Alarming Increase of Ketoacidosis Prevalence at Type 1 Diabetes-Onset in Austria—Results From a Nationwide Registry
ObjectiveWe analyzed the annual prevalence of onset-DKA (diabetic ketoacidosis) from 2012 to 2020 with a sub-analysis for lockdown-periods during the COVID-19 pandemic in 2020.DesignAll newly diagnosed children with type 1 diabetes (T1D) aged <15 years are prospectively registered in the popu...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-02-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.820156/full |
| _version_ | 1818284261979979776 |
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| author | Katrin Nagl Thomas Waldhör Sabine E. Hofer Maria Fritsch Dagmar Meraner Christine Prchla Birgit Rami-Merhar Elke Fröhlich-Reiterer |
| author_facet | Katrin Nagl Thomas Waldhör Sabine E. Hofer Maria Fritsch Dagmar Meraner Christine Prchla Birgit Rami-Merhar Elke Fröhlich-Reiterer |
| author_sort | Katrin Nagl |
| collection | DOAJ |
| description | ObjectiveWe analyzed the annual prevalence of onset-DKA (diabetic ketoacidosis) from 2012 to 2020 with a sub-analysis for lockdown-periods during the COVID-19 pandemic in 2020.DesignAll newly diagnosed children with type 1 diabetes (T1D) aged <15 years are prospectively registered in the population-based Austrian Diabetes Incidence Study in Austria.Main Outcome MeasuresThe annual DKA prevalence was analyzed using Joinpoint regression. Definition of DKA: pH <7.3, mild DKA: pH 7.3 to ≤ 7.1, severe DKA: pH <7.1. DKA prevalence during the lockdown periods in 2020 and the corresponding periods in 2015–2019 were examined using Fisher's exact test.ResultsIn the years 2012–2020 the mean prevalence for onset-DKA in Austria was 43.6% [95%CI (confidence interval): 41.6, 45.7] and thus above the mean prevalence of previous decades (1989–2011) of 37,1 % (95%CI: 35.6, 38.6). A particularly high prevalence was found among children <2 years of age (72.0% DKA, 32.8% severe DKA). No significant gender difference was found. Prevalence of severe DKA at T1D-onset increased significantly since 2015 (p = 0.023). During the lockdown in 2020, 59.3% of children were diagnosed with DKA at T1D-onset, compared to 42.1% during the previous 5 years (p = 0.022). Moreover, 20% of children had severe DKA at T1D diagnosis, compared to 14% during the comparison period.ConclusionsThe previously already high prevalence of DKA at T1D-onset has further increased over time. The COVID-19 pandemic has exacerbated the problem of a late or delayed diagnosis of diabetes in children resulting in onset-DKA. The alarmingly increased prevalence of DKA in Austrian children with T1D calls for urgent action. |
| first_indexed | 2024-12-13T00:50:00Z |
| format | Article |
| id | doaj.art-2d5a048296194640ba79968bd70cccca |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-13T00:50:00Z |
| publishDate | 2022-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-2d5a048296194640ba79968bd70cccca2022-12-22T00:04:56ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-02-011010.3389/fped.2022.820156820156Alarming Increase of Ketoacidosis Prevalence at Type 1 Diabetes-Onset in Austria—Results From a Nationwide RegistryKatrin Nagl0Thomas Waldhör1Sabine E. Hofer2Maria Fritsch3Dagmar Meraner4Christine Prchla5Birgit Rami-Merhar6Elke Fröhlich-Reiterer7Department for Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, AustriaDepartment for Epidemiology, Center of Public Health, Medical University of Vienna, Vienna, AustriaDepartment for Pediatrics, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaDepartment for Pediatrics, Medical University of Innsbruck, Innsbruck, AustriaDepartment for Pediatrics, Clinic Donaustadt, Vienna, AustriaDepartment for Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaObjectiveWe analyzed the annual prevalence of onset-DKA (diabetic ketoacidosis) from 2012 to 2020 with a sub-analysis for lockdown-periods during the COVID-19 pandemic in 2020.DesignAll newly diagnosed children with type 1 diabetes (T1D) aged <15 years are prospectively registered in the population-based Austrian Diabetes Incidence Study in Austria.Main Outcome MeasuresThe annual DKA prevalence was analyzed using Joinpoint regression. Definition of DKA: pH <7.3, mild DKA: pH 7.3 to ≤ 7.1, severe DKA: pH <7.1. DKA prevalence during the lockdown periods in 2020 and the corresponding periods in 2015–2019 were examined using Fisher's exact test.ResultsIn the years 2012–2020 the mean prevalence for onset-DKA in Austria was 43.6% [95%CI (confidence interval): 41.6, 45.7] and thus above the mean prevalence of previous decades (1989–2011) of 37,1 % (95%CI: 35.6, 38.6). A particularly high prevalence was found among children <2 years of age (72.0% DKA, 32.8% severe DKA). No significant gender difference was found. Prevalence of severe DKA at T1D-onset increased significantly since 2015 (p = 0.023). During the lockdown in 2020, 59.3% of children were diagnosed with DKA at T1D-onset, compared to 42.1% during the previous 5 years (p = 0.022). Moreover, 20% of children had severe DKA at T1D diagnosis, compared to 14% during the comparison period.ConclusionsThe previously already high prevalence of DKA at T1D-onset has further increased over time. The COVID-19 pandemic has exacerbated the problem of a late or delayed diagnosis of diabetes in children resulting in onset-DKA. The alarmingly increased prevalence of DKA in Austrian children with T1D calls for urgent action.https://www.frontiersin.org/articles/10.3389/fped.2022.820156/fulldiabetesketoacidosispopulation-based registryCOVID-19general pediatrics |
| spellingShingle | Katrin Nagl Thomas Waldhör Sabine E. Hofer Maria Fritsch Dagmar Meraner Christine Prchla Birgit Rami-Merhar Elke Fröhlich-Reiterer Alarming Increase of Ketoacidosis Prevalence at Type 1 Diabetes-Onset in Austria—Results From a Nationwide Registry Frontiers in Pediatrics diabetes ketoacidosis population-based registry COVID-19 general pediatrics |
| title | Alarming Increase of Ketoacidosis Prevalence at Type 1 Diabetes-Onset in Austria—Results From a Nationwide Registry |
| title_full | Alarming Increase of Ketoacidosis Prevalence at Type 1 Diabetes-Onset in Austria—Results From a Nationwide Registry |
| title_fullStr | Alarming Increase of Ketoacidosis Prevalence at Type 1 Diabetes-Onset in Austria—Results From a Nationwide Registry |
| title_full_unstemmed | Alarming Increase of Ketoacidosis Prevalence at Type 1 Diabetes-Onset in Austria—Results From a Nationwide Registry |
| title_short | Alarming Increase of Ketoacidosis Prevalence at Type 1 Diabetes-Onset in Austria—Results From a Nationwide Registry |
| title_sort | alarming increase of ketoacidosis prevalence at type 1 diabetes onset in austria results from a nationwide registry |
| topic | diabetes ketoacidosis population-based registry COVID-19 general pediatrics |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.820156/full |
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