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. 2024 Oct 30;60(11):1775.
doi: 10.3390/medicina60111775.

Impact of the COVID-19 Pandemic on Diabetic Ketoacidosis Patients Treated in a Pediatric Intensive Care Unit: A Single-Center Cross-Sectional Study

Eva Perak  1 , Dina Mrcela  2 , Josko Markic  2   3
Affiliations

Impact of the COVID-19 Pandemic on Diabetic Ketoacidosis Patients Treated in a Pediatric Intensive Care Unit: A Single-Center Cross-Sectional Study

Eva Perak et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Diabetic ketoacidosis (DKA) is a common complication of type 1 diabetes mellitus (T1DM) in children. Here, we explored the impact of the coronavirus disease 2019 (COVID-19) pandemic on the occurrence and severity of DKA in children in southern Croatia. Materials and Methods: The demographics and clinical and laboratory findings of all children and adolescents aged 0-18 years diagnosed with DKA and admitted to the pediatric intensive care unit (PICU) of the University Hospital of Split, Croatia from January 2013 to May 2023 were retrospectively collected. The participants were divided into two groups: (1) the pre-pandemic group (presenting before mid-March 2020) and (2) the pandemic group (presenting afterwards). Results: A total of 91 patients were included, 68 in the pre-pandemic and 23 in the pandemic group. The admission rate was similar (<1 patient per month) in both groups. In comparison to pre-pandemic patients, which mostly presented during the summer (52.9%) and winter seasons (23.5%), most pandemic cases occurred in spring (34.8%) and fall (30.4%, p = 0.002). No significant differences between the groups were identified in the severity of DKA, as reflected either by mean pH and median bicarbonate levels or by the proportion of patients with severe DKA. Nevertheless, HbA1c and triglycerides were significantly higher in the pandemic group (12.56% vs. 11.02%, p = 0.002 and 4.95 mmol/L vs. 2.8 mmol/L, p = 0.022, respectively) indicating poorer long-term glycemia. DKA complications were, overall, rare and without significant differences between the groups. Conclusions: The COVID-19 pandemic did not impact overall frequency or severity of DKA in children in southern Croatia. While the seasonal changes in DKA occurrence and a poorer long-term glycemia in pandemic patients may have been influenced by COVID-19 outbreaks and the imposed anti-pandemic measures, further studies are needed to determine if this was a temporary pandemic-related phenomenon or if this trend would persist in the future.

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

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Glaser N., Fritsch M., Priyambada L., Rewers A., Cherubini V., Estrada S., Wolfsdorf J.I., Codner E. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. Pediatr. Diabetes. 2022;23:835–856. doi: 10.1111/pedi.13406. - DOI - PubMed
    1. Dhatariya K.K., Glaser N.S., Codner E., Umpierrez G.E. Diabetic Ketoacidosis. Nat. Rev. Dis. Primer. 2020;6:40. doi: 10.1038/s41572-020-0165-1. - DOI - PubMed
    1. Sadauskaite-Kuehne V., Samuelsson U., Jasinskiene E., Padaiga Z., Urbonaite B., Edenvall H., Ludvigsson J., DEBS Study Group Severity at Onset of Childhood Type 1 Diabetes in Countries with High and Low Incidence of the Condition. Diabetes Res. Clin. Pract. 2002;55:247–254. doi: 10.1016/S0168-8227(01)00328-X. - DOI - PubMed
    1. Auzanneau M., Rosenbauer J., Warncke K., Maier W., Kamrath C., Hofmann T., Wurm M., Hammersen J., Schröder C., Hake K., et al. Frequency of Ketoacidosis at Diagnosis of Pediatric Type 1 Diabetes Associated with Socioeconomic Deprivation and Urbanization: Results from the German Multicenter DPV Registry. Diabetes Care. 2022;45:1807–1813. doi: 10.2337/dc21-2227. - DOI - PubMed
    1. Lévy-Marchal C., Patterson C.C., Green A., EURODIAB ACE Study Group Europe and Diabetes Geographical Variation of Presentation at Diagnosis of Type I Diabetes in Children: The EURODIAB Study. European and Dibetes. Diabetologia. 2001;44((Suppl. S3)):B75–B80. doi: 10.1007/PL00002958. - DOI - PubMed

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