Incidence of Type 1 Diabetes Mellitus and Characteristics of Diabetic Ketoacidosis in Children and Adolescents during the First Two Years of the COVID-19 Pandemic in Vojvodina

Vorgucin, Ivana; Savin, Marijana; Stanković, Đurđina; Miljković, Dejan; Ilić, Tatjana; Simić, Danijela; Vrebalov, Mirjana; Milanović, Borko; Barišić, Nenad; Stojanović, Vesna; Vijatov-Đurić, Gordana; Koprivšek, Katarina; Vilotijevic-Dautovic, Gordana; Antić, Jelena

doi:10.3390/medicina58081013

Cited by 14 publications

(23 citation statements)

References 20 publications

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“…After the abstract review, we retrieved 81 full-text articles to determine eligibility. Forty-two records met the full inclusion criteria . The manual search of the included studies’ reference lists did not yield additional studies.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-four studies (57.1%) reported DKA incidence at diagnosis . Incident cases of type 1 and type 2 diabetes were reported in 36 studies (85.7%) and 9 studies (21.4%), respectively. Two studies (4.8%) did not distinguish between diabetes types .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies (4.8%) did not distinguish between diabetes types . Thirty-two studies (76.2%) included children only, while the rest (10 [23.8%]) included both children and adults . Twenty-one studies (50.0%) were from Europe, 12 (28.6%) from North America, 7 (16.7%) from Asia, and 1 (2.4%) from Australia; 1 study (2.4%) included data from multiple countries across different continents.…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-two studies (76.2%) included children only, while the rest (10 [23.8%]) included both children and adults . Twenty-one studies (50.0%) were from Europe, 12 (28.6%) from North America, 7 (16.7%) from Asia, and 1 (2.4%) from Australia; 1 study (2.4%) included data from multiple countries across different continents. Nine studies (21.4%) reported either the race or ethnicity of the study population, and 1 study reported socioeconomic status .…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-four studies (57.1%) reported DKA incidence at diagnosis. 3, 5, 6, 8, 9, 12, 14, 18, 19, 22, 25, 27-31, 34, 35, 37, 38, 40, 42, 48, 49 Incident cases of type 1 and type 2 diabetes were reported in 36 studies (85.7%) 12,23,24,[27][28][29][30][31][32][33][35][36][37][38][39][40][41][42][44][45][46][47][48][49][50][51][52][53][54][55][56][58][59][60][61]63 and 9 studies (21.4%), 3,33,34,39,43,45,46,55,62 respectively. Two studies (4.8%) did not distinguish between diabetes types.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Incidence of Diabetes in Children and Adolescents During the COVID-19 Pandemic

D’Souza,

Empringham,

Pechlivanoglou

et al. 2023

JAMA Netw Open

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ImportanceThere are reports of increasing incidence of pediatric diabetes since the onset of the COVID-19 pandemic. Given the limitations of individual studies that examine this association, it is important to synthesize estimates of changes in incidence rates.ObjectiveTo compare the incidence rates of pediatric diabetes during and before the COVID-19 pandemic.Data SourcesIn this systematic review and meta-analysis, electronic databases, including Medline, Embase, the Cochrane database, Scopus, and Web of Science, and the gray literature were searched between January 1, 2020, and March 28, 2023, using subject headings and text word terms related to COVID-19, diabetes, and diabetic ketoacidosis (DKA).Study SelectionStudies were independently assessed by 2 reviewers and included if they reported differences in incident diabetes cases during vs before the pandemic in youths younger than 19 years, had a minimum observation period of 12 months during and 12 months before the pandemic, and were published in English.Data Extraction and SynthesisFrom records that underwent full-text review, 2 reviewers independently abstracted data and assessed the risk of bias. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline was followed. Eligible studies were included in the meta-analysis and analyzed with a common and random-effects analysis. Studies not included in the meta-analysis were summarized descriptively.Main Outcomes and MeasuresThe primary outcome was change in the incidence rate of pediatric diabetes during vs before the COVID-19 pandemic. The secondary outcome was change in the incidence rate of DKA among youths with new-onset diabetes during the pandemic.ResultsForty-two studies including 102 984 incident diabetes cases were included in the systematic review. The meta-analysis of type 1 diabetes incidence rates included 17 studies of 38 149 youths and showed a higher incidence rate during the first year of the pandemic compared with the prepandemic period (incidence rate ratio [IRR], 1.14; 95% CI, 1.08-1.21). There was an increased incidence of diabetes during months 13 to 24 of the pandemic compared with the prepandemic period (IRR, 1.27; 95% CI, 1.18-1.37). Ten studies (23.8%) reported incident type 2 diabetes cases in both periods. These studies did not report incidence rates, so results were not pooled. Fifteen studies (35.7%) reported DKA incidence and found a higher rate during the pandemic compared with before the pandemic (IRR, 1.26; 95% CI, 1.17-1.36).Conclusions and RelevanceThis study found that incidence rates of type 1 diabetes and DKA at diabetes onset in children and adolescents were higher after the start of the COVID-19 pandemic than before the pandemic. Increased resources and support may be needed for the growing number of children and adolescents with diabetes. Future studies are needed to assess whether this trend persists and may help elucidate possible underlying mechanisms to explain temporal changes.

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Section: Resultsmentioning

confidence: 99%