Increased frequency of severe diabetic ketoacidosis at type 1 diabetes onset among children during COVID-19 pandemic lockdown: an observational cohort study.
Pediatr Endocrinol Diabetes Metab
; 26(4): 167-175, 2020.
Article
in English
| MEDLINE | ID: covidwho-1112834
ABSTRACT
INTRODUCTION:
On March 11, 2020 the WHO announced a coronavirus disease 2019 (COVID-19) pandemic. Lockdown restrictions, compromised access to medical care and fear of potential exposure to SARS-CoV-2 have forced patients with non-COVID-19 illnesses such as type 1 diabetes (T1D) to stay home. Thisâ¯situation can lead to delay in T1D diagnosis and insulin treatmentâ¯resultingâ¯in rapid progression to diabetic ketoacidosis (DKA) and therefore increased risk of complications and death.â¯â¯.AIM:
The aim of this study was to evaluate the frequency and severity of DKA at the onset of T1D in children diagnosed in our department during COVID-19 pandemic lockdown from March 2020 till May 2020 in comparison to corresponding period of the previous year.â¯. MATERIAL ANDMETHODS:
We collected data ofâ¯children with newly diagnosed T1D. DKA was defined according to ISPAD guidelines.â¯.RESULTS:
The study cohort comprised 34 childrenâ¯in groupâ¯2020â¯and 52 in groupâ¯2019 with an average age 9.90 ±4.9 vs. 9.59±4.7 years with mean HbA1c 12.9 ±2.4â¯vs.â¯11.5 ±2.2%,â¯respectively. The incidence of DKA was higher by 12% inâ¯groupâ¯2020 vs.â¯2019 (52.94% vs 40.38%; p = 0.276).⯠Regarding the DKA severity (2020 vs. 2019)â¯32.35% vs. 11.54% wereâ¯severe (p = 0.026), 17.65 vs. 13% were moderate (p = 0.759), and 2.94 vs. 15.38%â¯wereâ¯mild (p = 0.081).â¯None of the analyzed patients were COVID-19 positive.CONCLUSIONS:
During the COVID-19 pandemic lockdown changes in society and health care system, the DKA rate has increased by 12 percentage points with more severe cases noted in children with newly diagnosedâ¯T1D. Regular education of the whole society about the symptoms of diabetes could contribute to faster diagnosis of T1D and reduction of DKA prevalence.â¯.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Quarantine
/
Diabetic Ketoacidosis
/
Diabetes Mellitus, Type 1
/
COVID-19
/
Health Services Accessibility
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
English
Journal:
Pediatr Endocrinol Diabetes Metab
Journal subject:
Endocrinology
/
Metabolism
/
Pediatrics
Year:
2020
Document Type:
Article
Affiliation country:
Pedm.2020.101003
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