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. 2023 Aug 23;15(3):264-267.
doi: 10.4274/jcrpe.galenos.2023.2022-11-4. Epub 2023 Mar 29.

The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes Mellitus

Arzu Jalilova  1 , Aysun Ata  1 , Günay Demir  1 , Hafize Işıklar  1 , Yasemin Atik Altınok  1 , Samim Özen  1 , Şükran Darcan  1 , Damla Gökşen  1
Affiliations

The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes Mellitus

Arzu Jalilova et al. J Clin Res Pediatr Endocrinol. .

Abstract

Objective: Diabetic ketoacidosis (DKA) is a life-threatening, acute complication of type 1 diabetes mellitus (T1DM). Infection is the most common precipitating factor for DKA, being responsible for more than 50% of such complications. The frequency and severity of DKA in children with T1DM, before and during the coronavirus disease 2019 outbreak were evaluated and compared with pre-pandemic presentation and severity rates.

Methods: In total, 199 patients younger than 18 years were included in the study. Patients were divided into two groups: the Coronavirus disease-2019 (COVID-19) pandemic group (new onset T1DM presenting from March 2020 to March 2021; the control group included new onset T1DM from March 2016 to March 2020.

Results: The rate of DKA at presentation was similar (p=0.393) during the pandemic period (58.3%) compared to the pre-pandemic years (44.8-64.3%). Although the percentage of DKA was similar, the rate of severe DKA in the COVID-19 group was higher than previous years. Although not significant, the duration of diabetes symptoms was longer in the COVID-19 period than the previous years.

Conclusion: This study suggests that the rate of severe DKA, but not the overall rate of DKA, has increased during the COVID-19 pandemic compared to the prior four years. This may be due to the behavior of the parents of sick children and the limited access to the healthcare system. Despite this limited access, parental concern may have been sufficiently high to seek medical attention for their children, avoiding an increased frequency of DKA as the first presentation of new-onset T1DM.

Keywords: diabetic ketoacidosis; Type 1 diabetes mellitus; Coronavirus disease-2019.

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Conflict of interest statement

Conflict of Interest: None declared.

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References

    1. Libman I, Haynes A, Lyons S, Pradeep P, Rwagasor E, Tung JY, Jefferies CA, Oram RA, Dabelea D, Craig ME. ISPAD Clinical Practice Consensus Guidelines 2022: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2022;23:1160–1174. - PubMed
    1. Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM) FEMS Immunol Med Microbiol. 1999;26:259–265. - PubMed
    1. Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes Metab Res Rev. 2007;23:3–13. - PubMed
    1. Zheng C, Zhou Z, Yang L, Lin J, Huang G, Li X, Zhou W, Wang X, Liu Z. Fulminant type 1 diabetes mellitus exhibits distinct clinical and autoimmunity features from classical type 1 diabetes mellitus in Chinese. Diabetes Metab Res Rev. 2011;27:70–78. - PubMed
    1. Makino S, Hamada S, Iwata M, Fujiwara M. A case of abrupt onset autoimmune type 1 diabetes mimicking fulminant type 1 diabetes. Endocr J. 2009;56:1113–1117. - PubMed