Diabetic ketoacidosis in pediatric patients with type 1- and type 2 diabetes during the COVID-19 pandemic

Loh, Charlotte; Weihe, Paul; Kuplin, Nicole; Placzek, Kerstin; Weihrauch‐Blüher, Susann

doi:10.1016/j.metabol.2021.154842

Cited by 20 publications

(9 citation statements)

References 22 publications

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“…2020 saw an increase in the severity of the onset of T1DM in children under 16 years of age (higher frequency of ketoacidosis, lower pH, lower base excess [BE] and higher glycated haemoglobin), as has been reported in other countries. 13 , 14 Although the association with lockdown and the fear of going to medical centres has been one of the hypotheses proposed to explain this8 the time since onset of symptoms was <2 weeks in slightly more than 50% of cases, with no differences compared to the previous years, suggesting that there was no delay in receiving health care, which leads us to believe that there must be other factors involved in this greater severity at onset. Moreover, no differences have been found in symptom duration between patients presenting with or without ketoacidosis.4 One feature of healthcare in the Autonomous Community of Madrid was the partial closure of primary care during the first months of the pandemic to support the care of patients with COVID-19 at the Hospital de Emergencias Enfermera Zendal, as well as the subsequent restriction of face-to-face consultations in favour of telephone appointments.…”

Section: Discussionmentioning

confidence: 97%

Severity of new-onset type 1 diabetes in children and adolescents during the coronavirus-19 disease pandemic

Rivero-Martín¹,

Rivas-Mercado²,

Ceñal-González-Fierro³

et al. 2022

Endocrinología, Diabetes y Nutrición (English ed.)

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Section: Discussionmentioning

confidence: 97%

Severity of new-onset type 1 diabetes in children and adolescents during the coronavirus-19 disease pandemic

Rivero-Martín¹,

Rivas-Mercado²,

Ceñal-González-Fierro³

et al. 2022

Endocrinología, Diabetes y Nutrición (English ed.)

View full text Add to dashboard Cite

“…However, in our meta-analysis, we excluded 5 of the 17 studies quantitatively analyzed by Elgenidy A et al because they did not report any of the events of interest or the lack of a control group. Moreover, these authors also included two case-control studies 35,55 and cross-sectional studies 36,46,53,60 and reported relative risks instead of odds ratios. Therefore, the same considerations previously mentioned for the meta-analysis of Alfayez OM et al should apply.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on the incidence and clinical outcomes of diabetic ketoacidosis among male and female children with type 1 diabetes: systematic review and meta-analysis

et al. 2023

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Background: Some studies suggest that the SARS-CoV-2 pandemic increased the incidence of type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA). However, the impact of this pandemic on pediatric T1DM is still mostly unknown. Therefore, we aimed to assess the effect of the COVID-19 pandemic on clinical outcomes in children with T1DM. Methods: We systematically searched for six databases up to 31 August 2022. We included 46 observational studies, 159,505 children of both sexes with T1DM, and 17,547 DKA events. Results: The COVID-19 pandemic significantly increased, in both sexes, the incidence of 1) DKA (OR 1.68; 95% CI 1.44–1.96), 2) severe DKA (OR 1.84; 95% CI 1.59–2.12), 3) DKA in newly diagnosed T1DM (OR 1.75; 95% CI 1.51–2.03), and 4) ICU admissions (OR 1.90; 95% CI 1.60–2.26). However, we did not find a significant association between this pandemic and 1) the incidence of T1DM, 2) the incidence of DKA in established T1DM, 3) the incidence of KDA complications, 4) the length of hospitalization stay, and 5) mortality. Subgroup analysis showed that the study design and the continent of origin accounted for the heterogeneity. Conclusions: The pandemic SARS-CoV-2 raised, in both sexes, the risk of DKA, severe DKA, DKA de novo, and ICU admissions.

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“…These latter two presentations can entail significant risk for morbidity and mortality if not recognized and appropriately treated. Increasing rates of DKA at presentation of new onset T2D have been reported during the COVID‐19 pandemic 91–93 …”

Section: Screening and Diagnosis Of Pre‐diabetes And Type 2 Diabetesmentioning

confidence: 99%

ISPAD Clinical Practice Consensus Guidelines 2022: Type 2 diabetes in children and adolescents

et al. 2022

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Since the 2018 ISPAD guidelines on this topic, follow-up of large cohorts from around the globe have continued informing the current incidence and prevalence of co-morbidities and complications in young adults with youth-onset type 2 diabetes (T2D). This chapter focuses on the risk factors, diagnosis and presentation of youthonset T2D, the initial and subsequent management of youth-onset T2D, and management of co-morbidities and complications. We include key updates from the observational phase of the multi-center Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial, the SEARCH for Diabetes in Youth (SEARCH) study and new data from the Restoring Insulin Secretion (RISE) study, a head-to-head comparison of youth onset vs adult-onset T2D. We also include an expanded section on risk factors associated with T2D, algorithms and tables for treatment, management, and assessment of co-morbidities and complications, and sections on recently approved pharmacologic therapies for the treatment of youth-onset T2D, social determinants of health, and settings of care given COVID-19 pandemic.

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Diabetic ketoacidosis in pediatric patients with type 1- and type 2 diabetes during the COVID-19 pandemic

Cited by 20 publications

References 22 publications

Severity of new-onset type 1 diabetes in children and adolescents during the coronavirus-19 disease pandemic

Severity of new-onset type 1 diabetes in children and adolescents during the coronavirus-19 disease pandemic

Impact of the COVID-19 pandemic on the incidence and clinical outcomes of diabetic ketoacidosis among male and female children with type 1 diabetes: systematic review and meta-analysis

ISPAD Clinical Practice Consensus Guidelines 2022: Type 2 diabetes in children and adolescents

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