Health-related quality of life and metabolic control in young patients with type 1 diabetes and in their parents before and after the COVID-19 lockdown

Introduction: Since the beginning of the COVID-19 pandemic, concerns for consequences in patients with type 1 diabetes (T1D) were raised. Objectives: To compare the diabetes-specific health-related quality of life (D-HRQOL) of youths with T1D and their parents before and after the COVID-19-related lockdown. Methods: The Pediatric Quality of Life Inventory™ 3.0 Diabetes Module (PedsQL™ 3.0 DM) was used to evaluate the D-HRQOL. Patients who filled the D-HRQOL before lockdown (Dec-19–Feb-20; T0) were recruited in the study and filled the same survey immediately after the lockdown was stopped (Jun-20; T1) during a routine outpatient or telemedicine visit. Results: Sixty-two patients (median age: 12.6 [5.25-17.8] yrs; T1D duration 4.23 [0.45- 16.4] yrs) with T1D and their parents (60 mothers, 10 fathers) were enrolled. Patients' scales scores did not significantly change from T0 to T1. Mothers significantly increased their Diabetes symptoms scale score (median 67.0 vs. 70.4; p=0.007). Data were also analyzed according to visit type (outpatient vs. telemedicine), glucose monitoring (SBGM vs. isCGM vs. rtCGM), and insulin therapy (MDI vs. CSII), but D-HRQOL data were longitudinally comparable and no difference was found between groups. During lockdown no DKA, severe hypoglycemic events, and SARS-CoV-2 were recorded. Despite the significant decrease of exercise (median 3.25 vs. 0.50 h/week; p<0.0001), median glycemic control (HbA1c 58.5 vs. 57.9 mmol/mol) and total daily insulin dose (0.86 vs. 0.82 IU/kg/day) were unchanged. At T1, the lower the HbA1c, the better patients' Diabetes symptoms (R=-0.41, p<0.001), Worry (R=-0.27, p=0.032) scales, and total scores (R=-0.33, p=0.009). Similar results were found in parents. Conclusions: During COVID-19 pandemic-related lockdown the D-HRQOL did not change in children and adolescents with T1D and their parents. Our data may be possibly related to staying at home, making diabetes managements easier and also allowing the maintenance of good glycemic control without acute complications.