Frontiers in Pediatrics (Jun 2022)

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

  • 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

DOI
https://doi.org/10.3389/fped.2022.926013
Journal volume & issue
Vol. 10

Abstract

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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.

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