Data_Sheet_1_Dietary Changes During COVID-19 Lockdown in Adults With Type 1 Diabetes on a Hybrid Artificial Pancreas.doc

In this retrospective analysis, we examine the impact of the lockdown of the coronavirus pandemic (COVID-19) on eating habits in individuals with type 1 diabetes (T1D) on a hybrid artificial pancreas (HAP). Dietary composition before and during lockdown was assessed by 7-day food records of 12 participants with T1D on HAP (three men and nine women, ages 38 ± 13 years, HbA1c 6.8 ± 0.3%, M ± SD). Continuous glucose monitoring (CGM) metrics and lifestyle changes (online questionnaire) were also assessed. Compared to prelockdown, reported body weight tended to increase during lockdown with no changes in total energy intake. Participants significantly decreased animal protein intake (−2.1 ± 3.7% of total energy intake, p = 0.048), but tended to increase carbohydrate intake (+17 ± 28 g/day, p = 0.052). These changes were induced by modifications of eating habits at breakfast and lunch during weekdays. Patients consumed more cereals (+21 ± 33 g/day, p = 0.038), whole grain (+22 ± 32 g/day, p = 0.044), and sweets (+13 ± 17 g/day, p = 0.021), and less animal protein sources (−42 ± 67 g/day, p = 0.054). Participants showed a more regular meal timing and decreased physical activity. Blood glucose control remained optimal (time-in-range 76 ± 8 vs. 75 ± 7% before lockdown), and daily total insulin infusion increased (42 ± 10 vs. 39 ± 12 I.U., p = 0.045). During the lockdown, patients with T1D on HAP modified dietary habits by decreasing animal protein and increasing carbohydrate intake. This increase, mainly concerning whole grain and low-glycemic-index products, did not influence blood glucose control.

本回顾性分析旨在探讨新型冠状病毒肺炎（COVID-19）疫情封控措施对使用混合式人工胰腺（hybrid artificial pancreas, HAP）的1型糖尿病（type 1 diabetes, T1D）患者饮食行为的影响。本研究通过12名使用HAP的T1D患者（3男9女，年龄38±13岁，糖化血红蛋白（HbA1c）6.8±0.3%，均值±标准差）的7天饮食记录，评估了封控前后的饮食结构；同时还通过在线问卷评估了动态血糖监测（Continuous Glucose Monitoring, CGM）指标及生活方式变化情况。与封控前相比，受试者报告的体重在封控期间呈上升趋势，但总能量摄入无明显变化。受试者的动物蛋白摄入量显著降低（较总能量摄入占比减少2.1±3.7%，p=0.048），而碳水化合物摄入量呈上升趋势（每日增加17±28g，p=0.052）。上述饮食变化主要源于工作日早餐与午餐的饮食行为调整：受试者的谷物摄入量（每日增加21±33g，p=0.038）、全谷物摄入量（每日增加22±32g，p=0.044）及甜食摄入量（每日增加13±17g，p=0.021）均有所上升，而动物蛋白来源食物摄入量有所下降（每日减少42±67g，p=0.054）。受试者的进餐时间更规律，但体力活动水平有所下降。血糖控制仍维持在最优水平（目标范围内时间为76±8%，封控前为75±7%），每日胰岛素总输注量有所增加（42±10 vs. 39±12国际单位（I.U.），p=0.045）。封控期间，使用HAP的T1D患者通过减少动物蛋白摄入、增加碳水化合物摄入调整了饮食结构；其中碳水化合物摄入的增加主要源于全谷物及低血糖生成指数食品，该变化并未对血糖控制产生不良影响。