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. 2024 Sep 3;16(9):e68566.
doi: 10.7759/cureus.68566. eCollection 2024 Sep.

Beyond Infection: Unmasking the Impact of COVID-19 on Diabetes Emergency Trends

Sedat C Güney  1 , Can Akçura  1 , Samet Alkan  1 , Gamze Gelir Çavdar  2 , Nilüfer Özdemir  1 , Zeliha Hekimsoy  1
Affiliations

Beyond Infection: Unmasking the Impact of COVID-19 on Diabetes Emergency Trends

Sedat C Güney et al. Cureus. .

Abstract

Introduction The relationship between COVID-19 and diabetes has been demonstrated in many studies. However, it is thought that the psycho-socioeconomic effects of the pandemic led to a worsening of glycemic control and an increase in diabetes-associated clinical emergencies in diabetic patients without a diagnosis of COVID-19. Objectives We aimed to reveal the change in the frequency of diabetes-related clinical emergencies before and during the COVID-19 pandemic. Patients and methods The data of the patients requiring endocrinology consultations in Manisa Celal Bayar University Faculty of Medicine Emergency Service between March 2018 and March 2022 were included. In total, 269 consultations were analyzed. The March 2018 - March 2020 period was considered as pre-COVID, and March 2020 - March 2022 as the COVID-19 period. The frequency of diabetes-related conditions between these two periods was compared. Results Compared to the pre-COVID period, there was a significant increase in the frequency of admissions with diabetic ketosis, hyperglycemic hyperosmolar state, hypoglycemia, and hyperglycemia in the COVID-19 period (p=0.022, p=0.037, p=0.044, and p=0.004 respectively). Although an increase was observed in the frequency of diabetic ketoacidosis (DKA) cases, no statistical significance was found. When the mortality data of the patients was evaluated, the total number of deaths was seen to increase significantly in the COVID-19 period (p=0.01). It was observed that the ratio of type 2 diabetes mellitus (DM)/type 1 DM among DKA patients increased significantly in the COVID-19 period (p=0.001). Conclusions It can be concluded that the increasing trend in diabetic emergencies that started even before the pandemic is exacerbated by COVID-19, especially in patients with poor glycemic control.

Keywords: coronavirus pandemic; covid-19; diabetes mellitus; diabetic emergencies; diabetic ketoasidosis; endocrinology consultations; hypoglycemia.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of Manisa Celal Bayar University Faculty of Medicine issued approval 20.478.486. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flow diagram of the consultation data identification and selection process
* n=33,254 (in pre-COVID-19 period) vs n=42,937 (in COVID-19 period), total=76,191
Figure 2
Figure 2. Distribution of patients presenting with DKA in the pre-COVID-19 and COVID-19 period by diabetes type
DKA - diabetic ketoacidosis
Figure 3
Figure 3. Annual distribution of patients presenting with DKA by diabetes type
DKA - diabetic ketoacidosis
See this image and copyright information in PMC

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