Effects of COVID-19 Lockdown on Glucose Control: Continuous Glucose Monitoring Data From People With Diabetes on Intensive Insulin Therapy

The coronavirus disease 2019 (COVID-19) outbreak forced Italy to begin lockdown on 9 March 2020. This suddenly changed the daily routine of people with diabetes, increasing sedentary behavior, changing eating patterns, and increasing their psychological burden (1,2), all of which may result in changes in glucose control. This is especially relevant for patients on complex therapeutic regimens such as multiple daily injections (MDI) of insulin or continuous subcutaneous insulin infusion (CSII). Therefore, the COVID-19 lockdown is an unprecedented model to investigate how acute changes in lifestyle affect glucose control in diabetes.To investigate the effects of lockdown on ambulatory glucose metrics, defined according to the international consensus on time in range (TIR) (3), we performed an analysis of continuous glucose monitoring (CGM) data of the 14 days preceding (baseline: 24 February to 8 March 2020) and following (lockdown: 10 March to 25 March 2020) the extension of lockdown to the whole of Italy in people with diabetes on MDI or CSII. After exclusion of individuals unable to upload data on online platforms or who had contact with diabetologists for therapeutic changes, 55 adults (43.6% male, median [25th, 75th percentile] age 41 [28, 49] years, disease duration 11 [5, 23] years) with diabetes (90.9% autoimmune, 5.5% type 2, 3.6% post-pancreatectomy) treated with MDI (≥4 insulin injections per day, 50.9%) or CSII (49.1%) …