Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 29:10:926013.
doi: 10.3389/fped.2022.926013. eCollection 2022.

Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey

Eylem Kiral  1 , Birgul Kirel  2 , Merve Havan  3 , Mehmet Keskin  4 , Murat Karaoglan  4 , Ahmet Yildirim  4 , Murat Kangin  5 , Mehmet Nur Talay  5 , Tuba Urun  5 , Umit Altug  6 , Selman Kesici  7 , Erennur Tufan  7 , Ebru Kacmaz  1 , Gurkan Bozan  1 , Ebru Azapagasi  8 , Mutlu Uysal Yazici  8 , Zeynelabidin Ozturk  8 , Osman Yesilbas  9 , Gulay Karaguzel  10 , Gulay Kaya  10 , Ulkem Barlas  11 , Muhterem Duyu  12 , Merve Boyraz  12 , Esra Sevketoglu  13 , Nihal Akcay  13 , Suna Hancili  14 , Ayla Guven  14 , Oǧuz Dursun  15 , Nazan Ulgen Tekerek  15 , Gokçen Ozcifci  16 , Pinar Yazici  17 , Eda Turanli  17 , Tanil Kendirli  18 , Fevzi Kahveci  18 , Ayse Filiz Yetimakman  19 , Agop Citak  20 , Guntulu Şik  20 , Ibrahim Bingol  20 , Fatih Aygun  21 , Cansu Durak  22 , Resul Yilmaz  22 , Fuat Bugrul  23 , Yusuf Sari  24 , Hakan Tekguç  25 , Hatice Albayrak  26 , Nazik Yener  26 , Hasan Agin  27 , Ekin Soydan  27 , Dincer Yildizdas  28 , Semine Ozdemir Dilek  29 , Nilufer Yalindag  30 , Feyza Incekoy-Girgin  30 , Nuri Alacakir  31 , Filiz Tutunculer  32 , Mehmet Ozgur Arslanaoglu  1 , Can Aydin  2 , Muzaffer Bilgin  33 , Enver Simsek  2 , Ener Cagri Dinleyici  1
Affiliations

Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey

Eylem Kiral et al. Front Pediatr. .

Abstract

Introduction: There have been some significant changes regarding healthcare utilization during the COVID-19 pandemic. Majority of the reports about the impact of the COVID-19 pandemic on diabetes care are from the first wave of the pandemic. We aim to evaluate the potential effects of the COVID-19 pandemic on the severity of diabetic ketoacidosis (DKA) and new onset Type 1 diabetes presenting with DKA, and also evaluate children with DKA and acute COVID-19 infection.

Methods: This is a retrospective multi-center study among 997 children and adolescents with type 1 diabetes who were admitted with DKA to 27 pediatric intensive care units in Turkey between the first year of pandemic and pre-pandemic year.

Results: The percentage of children with new-onset Type 1 diabetes presenting with DKA was higher during the COVID-19 pandemic (p < 0.0001). The incidence of severe DKA was also higher during the COVID-19 pandemic (p < 0.0001) and also higher among children with new onset Type 1 diabetes (p < 0.0001). HbA1c levels, duration of insulin infusion, and length of PICU stay were significantly higher/longer during the pandemic period. Eleven patients tested positive for SARS-CoV-2, eight were positive for new onset Type 1 diabetes, and nine tested positive for severe DKA at admission.

Discussion: The frequency of new onset of Type 1 diabetes and severe cases among children with DKA during the first year of the COVID-19 pandemic. Furthermore, the cause of the increased severe presentation might be related to restrictions related to the pandemic; however, need to evaluate the potential effects of SARS-CoV-2 on the increased percentage of new onset Type 1 diabetes.

Keywords: COVID-19; children; diabetes; diabetic ketoacidosis; pandemic; pediatric intensive care unit.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Number of children with diabetic ketoacidosis (red), number of previously type 1 diabetic children with DKA (green) and DKA among children with new onset type 1 diabetes (blue) during the pre-pandemic and COVID-19 pandemic period.
See this image and copyright information in PMC

References

    1. World Health Organization . Coronavirus Disease (COVID-19) Pandemic. Available online at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio... (accessed May 19, 2022).
    1. Castagnoli R, Votto M, Licari A, Brambilla I, Bruno R, Perlini S, et al. . Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review. JAMA Pediatr. (2020) 174:882-9. 10.1001/jamapediatrics.2020.1467 - DOI - PubMed
    1. Bhopal SS, Bagaria J, Olabi B, Bhopal R. Children and young people remain at low risk of COVID-19 mortality. Lancet Child Adolesc Health. (2021) 5:e12–3. 10.1016/S2352-4642(21)00066-3 - DOI - PMC - PubMed
    1. Dinleyici EC, Borrow R, Safadi MAP, van Damme P, Munoz FM. Vaccines and routine immunization strategies during the COVID-19 pandemic. Hum Vaccin Immunother. (2021) 17:400–7. 10.1080/21645515.2020.1804776 - DOI - PMC - PubMed
    1. Perra N. Non-pharmaceutical interventions during the COVID-19 pandemic: a review. Phys Rep. (2021) 913:1–52. 10.1016/j.physrep.2021.02.001 - DOI - PMC - PubMed