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COVID-19 Glycemic Control Study

Completed
Conditions
Type 1 Diabetes
Type 2 Diabetes
Interventions
Other: No interventions, observational study
Registration Number
NCT05977205
Lead Sponsor
Leiden University Medical Center
Brief Summary

Diabetes mellitus is a chronic disease characterized by the inability of the body to maintain normoglycemia. Treatment of diabetes relies mostly on diabetes self-management, requiring a large investment of time and energy on a daily basis. Psychological wellbeing, behavioral patterns and social context play a major role in diabetes self-management and glycemic control. Social isolation behavior (self-quarantining) may impact glycemic control by influencing daily routines, therapy adherence, physical activity, and self-measurement and eating behaviors. Therefore, a period of nationwide self-quarantine, such as during the lockdown issued during the COVID-19 outbreak in the Netherlands, may have a large effect on glycemic control in patients with diabetes.

In this observational cross sectional study, we aim to assess the impact of long-term self-quarantine on glycemic control, diabetes self-management and distress in patients with type 1 and type 2 diabetes mellitus.

A specific subgroup of patients with T1D are those with complicated diabetes who have received a pancreas or islet transplantation and use immunosuppression, having multiple risk factors for severe COVID-19. The impact of lockdown strategies on mental and physical health is expectedly even greater in patients at even higher risk for severe COVID-19. We therefore additionally investigated differences in behavioral, mental and physical implications of a nationwide lockdown on patients with type 1 diabetes with and without islet or pancreas transplantation.

Measurements will be performed during the lockdown period. Patients will be asked to perform a fingerprick HbA1c measurement once, sent back to the LUMC by mail. Data from continuous or flash glucose monitoring devices will be collected according to standard clinical practice. Furthermore, patients will be asked to fill out an online questionnaire once on diabetes self-management behavior, well-being and distress, along with questions about health status, level of education, medication use, employment, social situation and the impact of self-quarantine on daily routines. In this questionnaire, we ask patients to compare certain aspects of their life (e.g. anxiety, stress, weight, physical activity, glycemic control) at the time of the lockdown to before the lockdown. Data on demographics, type of diabetes, weight, BMI and HbA1c prior to the COVID-19 outbreak will be derived from the patient's electronic health file.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
492
Inclusion Criteria
  • Age ≥ 18 years
  • Diagnosed with type 1 or type 2 diabetes
  • Ability to perform fingerpricks
  • Sufficient comprehension of the Dutch language
  • Ability to fill out online questionnaires
Exclusion Criteria
  • Pregnancy
  • Newly diagnosed malignancy, with the exclusion of non-melanoma skin cancer, in the previous 6 months
  • Chemotherapy or immunotherapy for malignancy
  • Admission to hospital or rehabilitation center

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Type 2 DiabetesNo interventions, observational study155 patients with type 2 diabetes
Type 1 DiabetesNo interventions, observational study280 patients with type 1 diabetes
Type 1 Diabetes with Islet or Pancreas TransplantationNo interventions, observational study23 patients with islet transplantation, 7 with pancreas transplantation, 27 with simultaneous pancreas-kidney transplantation
Primary Outcome Measures
NameTimeMethod
Glycemic controlHbA1c measurement during lockdown (8 - 11 weeks after the start of the lockdown (March 15th 2020)) compared to last measurement before lockdown (last known measurement before March 15th 2020)

HbA1c (mmol/mol Hb)

Secondary Outcome Measures
NameTimeMethod
Physical activityQuestionnaire filled in between 8 - 11 weeks after the start of the lockdown (March 15th 2020))

Self-reported change in physical activity during lockdown compared to before lockdown

Glycemic control2 week period during lockdown compared to 2 week period before lockdown

Continuous Glucose Measurement parameters (time in range, time above range, time below range)

Glycemic control and insulin requirementsQuestionnaire filled in between 8 - 11 weeks after the start of the lockdown (March 15th 2020))

Self-reported change in difficulty with glycemic control and insulin requirements during lockdown compared to before lockdown

AnxietyQuestionnaire filled in between 8 - 11 weeks after the start of the lockdown (March 15th 2020))

Self-reported change in anxiety during lockdown compared to before lockdown

WeightQuestionnaire filled in between 8 - 11 weeks after the start of the lockdown (March 15th 2020))

Self-reported weight change during lockdown compared to before lockdown

Fear of COVID-19 infectionQuestionnaire filled in between 8 - 11 weeks after the start of the lockdown (March 15th 2020))

Fear of contracting COVID-19, scored using a Visual Analogue Scale (1-10), during lockdown

StressPSS During lockdown + self-comparison change to before lockdown (questionnaire filled in between 8 - 11 weeks after the start of the lockdown (March 15th 2020))

Perceived Stress Scale (PSS) + self-reported change in stress during lockdown compared to before lockdown

Social isolation behaviourQuestionnaire filled in between 8 - 11 weeks after the start of the lockdown (March 15th 2020))

Self-reported social isolation behaviour during lockdown

Trial Locations

Locations (1)

Leiden University Medical Center

🇳🇱

Leiden, Zuid-Holland, Netherlands

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