1244 COVID-19, lockdown 1.0, and the move to telemedicine: impact on glycated haemoglobin in paediatric diabetes mellitus

1244 Table 1Comparison of average HbA1c(mmol/mol) pre- and post-lockdown grouped by baseline HbA1cGroup Number of Subjects Pre-LD (1) Post-LD (2) Av-Post-LD (3) Improved 1–2 Improved 1–3 Improved 2–3 >69 38 86.67 76.94 76.49 Yes Yes Yes 64–69 25 65.69 61.82 61.07 Yes Yes Yes 58–63 44 60.14 58.31 59.78 Yes Yes No 53–57 23 55.35 54.23 54.63 Yes Yes No 48–52 18 50.51 52.25 52.59 No No No 69 group improving by 9.73mmol/mol and 10.18mmol/mol respectively. Only the two highest groups demonstrated a sustained improvement. In the two groups with the lowest initial HbA1c, a slight deterioration was seen when comparing Pre-LD to both Post-LD and Av-Post-LD, with a trend towards deterioration.ConclusionsPerhaps unsurprisingly, HbA1c testing fell during lockdown and never returned to pre-lockdown levels, highlighting the pandemic’s disruption to the care of patients with long-term conditions. Contrary to guidance, 14.73% of patients were not tested in the nine months post-lockdown, potentially reflecting reluctance to attend hospital during the pandemic. Nevertheless, where results were available, lockdown seemed to have a positive impact on HbA1c despite the enforced use of telemedicine, unless the patient was already close to target. It is possible that lockdown provided more routine and parental supervision for those with initially high HbA1c but disrupted the successful routine and sporting activities of those initially closer to target.