ESPE Abstracts

Introduction: The beginning of the COVID-19 pandemic encouraged a sedentary lifestyle and “covibesity” was reported. Concerns for consequences on anthropometric data, glycemic control, and lipid profile in subjects with type 1 diabetes (T1D) were raised.

Objectives: Longitudinal and observational study aimed to investigate the 2-years effects of the COVID-19 pandemic on BMI, glycemic control, and lipid profile in children and young people (CYP) with T1D.

Methods: Anthropometric parameters, insulin total daily dose (I-TDD), glycemic control (A1c), lipid profile, and exercize were collected during the routine outpatient visits attended between December 2019 and February 2020 (T0, before the lockdown) and were compared with the ones recorded in the same months 1-year (T1) and 2-years after (T2).

Results: Eighty-three children and adolescents with T1D (65% male; at T2, median age 14.3 years and duration of diabetes 7.09 years) were recruited. BMI z-score significantly changed between periods (0.19 vs 0.08 vs 0.23 SDS; χ²=15.9; P<0.001); values were increased in 68.7% of CYP at T2. Exercize was significantly different between periods (4 vs 0 vs 5 h/week; χ²=128.4; P<0.0001). Rate of patients declaring low exercize (<6 h/week) decreased from 96.4% (T1) to 56.6% (T2). I-TDD was significantly changed (0.84 vs 0.92 vs 0.92 IU/kg/day; χ²=8.19; P=0.017). Annual HbA1c (62.1 vs 60.5 vs 60.6 mmol/mol; χ²=12.8; P=0.002) and TIR (48.1 vs 50.4 vs 55.4 %; χ²=16.3; P<0.001) were improved. A worsening of TC (158 vs 162.5 vs 161 mg/dl; χ²=8.45; P=0.015), LDL-C (77.6 vs 88.6 vs 92.4 mg/dl; χ²=28.1; P<0.0001), and HDL-C (63 vs 60 vs 57 mg/dl; χ²=21.3; P<0.0001) levels was found. Rate of subjects having TC >95th centile for gender and age increased from 9.76% (T0) to 12.3% (T2) (χ²=11.4; P<0.001). LDL-C levels were positively related to BMI z-score (P<0.05) and HDL-C were negatively correlated (P<0.05).

Conclusions: Two-years after the COVID-19 pandemic, in our CYP with T1D we found an increase of the BMI z-score that was still within the normal range. Glycemic control remained improved, while a worsening of the lipid profile was found. Our data may be due to both the resuming of regular physical activity and the increased use of sensor that allowed us to continue with telemedicine visits in T2, adjusting patients’ I-TDD. However, in some patients we must pay attention to the effects on cardiovascular health probably related to the increased consumption of canned food and industrialized foods during the pandemic.