The Impact of COVID-19 Pandemic Lockdown on the Incidence of New-Onset Type 1 Diabetes and Ketoacidosis Among Saudi Children

Alaqeel, Aqeel; Aljuraibah, Fahad; Alsuhaibani, Mohammed; Huneif, Mohammed Ayed; Alsaheel, Abdulhameed Y; Dubayee, Mohammad Al; Alsaedi, Abdulaziz; Bakkar, Ayman; Alnahari, Ahmed; Taha, Areej; Alharbi, Khulood; Alanazi, Yousef S; Almadhi, Samia; Khalifah, Reem Al

doi:10.3389/fendo.2021.669302

Cited by 54 publications

(66 citation statements)

References 23 publications

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“…At this time, there is a lack of studies regarding diabetic ketoacidosis among patients with COVID-19 in Saudi Arabia. However, an existing study from Saudi Arabia reported that 83 % were admitted for DKA during the lockdown, which was higher than 2019 (73 %; risk ratio = 1.15), after adjusting for age and sex [ 58 ]. Therefore, ketosis and ketoacidosis should be examined in all hospitalized COVID-19 patients to decline the morbidity and mortality risks [ 53 ].…”

Section: Why Diabetes Is Important?mentioning

confidence: 99%

“…The government of Saudi Arabia had implemented timely measures to decline the virus transmission before COVID-19 being declared as a pandemic [ 58 ]. However, in March 2020, after the WHO announces the COVID-19 outbreak a pandemic, and owing to an increase in infected cases, Saudi Arabia executed further defensive measures, comprising a nationwide lockdown, closing of schools, international and national travel restrictions, postponement of elective procedures and non-essential visits to hospitals to combating COVID-19 [ 58 , 59 ].…”

Section: Why Diabetes Is Important?mentioning

confidence: 99%

“…Telemedicine technology has been an effective method to deliver care for known and new-onset diabetic patients during this current pandemic. Thus, in such situations in the future, technology and telemedicine should be used to fill the gaps when the healthcare system is overloaded [ 58 , 73 ]. A recent study from Saudi Arabia stated a significant progressive effect of telemedicine care on glycaemic control among high-risk patients with diabetes during the COVID-19 pandemic [ 74 ].…”

Section: Why Diabetes Is Important?mentioning

confidence: 99%

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COVID-19 among people with diabetes mellitus in Saudi Arabia: Current situation and new perspectives

Robert

Saeed

Dawish

2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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Background and aim This review aims to report the current status of COVID-19 among people with diabetes, newly diagnosed diabetes, diabetic ketoacidosis, and programmatic efforts including vaccinations. Methods We conducted a literature search using PubMed, Google, and Scopus until July 15, 2021. Results In Saudi Arabia, most studies have reported diabetes as one of the highly prevalent comorbidities among patients with COVID-19. Currently, there are limited studies from Saudi Arabia on the newly diagnosed diabetes and diabetic ketoacidosis caused by COVID-19. The Saudi ministry has taken several measures to control the impact of COVID-19 among people with diabetes, including comprehensive guidelines and prioritized vaccinations. During the COVID-19 pandemic, the use of telehealth services dramatically increased in diabetes clinics in Saudi Arabia. Conclusions Focused and evidence-based interventions are essential to control the impact of COVID-19 among people with diabetes.

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Section: Why Diabetes Is Important?mentioning

confidence: 99%

Section: Why Diabetes Is Important?mentioning

confidence: 99%

Section: Why Diabetes Is Important?mentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 among people with diabetes mellitus in Saudi Arabia: Current situation and new perspectives

Robert

Saeed

Dawish

2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

View full text Add to dashboard Cite

show abstract

“…One study found that pediatric patients of T1D presented a higher HbA1c value during the lockdown. The increase is suspected to be correlated with increased BMI, decreased physical activity, and increased screen time [21]. Al-Agha et al [30] found a decrease in HbA1c.…”

Section: Discussionmentioning

confidence: 98%

“…A total of eleven studies [21][22][23][24][25][26][27][28][29][30][31] with 1357 pre-lockdown and 1325 lockdown total participants, consisting of T1D and T2D patients, reported the mean level of HbA1c and estimated A1c which obtained either from CGM or FGM (Figure 2). A pooled estimate showed that lockdown did not significantly give rise to changes in HbA1c parameter (MD=0.06% [95%CI -0.10 to 0.23], I 2 =77%, random-effects).…”

Section: Primary Outcomes Glycated Hemoglobin A1c (Hba1c)mentioning

confidence: 99%

Impact of COVID-19 Lockdown on the Metabolic Control Parameters in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis

Ia¹,

Nr²,

Sofia³

et al. 2021

Preprint

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Background: The abrupt implementation of COVID-19 lockdown had impacted the management of diabetes mellitus. Limited access to health facilities and alterations in daily lifestyle put metabolic control among patients at risk. Thus, we observed the differences in metabolic control parameters in diabetic patients before and during the lockdown. Methods: We performed searches from five databases. Meta-analyses were done using random or fixed-effect approaches with glycemic control parameters (HbA1c, RBG, FBG, TIR, TAR, TBR) as primary outcomes. Mean difference (MD), Confidence Interval (CI), and p-value were calculated. Lipid profile presented as secondary outcome. Results: 21 studies with 3992 diabetic patients were included in the study. Meta-analysis presented an increase on HbA1c of T1D and T2D patients [MD=+0.06% (95%CI -0.10–0.23), I2=77%, p=0.45], TBR of T1D patients [MD=-0.05% (95%CI -0.38–0.28), I2=0%, p=0.77], FBG of T2D patients [MD=+3,47 mg/dL (95%CI 1.22–5.73), I2=0%, p=0.002], and lipid profile on qualitative analysis. However, TIR, TAR, and RBG of T1D patients were improved [MD=+3.52% (95%CI 0.29–6.74), I2=76%, p=0.03; MD=-3.36% (95%CI -6.48–-0.25), I2=75%, p=0.03; MD=-0.91 mg/dL (95%CI -4.52–6.34), I2=88%, p=0.74]. Conclusion: Lockdown enforcement did not worsen the glycemic control parameter in diabetic patients. Particular parameters inclined to improve during the lockdown.

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Factors Associated With Diabetic Ketoacidosis at Onset of Type 1 Diabetes Among Pediatric Patients

et al. 2022

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ImportancePresenting with diabetic ketoacidosis (DKA) at onset of type 1 diabetes (T1D) remains a risk. Following a 2011 systematic review, considerable additional articles have been published, and the review required updating.ObjectiveTo evaluate factors associated with DKA at the onset of T1D among pediatric patients.Evidence ReviewIn this systematic review, PubMed, Embase, Scopus, CINAHL, Web of Science, and article reference lists were searched using the population, intervention, comparison, outcome search strategy for primary research studies on DKA and T1D onset among individuals younger than 18 years that were published from January 2011 to November 2021. These studies were combined with a 2011 systematic review on the same topic. Data were pooled using a random-effects model.FindingsA total of 2565 articles were identified; 149 were included, along with 46 from the previous review (total 195 articles). Thirty-eight factors were identified and examined for their association with DKA at T1D onset. Factors associated with increased risk of DKA were younger age at T1D onset (&lt;2 years vs ≥2 years; odds ratio [OR], 3.51; 95% CI, 2.85-4.32; P &lt; .001), belonging to an ethnic minority population (OR, 0.40; 95% CI, 0.21-0.74; P = .004), and family history of T1D (OR, 0.46; 95% CI, 0.37-0.57; P &lt; .001), consistent with the 2011 systematic review. Some factors that were not associated with DKA in the 2011 systematic review were associated with DKA in the present review (eg, delayed diagnosis: OR, 2.27; 95% CI, 1.72-3.01; P &lt; .001). Additional factors associated with risk of DKA among patients with new-onset T1D included participation in screening programs (OR, 0.35; 95% CI, 0.21-0.59; P &lt; .001) and presentation during the COVID-19 pandemic (OR, 2.32; 95% CI, 1.76-3.06; P &lt; .001).Conclusions and RelevanceIn this study, age younger than 2 years at T1D onset, belonging to an ethnic minority population, delayed diagnosis or misdiagnosis, and presenting during the COVID-19 pandemic were associated with increased risk of DKA. Factors associated with decreased risk of DKA included greater knowledge of key signs or symptoms of DKA, such as a family history of T1D or participation in screening programs. Future work should focus on identifying and implementing strategies related to these factors to reduce risk of DKA among new patients with T1D.

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The Impact of COVID-19 Pandemic Lockdown on the Incidence of New-Onset Type 1 Diabetes and Ketoacidosis Among Saudi Children

Cited by 54 publications

References 23 publications

COVID-19 among people with diabetes mellitus in Saudi Arabia: Current situation and new perspectives

COVID-19 among people with diabetes mellitus in Saudi Arabia: Current situation and new perspectives

Impact of COVID-19 Lockdown on the Metabolic Control Parameters in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis

Factors Associated With Diabetic Ketoacidosis at Onset of Type 1 Diabetes Among Pediatric Patients

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