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COVID-19 Exacerbates Insulin Resistance During Diabetic Ketoacidosis in Pediatric Patients With Type 1 Diabetes.
Keiner, Elizabeth S; Slaughter, James C; Datye, Karishma A; Cherrington, Alan D; Moore, Daniel J; Gregory, Justin M.
  • Keiner ES; Division of Pediatric Emergency Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN.
  • Slaughter JC; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
  • Datye KA; Ian M. Burr Division of Pediatric Endocrinology and Diabetes, Vanderbilt University School of Medicine, Nashville, TN.
  • Cherrington AD; Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN.
  • Moore DJ; Ian M. Burr Division of Pediatric Endocrinology and Diabetes, Vanderbilt University School of Medicine, Nashville, TN.
  • Gregory JM; Ian M. Burr Division of Pediatric Endocrinology and Diabetes, Vanderbilt University School of Medicine, Nashville, TN.
Diabetes Care ; 45(10): 2406-2411, 2022 10 01.
Article in English | MEDLINE | ID: covidwho-1987390
ABSTRACT

OBJECTIVE:

Although mortality from coronavirus disease 2019 (COVID-19) among youth with type 1 diabetes is rare, severe acute respiratory syndrome coronavirus 2 is associated with increased pediatric hospitalizations for diabetic ketoacidosis (DKA). To clarify whether the relationship between COVID-19 and DKA is coincidental or causal, we compared tissue glucose disposal (TGD) during standardized treatment for DKA between pediatric patients with COVID-19 and those without COVID-19. RESEARCH DESIGN AND

METHODS:

We retrospectively compared TGD during standardized therapy for DKA in all children with preexisting type 1 diabetes with or without COVID-19. Cases were assessed beginning with the first case of COVID-19-positive DKA on 19 June 2020 through 2 February 2022.

RESULTS:

We identified 93 COVID-19-negative patients and 15 COVID-19-positive patients who were treated for DKA, with similar baseline characteristics between groups. Median TGD was 46% lower among patients who had COVID-19 compared with those who did not (P = 0.013).

CONCLUSIONS:

These results suggest that COVID-19 provokes a metabolic derangement over and above factors that typically contribute to pediatric DKA. These findings underscore the significant and direct threat posed by COVID-19 in pediatric type 1 diabetes and emphasize the importance of mitigation and monitoring including through vaccination as a primary prevention.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Insulin Resistance / Diabetic Ketoacidosis / Diabetes Mellitus, Type 1 / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Topics: Long Covid / Vaccines Limits: Adolescent / Child / Humans Language: English Journal: Diabetes Care Year: 2022 Document Type: Article Affiliation country: Dc22-0396

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Insulin Resistance / Diabetic Ketoacidosis / Diabetes Mellitus, Type 1 / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Topics: Long Covid / Vaccines Limits: Adolescent / Child / Humans Language: English Journal: Diabetes Care Year: 2022 Document Type: Article Affiliation country: Dc22-0396