Aims

Malaysia implemented nationwide lockdown from 18th March till 3rd May 2020 to mitigate the spread of coronavirus disease (COVID-19). This study aimed to examine the impact of the lockdown on glycaemic control and lifestyle changes in children and adolescents with type 1 (T1DM) and 2 diabetes mellitus (T2DM) aged less than 18 years old.

Methods

In this cross-sectional study, interviews and a standardised questionnaire comparing lifestyle changes before and during the lockdown were performed in follow-up clinic visits after the lockdown. Anthropometry measurements and glycated haemoglobin (HbA1c) values were compared 3 months prior and after the lockdown.

Results

Participants were 93 patients with T1DM (11.08 ± 3.47 years) and 30 patients with T2DM (13.81 ± 2.03 years). Male gender, T2DM and pubertal adolescents were found to have a significant deterioration in glycaemic control. A significant increment of HbA1c was observed in patients with T2DM (8.5 ± 0.40 vs 9.9 ± 0.46%), but not in patients with T1DM (8.6 ± 0.28 vs 8.7 ± 0.33%). Contrarily, there was an improved glycaemic control in pre-pubertal T1DM children likely due to parental supervision during home confinement. Weight and BMI SDS increased in T1DM patients but surprisingly reduced in T2DM patients possibly due to worsening diabetes control. Reduced meal frequency mainly due to skipping breakfast, reduced physical activity level scores, increased screen time and sleep duration were observed in both groups.

Conclusions

Adverse impact on glycaemic control and lifestyle were seen mostly in patients with T2DM and pubertal adolescent boys.

中文翻译：

---

COVID-19 封锁对 1 型和 2 型糖尿病儿童和青少年血糖控制和生活方式改变的影响

目标

马来西亚于 2020 年 3 月 18 日至 5 月 3 日实施全国封锁，以减轻冠状病毒病 (COVID-19) 的传播。本研究旨在检查封锁对 18 岁以下患有 1 型 (T1DM) 和 2 型糖尿病 (T2DM) 的儿童和青少年的血糖控制和生活方式改变的影响。

方法

在这项横断面研究中，在锁定后的后续诊所访问中进行了访谈和比较锁定之前和期间生活方式变化的标准化问卷。比较了封锁前后 3 个月的人体测量学测量值和糖化血红蛋白 (HbA1c) 值。

结果

参与者为 93 名 T1DM 患者（11.08 ± 3.47 年）和 30 名 T2DM 患者（13.81 ± 2.03 年）。发现男性、T2DM 和青春期青少年的血糖控制显着恶化。在 T2DM 患者中观察到 HbA1c 显着增加（8.5 ± 0.40 vs 9.9 ± 0.46%），但在 T1DM 患者中没有观察到（8.6 ± 0.28 vs 8.7 ± 0.33%）。相反，青春期前 1 型糖尿病儿童的血糖控制得到改善，这可能是由于在家禁闭期间父母的监督。T1DM 患者的体重和 BMI SDS 增加，但 T2DM 患者的体重和 BMI SDS 却出人意料地降低，这可能是由于糖尿病控制恶化。在两组中观察到主要由于不吃早餐、体力活动水平评分降低、屏幕时间增加和睡眠时间增加导致进餐频率降低。

结论

对血糖控制和生活方式的不利影响主要见于 T2DM 患者和青春期男孩。