Glycemic Fluctuations of Children and Adolescence Type 1 Diabetes Mellitus and the Impressive Aspects of SARS-CoV-2 Since the Onset of Pandemic Lockdown: A Review Paper

Abstract

Background: The COVID-19 pandemic limited the daily activities of children and adolescents with type 1 diabetes mellitus, and several factors are impacting ongoing care. The role of pandemics on glycemic control is unknown. We plan to assess the glycemic status and the factors that influence it during the pandemic. Objectives: Our goal was to examine the impact of COVID-19 quarantine on the glycemic control of children and adolescents with type 1 diabetes mellitus. Methods: Databases including PubMed, Scopus, Web of Science, and Science Direct, with English-type articles extracted from December 31, 2019, to March 3, 2022, were searched. The article review was based on factors influencing glycemic control in type 1 diabetes mellitus cases younger than 18 years of age during the pandemic period such as psychological factors, telemedicine role, lifestyle changes, various diabetes technology (cost, availability…), caregivers’ role, and socioeconomic factors. Results: We scanned 573 articles as an initial search for titles/abstracts and full-text reviews, and 54 articles remained after title/abstract screening for full-text assessment among which 14 articles (cohort studies) were included. Most studies reported glycemic improvement based on blood glucose metrics while some studies reported stable glycemic control. Although the pre-pandemic glucose profile is important, factors such as telemedicine, diabetes technology, and lifestyle play a more tangible role in improving glycemic control during the pandemic. Conclusions: Overall, the studies did not contain strong evidence that glycemic control worsened in children and adolescents with type 1 diabetes mellitus during the pandemic. Although the assessment was conducted over a short period, long-term multicenter studies would be useful for a more precise assessment of the mentioned potential factors.