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Increased frequency of severe diabetic ketoacidosis at type 1 diabetes onset among children during COVID-19 pandemic lockdown: an observational cohort study.
Dzygalo, Katarzyna; Nowaczyk, Jedrzej; Szwilling, Alicja; Kowalska, Agnieszka.
  • Dzygalo K; Clinical Department of Pediatric Diabetology and Pediatrics, UCK WUM DSK, Medical University of Warsaw, Poland.
  • Nowaczyk J; Department of Pediatrics, Medical University of Warsaw, Poland.
  • Szwilling A; Clinical Department of Pediatric Diabetology and Pediatrics, UCK WUM DSK, Medical University of Warsaw, Poland.
  • Kowalska A; Clinical Department of Pediatric Diabetology and Pediatrics, UCK WUM DSK, Medical University of Warsaw, Poland.
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. This situation can lead to delay in T1D diagnosis and insulin treatment resulting in rapid progression to diabetic ketoacidosis (DKA) and therefore increased risk of complications and death.  .

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. . MATERIAL AND

METHODS:

We collected data of children with newly diagnosed T1D. DKA was defined according to ISPAD guidelines. .

RESULTS:

The study cohort comprised 34 children in group 2020 and 52 in group 2019 with an average age 9.90 ±4.9 vs. 9.59±4.7 years with mean HbA1c 12.9 ±2.4 vs. 11.5 ±2.2%, respectively. The incidence of DKA was higher by 12% in group 2020 vs. 2019 (52.94% vs 40.38%; p = 0.276).  Regarding the DKA severity (2020 vs. 2019) 32.35% vs. 11.54% were severe (p = 0.026), 17.65 vs. 13% were moderate (p = 0.759), and 2.94 vs. 15.38% were mild (p = 0.081). 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 diagnosed T1D. Regular education of the whole society about the symptoms of diabetes could contribute to faster diagnosis of T1D and reduction of DKA prevalence. .
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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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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