Ann Pediatr Endocrinol Metab.  2025 Feb;30(1):38-44. 10.6065/apem.2448036.018.

Changes in metrics of continuous glucose monitoring during COVID-19 in Korean children and adolescents with type 1 diabetes mellitus

• Kim HY
• Shin SH
• Lee H
• Kim J

• KMID: 2565215
• DOI: http://doi.org/10.6065/apem.2448036.018

Abstract

Purpose
There are limited data regarding changes in glucose control in pediatric patients with type 1 diabetes (T1D) affected by coronavirus disease 2019 (COVID-19). This study aimed to evaluate changes in the metrics of a continuous glucose monitoring (CGM) system during COVID-19 infection in children and adolescents with T1D.
Methods
Eighteen patients with T1D (<18 years of age) were included in this retrospective study. The effects of COVID-19 on CGM metrics were assessed at 5 time points (2 weeks before COVID-19 [time 1], 1 week before COVID-19 [time 2], during COVID-19 [time 3], 1 week after COVID-19 [time 4], and 2 weeks after COVID-19 [time 5]).
Results
All participants had at least 1 symptom of COVID-19 and did not need to be hospitalized. The glucose management indicator (GMI) was higher at time 3 (7.7%±1.4%) compared to time 1 (7.1%±1.1%; P=0.016) and time 5 (7.0%±1.2%; P=0.008). According to the insulin delivery method, the GMI at time 3 was significantly higher than that at time 5 in patients treated with multiple daily injections (MDI) (median and interquartile range, 8.0% [6.1%–8.5%] vs. 7.1% [5.8%–7.9%]; P=0.020) but not in those treated with continuous subcutaneous insulin infusion (CSII).
Conclusion
Pediatric patients with T1D and mild COVID-19 showed worsening glycemic control during COVID-19 infection, but it returned to preinfection levels within 2 weeks of infection. CSII is more effective in maintaining stable glycemic control during COVID-19 infection than is MDI therapy.

Keyword

COVID-19; Continuous glucose monitoring; Adolescent; Child; Type 1 diabetes mellitus; Korea

Figure

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  Fig. 1. Flowchart of the study population. T1D, type 1 diabetes; COVID-19, coronavirus disease 2019; CGM, continuous glucose monitoring.

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  Fig. 2. Changes in glycemic metrics over time. TBR2, time below range level 2; TBR1, time below range level 1; TIR, time in range; TAR1, time above range level 1; TAR2, time above range level 2.

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