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

KIRAL, EYLEM; KIREL, BİRGÜL; Havan, Merve; Keskin, Mehmet; Karaoglan, Murat; Yildirim, Ahmet; Kangin, Murat; Talay, Mehmet; Urun, Tuba; Altug, Umit; Kesici, Selman; Tufan, Erennur; Kacmaz, Ebru; Bozan, Gurkan; Azapagasi, EBRU; Uysal Yazici, MUTLU; Ozturk, Zeynelabidin; Yesilbas, Osman; Karaguzel, Gulay; Kaya, Gulay; Barlas, Ulkem; Duyu, Muhterem; Boyraz, Merve; Sevketoglu, Esra; Akcay, Nihal; Hancili, Suna; Guven, Ayla; Dursun, Oguz; Tekerek, Nazan; Ozcifci, Gokcen; Yazici, Pinar; Turanli, Eda; Kendirli, Tanil; Kahveci, Fevzi; Yetimakman, Ayse; Citak, Agop; Sik, Guntulu; Bingol, Ibrahim; Aygun, Fatih; Durak, Cansu; Yilmaz, Resul; Bugrul, Fuat; Sari, Yusuf; Tekguc, Hakan; Albayrak, Hatice; Yener, Nazik; Agin, Hasan; Soydan, Ekin; Yildizdas, Dincer; Dilek, Semine; Yalindag, Nilufer; Incekoy-Girgin, Feyza; Alacakir, Nuri; Tutunculer, Filiz; Arslanaoglu, Mehmet; Aydin, Can; Bilgin, Muzaffer; Simsek, Enver; Dinleyici, Ener

doi:10.3389/fped.2022.926013

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

Atıf İçin Kopyala

KIRAL E., KIREL B., Havan M., Keskin M., Karaoglan M., Yildirim A., ...Daha Fazla

FRONTIERS IN PEDIATRICS, cilt.10, 2022 (SCI-Expanded)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 10
Basım Tarihi: 2022
Doi Numarası: 10.3389/fped.2022.926013
Dergi Adı: FRONTIERS IN PEDIATRICS
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
Anahtar Kelimeler: COVID-19, children, diabetes, diabetic ketoacidosis, pandemic, pediatric intensive care unit, RISK
Gazi Üniversitesi Adresli: Evet

Özet

IntroductionThere 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. MethodsThis 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. ResultsThe 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. DiscussionThe 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.