The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes Mellitus
INTRODUCTION: Diabetic ketoacidosis (DKA) is a life-threatening, acute complication of type 1 diabetes mellitus (T1DM). Infection is the most common precipitating factor for DKA, being responsible for more than 50% of such complications. The frequency and severity of DKA in children with T1DM, befor...
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| Format: | Article |
| Language: | English |
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Galenos Yayincilik
2023-09-01
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| Series: | JCRPE |
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| Online Access: | https://jcrpe.org/jvi.aspx?pdir=jcrpe&plng=eng&un=JCRPE-10337&look4= |
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| author | Arzu Jalilova Aysun Ata Günay Demir Hafize Işıklar Yasemin Atik Altınok Samim Özen Şükran Darcan Damla Gökşen |
| author_facet | Arzu Jalilova Aysun Ata Günay Demir Hafize Işıklar Yasemin Atik Altınok Samim Özen Şükran Darcan Damla Gökşen |
| author_sort | Arzu Jalilova |
| collection | DOAJ |
| description | INTRODUCTION: Diabetic ketoacidosis (DKA) is a life-threatening, acute complication of type 1 diabetes mellitus (T1DM). Infection is the most common precipitating factor for DKA, being responsible for more than 50% of such complications. The frequency and severity of DKA in children with T1DM, before and during the coronavirus disease 2019 outbreak were evaluated and compared with pre-pandemic presentation and severity rates.
METHODS: In total, 199 patients younger than 18 years were included in the study. Patients were divided into two groups: the Coronavirus disease-2019 (COVID-19) pandemic group (new onset T1DM presenting from March 2020 to March 2021; the control group included new onset T1DM from March 2016 to March 2020.
RESULTS: The rate of DKA at presentation was similar (p=0.393) during the pandemic period (58.3%) compared to the pre-pandemic years (44.8-64.3%). Although the percentage of DKA was similar, the rate of severe DKA in the COVID-19 group was higher than previous years. Although not significant, the duration of diabetes symptoms was longer in the COVID-19 period than the previous years.
DISCUSSION AND CONCLUSION: This study suggests that the rate of severe DKA, but not the overall rate of DKA, has increased during the COVID-19 pandemic compared to the prior four years. This may be due to the behavior of the parents of sick children and the limited access to the healthcare system. Despite this limited access, parental concern may have been sufficiently high to seek medical attention for their children, avoiding an increased frequency of DKA as the first presentation of new-onset T1DM. |
| first_indexed | 2024-03-12T13:31:54Z |
| format | Article |
| id | doaj.art-e4d517f7bfb746edaa81a8bec4939877 |
| institution | Directory Open Access Journal |
| issn | 1308-5727 1308-5735 |
| language | English |
| last_indexed | 2024-03-12T13:31:54Z |
| publishDate | 2023-09-01 |
| publisher | Galenos Yayincilik |
| record_format | Article |
| series | JCRPE |
| spelling | doaj.art-e4d517f7bfb746edaa81a8bec49398772023-08-24T11:12:00ZengGalenos YayincilikJCRPE1308-57271308-57352023-09-0115326426710.4274/jcrpe.galenos.2023.2022-11-4JCRPE-10337The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes MellitusArzu Jalilova0https://orcid.org/0000-0002-5153-8826Aysun Ata1https://orcid.org/0000-0002-6987-0923Günay Demir2https://orcid.org/0000-0003-1468-1647Hafize Işıklar3https://orcid.org/0000-0001-9750-3971Yasemin Atik Altınok4https://orcid.org/0000-0001-5851-1012Samim Özen5https://orcid.org/0000-0001-7037-2713Şükran Darcan6https://orcid.org/0000-0002-1330-6397Damla Gökşen7https://orcid.org/0000-0001-6108-0591Ege University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İzmir, TurkeyEge University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İzmir, TurkeyEge University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İzmir, TurkeyEge University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İzmir, TurkeyEge University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İzmir, TurkeyEge University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İzmir, TurkeyEge University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İzmir, TurkeyEge University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, İzmir, TurkeyINTRODUCTION: Diabetic ketoacidosis (DKA) is a life-threatening, acute complication of type 1 diabetes mellitus (T1DM). Infection is the most common precipitating factor for DKA, being responsible for more than 50% of such complications. The frequency and severity of DKA in children with T1DM, before and during the coronavirus disease 2019 outbreak were evaluated and compared with pre-pandemic presentation and severity rates. METHODS: In total, 199 patients younger than 18 years were included in the study. Patients were divided into two groups: the Coronavirus disease-2019 (COVID-19) pandemic group (new onset T1DM presenting from March 2020 to March 2021; the control group included new onset T1DM from March 2016 to March 2020. RESULTS: The rate of DKA at presentation was similar (p=0.393) during the pandemic period (58.3%) compared to the pre-pandemic years (44.8-64.3%). Although the percentage of DKA was similar, the rate of severe DKA in the COVID-19 group was higher than previous years. Although not significant, the duration of diabetes symptoms was longer in the COVID-19 period than the previous years. DISCUSSION AND CONCLUSION: This study suggests that the rate of severe DKA, but not the overall rate of DKA, has increased during the COVID-19 pandemic compared to the prior four years. This may be due to the behavior of the parents of sick children and the limited access to the healthcare system. Despite this limited access, parental concern may have been sufficiently high to seek medical attention for their children, avoiding an increased frequency of DKA as the first presentation of new-onset T1DM.https://jcrpe.org/jvi.aspx?pdir=jcrpe&plng=eng&un=JCRPE-10337&look4=type 1 diabetes mellitusdiabetic ketoacidosiscoronavirus disease-2019 |
| spellingShingle | Arzu Jalilova Aysun Ata Günay Demir Hafize Işıklar Yasemin Atik Altınok Samim Özen Şükran Darcan Damla Gökşen The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes Mellitus JCRPE type 1 diabetes mellitus diabetic ketoacidosis coronavirus disease-2019 |
| title | The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes Mellitus |
| title_full | The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes Mellitus |
| title_fullStr | The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes Mellitus |
| title_full_unstemmed | The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes Mellitus |
| title_short | The Effect of the SARS-CoV-2 Pandemic on Presentation with Diabetic Ketoacidosis in Children with New Onset Type 1 Diabetes Mellitus |
| title_sort | effect of the sars cov 2 pandemic on presentation with diabetic ketoacidosis in children with new onset type 1 diabetes mellitus |
| topic | type 1 diabetes mellitus diabetic ketoacidosis coronavirus disease-2019 |
| url | https://jcrpe.org/jvi.aspx?pdir=jcrpe&plng=eng&un=JCRPE-10337&look4= |
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