The Effect of Lockdown and Physical Activity on Glycemic Control in Italian Children and Young Patients With Type 1 Diabetes.

Aims: The purpose of the study was to evaluate the impact of the lockdown established by the Italian government to limit the spread of Coronavirus disease (COVID-19) on glycemic control in a large sample of patients with type 1 diabetes (T1D) based on age, type of insulin therapy, number of telemedicine visits and physical activity. Material and methods: We retrospectively evaluated glycemic control in young T1D patients using DexcomG6® system before the Italian lockdown (February 10-23, 2020 – Time 0) and during lockdown (April 17-30, 2020 – Time 1). Data on age, type of insulin therapy, number of telemedicine visits and physical activity of 202 patients with T1D and a median age of 18.2 years (range 6-39) were collected. Results: Data showed a significant improvement of TIR from 54.58% at T0 to 59.09% at T1 (p ≤ 0.0001). Glycemic control improved in all the age groups and significantly in patients ≥ 14 years old, showing the best outcome in the “university students and young adults” group (55.40% at T0 and 61.37% at T1, p≤0.001). All patients reduced physical activity during lockdown; in the 56 patients of “intense physical activity” group both at T0 and T1 TIR increased from 56.91± to 64.11% (p ≤ 0.0001). Conclusions: Overall, the lockdown led to an unexpected improvement in glycemic control of young patients with T1D. A healthier and stressless lifestyle changes synergistically with the maintenance of physical activity resulted in a significant age-proportional improvement in glycemic control.