1. Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey
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Eylem Kiral, Birgul Kirel, Merve Havan, Mehmet Keskin, Murat Karaoglan, Ahmet Yildirim, Murat Kangin, Mehmet Nur Talay, Tuba Urun, Umit Altug, Selman Kesici, Erennur Tufan, Ebru Kacmaz, Gurkan Bozan, Ebru Azapagasi, Mutlu Uysal Yazici, Zeynelabidin Ozturk, Osman Yesilbas, Gulay Karaguzel, Gulay Kaya, Ulkem Barlas, Muhterem Duyu, Merve Boyraz, Esra Sevketoglu, Nihal Akcay, Suna Hancili, Ayla Guven, Oǧuz Dursun, Nazan Ulgen Tekerek, Gokçen Ozcifci, Pinar Yazici, Eda Turanli, Tanil Kendirli, Fevzi Kahveci, Ayse Filiz Yetimakman, Agop Citak, Guntulu Şik, Ibrahim Bingol, Fatih Aygun, Cansu Durak, Resul Yilmaz, Fuat Bugrul, Yusuf Sari, Hakan Tekguç, Hatice Albayrak, Nazik Yener, Hasan Agin, Ekin Soydan, Dincer Yildizdas, Semine Ozdemir Dilek, Nilufer Yalindag, Feyza Incekoy-Girgin, Nuri Alacakir, Filiz Tutunculer, Mehmet Ozgur Arslanaoglu, Can Aydin, Muzaffer Bilgin, Enver Simsek, and Ener Cagri Dinleyici
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COVID-19 ,children ,diabetes ,diabetic ketoacidosis ,pandemic ,pediatric intensive care unit ,Pediatrics ,RJ1-570 - Abstract
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.
- Published
- 2022
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