The Effect of COVID-19 Lockdown Among Adolescents with Type 1 Diabetes: A Systematic Review and Meta-Analysis

Objective: The aim of this study was to assess how the lockdown of the COVID-19 pandemic had affected the glycaemic control of adolescents aged 10-19 with type 1 diabetes. Methods: A comprehensive search of literature was performed in PubMed, Scopus, Web of Science, and ProQuest. Published articles up to September 2022 were included. The Glucose Monitoring Index (GMI) and HbA1c level were defined as outcome variables. Average glucose level was found to be a common variable in both HbA1c levels and GMI; therefore, HbA1c and GMI were converted to average glucose (mg/dL) using appropriate formulas. Studies reported the outcomes in two or three periods (pre-lockdown, lockdown, and post-lockdown) were included in the analysis. A paired wise meta-analysis was performed among the studies that reported all three periods. Homogeneity across studies was assessed using I² statistic. Results: Fourteen studies were included in the study. The pooled average glucose during the lockdown decreased to 166.9 mg/dL (95% CI, 153.78, 180.02) from 205.793 mg/dL (95% CI, 188.412, 223.173) during the pre-lockdown period, then it increased to 204.23 mg/dL (95% CI, 186.17, 222.29) during the post-lockdown period. A paired wise meta-analysis indicated a reduction in average glucose levels. However, it was not statistically significant, possibly due to the small number of studies that reported data from all three periods. Conclusion: Although the descriptive analysis of our study showed that the lockdown had affected (decreased) the average glucose level among adolescents with type 1 diabetes, this was not statistically significant in the pooled analysis.