed Ahmed Butt 4
1Department of Paediatric Medicine, Pakistan Institute of Medical Sciences, Islamabad, Pakistan; 2Department of Paediatric Medicine, Benazir Bhutto Hospital, Rawalpindi, Pakistan; 3Department of Paediatric Endocrinology & Diabetes, Mayo Hospital, Lahore, Pakistan; 4Department of Paediatric Endocrinology & Diabetes, The Children’s Hospital & The institute of Child Health, Lahore, Pakistan
Background and Objectives: Managing type 1 diabetes (TIDM) in covid pandemic is a real challenge in resource limited countries like Pakistan. This study was aimed to determine the effects of covid 19 in managing type 1 diabetes in resource limited countries.
Methods: Cross-sectional observational study, included all type 1 diabetes patients who were already enrolled in endocrine and diabetes clinic and were on regular follow up.
Results: Eighty-three patients of T1DM (48 from rural area) were included in this study. 64% belonged to lower middle or lower class (monthly income less than PKR 50,000) while 36% belonged to middle class (monthly income = or > than 50,000 but less than PKR100,000. Thirteen out of 83 were doing daily blood glucose monitoring 4 times; 15 patients 3 times; 33 patients 2 times, and no monitoring was done by 16 patients. Only 6 cases were monitoring blood glucose 6 times/day (pre and most meal). Most of the patients had poor glycemic control with 16/83(19%) between 300-350mg/dl; 25/83(30%) between 250-300mg/dl and 33/83(40%) between 200-250mg/dl. Patients showing glucose levels less than 200 mg/dl were only 9%. HbA1c was more than 10% in 59/83 (71%) patients and 24/83(29%) had less than 10%. Fifty-five cases have no telemedicine access to doctor and 28 were having partial access.
Conclusion: Covid 19 seems to have a huge impact on managing type-1 diabetes. Due to lockdown, fear of coming to hospital and lack of telemedicine clinic, many patients are not properly monitoring blood glucose thus leading to poor control which can lead to complications like diabetic ketoacidosis.
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