Severity in pediatric type 1 diabetes mellitus debut during the COVID-19 pandemic

Güemes, María; Storch-de-Gracia, Pilar; Enríquez, Sara Vinagre; Martín‐Rivada, Álvaro; Brabin, Anthony González; Argente, Jesús

doi:10.1515/jpem-2020-0481

Cited by 17 publications

(15 citation statements)

References 8 publications

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“…COVID-19 and other viral infections can lead to significant consequences in persons with diabetes, such as DKA. Adults and children can develop new-onset diabetes as a result of COVID-19 infection; however, there have only been a few case reports on this matter so far (23)(24)(25)(26)(27)(28)(29)(30)(31). In our study, during the COVID-19 pandemic, 11 children with DKA (ages 32 to 216 months; three boys and eight girls) tested positive for SARS-CoV-2) at admission.…”

Section: Comparison Between the First Year Of The Covid-19 Pandemic A...mentioning

confidence: 58%

“…Hawkes et al ( 16 ) found 73 cases of newly diagnosed T1D between March 16 and July 31, 2020, of which two (a 3-year-old girl and a 9-year-old boy) were positive with mild disease. Guemes et al ( 27 ) found that the severity of new-onset Type 1 diabetes in the pandemic group, which included 10 children, two of whom tested positive for SARS CoV-2 between March 21 and May 6, 2020, was considerably greater. Because two of these patients had minimal respiratory symptoms, no special SARS-CoV-2 therapy was necessary.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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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Section: Comparison Between the First Year Of The Covid-19 Pandemic A...mentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…In light of this, many reports have revealed an increase in severe presentations of new-onset T1DM in children during this pandemic era. Additionally, a review of the Spanish SARS-CoV-2 epicentre included cases of younger individuals [7] as compared to prior years, and, accordingly, our case involved a three-yearold boy. In fact, Italy recorded 44.3% of severe cases of DKA, compared to 36% during the same period in 2019 [8].…”

Section: Discussionmentioning

confidence: 99%

Diabetic Ketoacidosis at Onset of Pediatric Type-1 Diabetes Triggered by Covid-19: An Original Case Report

Benyakhlef¹,

Abdellaoui²,

Tahri³

et al. 2021

Cureus

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During the course of this year, scientific research has revolved around coronavirus disease 2019 (COVID-19), with much uncertainty surrounding its pathogenesis, complications, and mortality as well as limited pediatric evidence. The exact relationship between COVID-19 and new-onset type 1 diabetes, especially in children, remains an unresolved issue. Our case exhibited a unique presentation of diabetic ketoacidosis (DKA) triggering COVID-19 diagnosis at this age. A three-year-old Moroccan boy was admitted with a history of acute dyspnea accompanied by vomiting and weight loss, leading to a diagnosis of DKA. However, evident respiratory distress signs did not disappear, even though glycemic levels were normalized and acidosis resolved. The boy subsequently tested positive for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), with specific biological and radiological findings. Our clinical case potentially augmented the global registry of COVID-19-related diabetes (CoviDiab project) cases and provides a basis for further studies that seek to elucidate the correlation between new-onset type 1 diabetes and SARS-CoV-2 in the pediatric population.

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“…A number of studies examining the presentation of new cases of type 1 diabetes in children and adolescents after the declaration of the pandemic, reported an increase in the frequency severity of diabetes ketoacidosis (DKA) presentation [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. On the other hand, some studies have described an increase in the frequency of new case presentations [ 6 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ], while others reported no increase or even a decrease in the number of type 1 diabetes [ 9 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Increased Presentation of Diabetic Ketoacidosis and Changes in Age and Month of Type 1 Diabetes at Onset during the COVID-19 Pandemic in Spain

Leiva-Gea

Fernández²,

Cardona-Hernández

et al. 2022

JCM

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Objective: To assess the impact of the COVID-19 pandemic and lockdown measures on the presenting characteristics (age at diagnosis, severity, monthly distribution) of newly diagnosed type 1 diabetes in Spanish children. Research Design and Methods: An ambispective observational multicenter study was conducted in nine Spanish tertiary-level hospitals between January 2015 and March 2021. Inclusion criteria: new cases of type 1 diabetes in children (0–14 years) recording age, sex, date of diagnosis, presence of diabetic ketoacidosis (DKA) at onset, and severity of DKA. Data were compared before and during the pandemic. Results: We registered 1444 new cases of type 1 diabetes in children: 1085 in the pre-pandemic period (2015–2019) and 359 during the pandemic (2020–March 2021). There was a significant increase in the group aged ≤4 years in the pandemic period (chi-squared = 10.986, df 2, p = 0.0041). In 2020–2021, cases of DKA increased significantly by 12% (95% CI: 7.2–20.4%), with a higher percentage of moderate and severe DKA, although this increase was not significant. In 2020, there was a sharp decrease in the number of cases in March, with a progressive increase from May through November, higher than in the same months of the period 2015–2019, highlighting the increase in the number of cases in June, September, and November. The first three months of 2021 showed a different trend to that observed both in the years 2015–2019 and in 2020, with a marked increase in the number of cases. Conclusions: A change in monthly distribution was described, with an increase in DKA at onset of type 1 diabetes. No differences were found in severity, although there were differences in the age distribution, with an increase in the number of cases in children under 4 years of age.

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Severity in pediatric type 1 diabetes mellitus debut during the COVID-19 pandemic

Cited by 17 publications

References 8 publications

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

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

Diabetic Ketoacidosis at Onset of Pediatric Type-1 Diabetes Triggered by Covid-19: An Original Case Report

Increased Presentation of Diabetic Ketoacidosis and Changes in Age and Month of Type 1 Diabetes at Onset during the COVID-19 Pandemic in Spain

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