학술논문
Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey.
Document Type
Academic Journal
Author
Kiral E; Pediatric Intensive Care Unit, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.; Kirel B; Department of Pediatric Endocrinology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.; Havan M; Pediatric Intensive Care Unit, Mersin City Hospital, University of Health Sciences, Mersin, Turkey.; Keskin M; Department of Pediatric Endocrinology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.; Karaoglan M; Department of Pediatric Endocrinology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.; Yildirim A; Department of Pediatric Endocrinology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.; Kangin M; Pediatric Intensive Care Unit, Gazi Yasargil Training and Research Hospital, University of Heath Sciences, Diyarbakir, Turkey.; Talay MN; Pediatric Intensive Care Unit, Gazi Yasargil Training and Research Hospital, University of Heath Sciences, Diyarbakir, Turkey.; Urun T; Pediatric Intensive Care Unit, Gazi Yasargil Training and Research Hospital, University of Heath Sciences, Diyarbakir, Turkey.; Altug U; Pediatric Intensive Care Unit, Sanliurfa Training and Research Hospital, University of Heath Sciences, Sanliurfa, Turkey.; Kesici S; Pediatric Intensive Care Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey.; Tufan E; Pediatric Intensive Care Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey.; Kacmaz E; Pediatric Intensive Care Unit, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.; Bozan G; Pediatric Intensive Care Unit, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.; Azapagasi E; Pediatric Intensive Care Unit, Dr Sami Ulus Gynecology Obstetrics and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.; Uysal Yazici M; Pediatric Intensive Care Unit, Dr Sami Ulus Gynecology Obstetrics and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.; Ozturk Z; Pediatric Intensive Care Unit, Dr Sami Ulus Gynecology Obstetrics and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.; Yesilbas O; Pediatric Intensive Care Unit, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.; Karaguzel G; Department of Pediatric Endocrinology, Faculty of Medicine, Karadeniz Technical Universit, Trabzon, Turkey.; Kaya G; Department of Pediatric Endocrinology, Faculty of Medicine, Karadeniz Technical Universit, Trabzon, Turkey.; Barlas U; Pediatric Intensive Care Unit, Bagcilar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.; Duyu M; Pediatric Intensive Care Unit, Prof. Dr. Süleyman Yalcin City Hospital, Medeniyet University, Istanbul, Turkey.; Boyraz M; Pediatric Intensive Care Unit, Prof. Dr. Süleyman Yalcin City Hospital, Medeniyet University, Istanbul, Turkey.; Sevketoglu E; Pediatric Intensive Care Unit, Bakirköy Dr Sadi Konuk Research and Training Hospital, University of Heath Sciences, Istanbul, Turkey.; Akcay N; Pediatric Intensive Care Unit, Bakirköy Dr Sadi Konuk Research and Training Hospital, University of Heath Sciences, Istanbul, Turkey.; Hancili S; Department of Pediatric Endocrinology, Zeynep Kamil Women and Children Diseases Traning and Research Hospital, University of Heath Sciences, Istanbul, Turkey.; Guven A; Department of Pediatric Endocrinology, Zeynep Kamil Women and Children Diseases Traning and Research Hospital, University of Heath Sciences, Istanbul, Turkey.; Dursun O; Pediatric Intensive Care Unit, Akdeniz University Faculty of Medicine, Antalya, Turkey.; Ulgen Tekerek N; Pediatric Intensive Care Unit, Akdeniz University Faculty of Medicine, Antalya, Turkey.; Ozcifci G; Van Training and Research Hospital, University of Heath Sciences, Van, Turkey.; Yazici P; Pediatric Intensive Care Unit, Ege University Faculty of Medicine, Izmir, Turkey.; Turanli E; Pediatric Intensive Care Unit, Ege University Faculty of Medicine, Izmir, Turkey.; Kendirli T; Pediatric Intensive Care Unit, Ankara University Faculty of Medicine, Ankara, Turkey.; Kahveci F; Pediatric Intensive Care Unit, Ankara University Faculty of Medicine, Ankara, Turkey.; Yetimakman AF; Pediatric Intensive Care Unit, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.; Citak A; Pediatric Intensive Care Unit, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.; Şik G; Pediatric Intensive Care Unit, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.; Bingol I; Pediatric Intensive Care Unit, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.; Aygun F; Pediatric Intensive Care Unit, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.; Durak C; Pediatric Intensive Care Unit, Selcuk University Faculty of Medicine, Konya, Turkey.; Yilmaz R; Pediatric Intensive Care Unit, Selcuk University Faculty of Medicine, Konya, Turkey.; Bugrul F; Department of Pediatric Endocrinology, Selcuk University Faculty of Medicine, Konya, Turkey.; Sari Y; Pediatric Intensive Care Unit, Firat University Faculty of Medicine, Elazig, Turkey.; Tekguç H; Pediatric Intensive Care Unit, Dr. Burhan Nalbantoglu Hospital, Lefkosa, Cyprus.; Albayrak H; Pediatric Intensive Care Unit, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.; Yener N; Pediatric Intensive Care Unit, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.; Agin H; Pediatric Intensive Care Unit, Dr Behçet Uz Children's Hospital, Izmir, Turkey.; Soydan E; Pediatric Intensive Care Unit, Dr Behçet Uz Children's Hospital, Izmir, Turkey.; Yildizdas D; Pediatric Intensive Care Unit, Cukurova University Faculty of Medicine, Adana, Turkey.; Dilek SO; Department of Pediatric Endocrinology, Cukurova University Faculty of Medicine, Adana, Turkey.; Yalindag N; Pediatric Intensive Care Unit, Marmara University Faculty of Medicine, Istanbul, Turkey.; Incekoy-Girgin F; Pediatric Intensive Care Unit, Marmara University Faculty of Medicine, Istanbul, Turkey.; Alacakir N; Pediatric Intensive Care Unit, Trakya University Faculty of Medicine, Edirne, Turkey.; Tutunculer F; Department of Pediatric Endocrinology, Trakya University Faculty of Medicine, Edirne, Turkey.; Arslanaoglu MO; Pediatric Intensive Care Unit, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.; Aydin C; Department of Pediatric Endocrinology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.; Bilgin M; Department of Biostatistics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.; Simsek E; Department of Pediatric Endocrinology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.; Dinleyici EC; Pediatric Intensive Care Unit, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
Source
Publisher: Frontiers Media SA Country of Publication: Switzerland NLM ID: 101615492 Publication Model: eCollection Cited Medium: Print ISSN: 2296-2360 (Print) Linking ISSN: 22962360 NLM ISO Abbreviation: Front Pediatr Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2296-2360
Abstract
Introduction: There 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.
Methods: This 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.
Results: The 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.
Discussion: The 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.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2022 Kiral, Kirel, Havan, Keskin, Karaoglan, Yildirim, Kangin, Talay, Urun, Altug, Kesici, Tufan, Kacmaz, Bozan, Azapagasi, Uysal Yazici, Ozturk, Yesilbas, Karaguzel, Kaya, Barlas, Duyu, Boyraz, Sevketoglu, Akcay, Hancili, Guven, Dursun, Ulgen Tekerek, Ozcifci, Yazici, Turanli, Kendirli, Kahveci, Yetimakman, Citak, Şik, Bingol, Aygun, Durak, Yilmaz, Bugrul, Sari, Tekguç, Albayrak, Yener, Agin, Soydan, Yildizdas, Dilek, Yalindag, Incekoy-Girgin, Alacakir, Tutunculer, Arslanaoglu, Aydin, Bilgin, Simsek and Dinleyici.)
Methods: This 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.
Results: The 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.
Discussion: The 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.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2022 Kiral, Kirel, Havan, Keskin, Karaoglan, Yildirim, Kangin, Talay, Urun, Altug, Kesici, Tufan, Kacmaz, Bozan, Azapagasi, Uysal Yazici, Ozturk, Yesilbas, Karaguzel, Kaya, Barlas, Duyu, Boyraz, Sevketoglu, Akcay, Hancili, Guven, Dursun, Ulgen Tekerek, Ozcifci, Yazici, Turanli, Kendirli, Kahveci, Yetimakman, Citak, Şik, Bingol, Aygun, Durak, Yilmaz, Bugrul, Sari, Tekguç, Albayrak, Yener, Agin, Soydan, Yildizdas, Dilek, Yalindag, Incekoy-Girgin, Alacakir, Tutunculer, Arslanaoglu, Aydin, Bilgin, Simsek and Dinleyici.)