The Association between SARS-CoV-2 Infection and Diabetic Ketoacidosis in Patients with New-Onset Diabetes: A Retrospective Study from a Diabetic Center in Saudi Arabia

Abstract

Background: Various reports described new-onset diabetes during or after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with no previous history of diabetes or glucocorticoid use. Further, SARS-CoV-2 could increase the risk of diabetes, including diabetic ketoacidosis (DKA). However, data on the relationship between new-onset diabetes and COVID-19 are still limited in our region. Thus, we aimed in this study to evaluate the association between new-onset diabetes and DKA in patients with COVID-19. Methods: A retrospective, cross-sectional study was conducted at a diabetic center in Jazan province, Saudi Arabia, between 2020 and 2021. Demographic data, COVID-19 status, and DKA incidence were collected and verified manually from diabetic patients’ medical records. Data were analyzed using a t-test and chi-square test. Results: We included 54 diabetic patients diagnosed during the COVID-19 pandemic, with a median age of 17 years. The majority of patients were females (57.4%). About 38.8% were diagnosed with COVID-19, and 16.6% reported having DKA. About 33.3% of the patients who experienced DKA reported being COVID-19-positive. However, only 6% of patients who denied contracting SARS-CoV-2 developed DKA (p-value = 0.020). Conclusions: Patients with newly diagnosed diabetes due to COVID-19 seem at a higher risk of developing DKA. Further epidemiological and molecular studies are required for a better understanding of the correlation between DKA in patients with diabetes and COVID-19.

New‐onset type 1 diabetes in children and adolescents as postacute sequelae of SARS‐CoV‐2 infection: A systematic review and meta‐analysis of cohort studies

“…SARS‐CoV‐2 infection was defined by first positive PCR test for SARS‐CoV‐2 in all included studies. The control group in six studies was from non‐COVID‐19 participant 2–4,6–8 and in one study selected from patients with other respiratory tract infections 5 . Studies reported the risk of new‐onset T1DM based on adjustment for age, 3,8 gender, 3,7,8 geographical area and socioeconomic factors, comorbidity, vaccine doses, parental history of T1DM, 7 and calendar time 6,7 .…”

“…All meta-analyses in the current study were conducted using Review Manager (version 5.4; The Nordic Cochrane Center) and a two-sided p value less than 0.05 was considered statistically significant. was from non-COVID-19 participant [2][3][4][6][7][8] and in one study selected from patients with other respiratory tract infections. 5 Studies reported the risk of new-onset T1DM based on adjustment for age, 3,8 gender, 3,7,8 geographical area and socioeconomic factors, comorbidity, vaccine doses, parental history of T1DM, 7 and calendar time.…”

“…Three reports from two studies 2,4 involving 763 new-onset T1DM patients with DKA (490 new cases in children and adolescents following SARS-CoV-2 infection and 273 new cases in the respective control groups) were included. The random-effect model showed that SARS-CoV-2 infection was associated with an elevation in the risk of DKA in children and adolescents compared with non-COVID-19 control groups (RR = 2.56, 95% CI 1.07−6.11, p = 0.03) (Figure 6).…”

“…The novel coronavirus disease 2019 (COVID‐19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has affected 50%−70% of children and adolescents globally 1 . Among its various complications, there is growing evidence that SARS‐CoV‐2 infection may trigger or accelerate the onset of type 1 diabetes mellitus (T1DM) in children and adolescents 2–8 . T1DM is an autoimmune disorder characterized by destruction of pancreatic beta cells and insulin deficiency that is differentiated from type 2 diabetes mellitus (T2DM) by a unique pathophysiology, which makes up approximately 5% of all diabetes at young age 9 .…”

Adverse Childhood Experience as a Risk Factor for Developing Type 2 Diabetes among the Jazan Population: A Cross-Sectional Study

“…However, we studied alcohol and substance abuse, which was not previously studied in Saudi Arabia [ 13 ], and our sample was homogeneous, increasing the accuracy of our results. We recommend further longitudinal, prospective clinical studies with an extensive and representative sample to understand the association between ACEs and T2DM [ 37 , 38 ].…”