Increase in blood glucose level and incidence of diabetic ketoacidosis in children with type 1 diabetes in the Daegu-Gyeongbuk area during the COVID-19 pandemic

ABSTRACT

Introduction: In Korea, the first imported case of coronavirus disease 2019 (COVID-19) was confirmed on January 20, 2020. After the first case in the Daegu-Gyeongbuk area reported on February 18, 2020, there was a rapid increase in the number of patients, which was the first large outbreak in countries other than China. The COVID-19 outbreak in the Daegu-Gyeongbuk area in 2020 has caused difficulties in the daily life and hospital care of children with type 1 diabetes (T1DM). Objectives: We detected an increase in overall blood sugar levels compared to the levels before COVID-19 in patients with T1DM in the Daegu-Gyeongbuk area and also encountered new patients who were hospitalized with more severe diabetic ketoacidosis (DKA). Methods: This study was conducted in a single center, Kyungpook National University Hospital. The following patient groups were included (1) 45 returning patients diagnosed with T1DM and undergoing insulin treatment for more than 2 years and (2) 20 newly diagnosed T1DM patients were selected by age matching before and after COVID-19. Returning patients before and after the outbreak were selected, and changes in hemoglobin A1c (HbA1c) was retrospectively reviewed. The HbA1c level and the severity of symptoms of newly diagnosed patients during hospitalization were examined. Results: HbA1c levels in returning patients with T1DM were significantly increased after COVID-19 (before 7.70%±1.38% vs. after 8.30%±2.05%, p=0.012). There were 10 and 10 newly diagnosed patients before and after COVID-19. The proportion of patients with drowsiness and dyspnea at the time of admission was higher after COVID-19 than before (before 2/10 [20%] vs. after 4/10 [40%]). The HbA1c level was higher in newly diagnosed patients hospitalized after COVID-19 than before (before 11.15% vs. after 13.60%, p=0.036). Conclusions: Due to COVID-19 in the Daegu-Gyeongbuk area, there was an increase in blood sugar level in children with T1DM and in severe DKA incidence in newly diagnosed diabetes patients.