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Type 1 diabetes is a chronic disease caused by autoimmune destruction of pancreatic
β cells. Individuals with type 1 diabetes are reliant on insulin for survival. Despite
enhanced knowledge related to the pathophysiology of the disease, including interactions
between genetic, immune, and environmental contributions, and major strides in treatment
and management, disease burden remains high. Studies aimed at blocking the immune
attack on β cells in people at risk or individuals with very early onset type 1 diabetes
show promise in preserving endogenous insulin production.
VestergaardSyddanmarkDenmarkLampeterCeredigionUnited-kingdomHerrathNordrhein-westfalenGermanyWasserfallPathirajaCentralType 2 diabetes accounts for nearly 90% of the approximately 537 million cases of
diabetes worldwide. The number affected is increasing rapidly with alarming trends
in children and young adults (up to age 40 years). Early detection and proactive management
are crucial for prevention and mitigation of microvascular and macrovascular complications
and mortality burden. Access to novel therapies improves person-centred outcomes beyond
glycaemic control. Precision medicine, including multiomics and pharmacogenomics,
hold promise to enhance understanding of disease heterogeneity, leading to targeted
therapies.
TaiwanCorkeyBallymoneyUnited-kingdomJapanUnited-statesIndiaHeianzaOkinawaChinaFinlandKhuntiThe COVID-19 pandemic has disproportionately affected certain groups, such as older
people (ie, >65 years), minority ethnic populations, and people with specific chronic
conditions including diabetes, cardiovascular disease, kidney disease, and some respiratory
diseases. There is now evidence of not only direct but also indirect adverse effects
of COVID-19 in people with diabetes. Recurrent lockdowns and public health measures
throughout the pandemic have restricted access to routine diabetes care, limiting
new diagnoses, and affecting self-management, routine follow-ups, and access to medications,
as well as affecting lifestyle behaviours and emotional wellbeing globally.
BrazilNew-yorkUnited-statesJapanCopenhagenKøavnDenmarkHong-kongMotoshimaAkagawaUnited-kingdomSeiduImportance: There is no consensus on the impact of the 2020 COVID-19 pandemic lockdown on glycemic control in children and adolescents with type 1 diabetes (T1D) in the US. Aim: To determine the impact of the pandemic lockdown of March 15th through July 6th, 2020 on glycemic control after controlling for confounders. Subjects and Methods: An observational study of 110 subjects of mean age 14.8 ± 4.9 years(y), [male 15.4 ± 4.0y, (n=57); female 14.1 ± 3.8y, (n=53), p=0.07] with T1D of 6.31 ± 4.3y (95% CI 1.0-19.7y). Data were collected at 1-4 months before the lockdown and 1-4 months following the lifting of the lockdown at their first post-lockdown clinic visit. Results: There was no significant change in A1c between the pre- and post-pandemic lockdown periods, 0.18 ± 1.2%, (95% CI -0.05 to 0.41), p=0.13. There were equally no significant differences in A1c between the male and female subjects, -0.16 ± 1.2 vs -0.19 ± 1.2%, p=0.8; insulin pump users and non-pump users, -0.25 ± 1.0 vs -0.12 ± 1.4%, p=0.5; and pubertal vs prepubertal subjects, 0.18±1.3 vs -0.11 ± 0.3%, p=0.6. The significant predictors of decrease in A1c were pre-lockdown A1c (p<0.0001) and the use of CGM (p=0.019). The CGM users had significant reductions in point-of-care A1c (0.4 ± 0.6%, p=0.0012), the CGM-estimated A1c (p=0.0076), mean glucose concentration (p=0.022), a significant increase in sensor usage (p=0.012), with no change in total daily dose of insulin (TDDI). The non-CGM users had significantly increased TDDI (p<0.0001) but no change in HbA1c, 0.06 ± 1.8%, p=0.86. Conclusions: There was no change in glycemic control during the pandemic lockdown of 2020 in US children.
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