Impact of school closure and lockdown during COVID- 19 emergency on glucose metrics of children and adolescents with type 1 diabetes in Piedmont region, Italy

Objectives: From 23rd February 2020, to limit viral spreading during Coronavirus Disease (COVID-19) outbreak in Piedmont (one of the most affected area in Italy), schools were shut down for every age group Likewise, recreational activities such as gyms and pools, as well as outpatients' clinics, were closed From the same day, children were forced to stay at home and school lessons were provide remotely We sought to determine the impact of school closure and lockdown on children with type 1 diabetes (T1D), measuring metrics from continuous glucose monitoring (CGM) Methods: The Regional Pediatric Diabetes network randomly selected patients (0-18 years) with T1D from every age group in Piedmont, between those using a CGM from at least 6 months Time spent in range 70-180 mg/dL (TIR), below range (TBR), above range (TAR) as well as coefficient of variation (CV) and glucose management index (GMI) were measured during 90 days of lockdown and compared (paired t-test, 95%) with 90 days before Patients also reported physical activity and total daily insulin dose (TDD) in the same study period Results: Data of our study population are showed in Table Mean TIR from 90 days before was 59 7%, while during lockdown was 62 5% (p = 0 018) To the same extent, TBR went from 2 6% to 2 4% (p = 0 152), and TAR went from 39 5% to 36 7% (p = 0 004), respectively CV moved from 35 9% to 34 9% during lockdown (p = 0 003), and GMI decreased from 7 5% to 7 4% (p = 0 05) Physical activity dropped from 6 1 to 2 7 hours per week (p < 0 001), while TDD increased from 36 4 to 40 3 UI/day (p = 0 005) Sensor usage increased from 86 5% to 91 5% of time Conclusions: The presented data on children and adolescents with T1D show an improvement of glucose metrics (especially TIR and TAR) with less variability during lockdown An increased CGM use might have helped families in adjusting insulin therapy despite lifestyle changes and decreased physical activity (Table Presented)