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
article
Author
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; Ener Cagri Dinleyici
Source
Frontiers in Pediatrics, Vol 10 (2022)
Subject
Language
English
ISSN
2296-2360
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.