A Worldwide Perspective on COVID-19 and Diabetes Management in 22,820 Children from the SWEET Project: Diabetic Ketoacidosis Rates Increase and Glycemic Control Is Maintained

Danne, Thomas; Lanzinger, Stefanie; Bock, Martin de; Rhodes, Erinn T.; Alonso, G. Todd; Barat, P.; Elhenawy, Yasmine Ibrahim; Kershaw, Melanie; Saboo, Banshi; Pinto, Mauro Scharf; Chobot, Agata; Dovč, Klemen

doi:10.1089/dia.2021.0110

Cited by 35 publications

(37 citation statements)

References 29 publications

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“…This finding suggests that the delay in diagnosing type 1 diabetes is not the only cause for an increased risk of DKA. This result might also be supported by the reported no-change or unexpected lower HbA1c levels during the pandemic ( 25 , 28 ). That said, a limitation does exist regarding the duration of symptoms given that the information provided in the studies depends on parents’ ability to recall those symptoms.…”

Section: Discussionsupporting

confidence: 59%

“…showed no difference in DKA cases in those with preexisting type 1 diabetes ( 34 ). Although some studies have reported a decrease in physical activities during the lockdown period ( 25 , 41 ), many studies have observed good glycemic control during the lockdown period, which might be a result of close parental supervision during the lockdown or the increased use of diabetes-related technology in some countries ( 25 , 42 – 45 ).…”

Section: Discussionmentioning

confidence: 99%

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Incidence of Diabetic Ketoacidosis Among Pediatrics With Type 1 Diabetes Prior to and During COVID-19 Pandemic: A Meta-Analysis of Observational Studies

et al. 2022

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BackgroundPrevious reports suggest that the Coronavirus Disease-2019 (COVID-19) pandemic might have affected incidences of diabetic ketoacidosis (DKA) and new diagnoses of type 1 diabetes. This systematic review and meta-analysis aimed to estimate the risk of DKA, including severe DKA, during the COVID-19 pandemic versus the prior-to-COVID-19 period among pediatric patients with type 1 diabetes.MethodsPubMed and EMBASE were searched for observational studies investigating the risk of DKA among pediatric patients with type 1 diabetes during the COVID-19 pandemic and the prior-to-COVID-19 period. A random meta-analysis model was performed to estimate the relative risk of DKA during the COVID-19 pandemic compared to before the pandemic. Subgroup analyses were conducted based on the type 1 diabetes status, established or newly diagnosed. In addition, sensitivity analysis was conducted for studies that reported results from adjusted analysis for potential confounders using fixed effect model.ResultsA total of 20 observational studies reported the risk of DKA, of which 18 reported the risk of severe DKA. The risks of DKA and severe DKA were 35% (RR 1.35, 95%CI 1.2-1.53, I2 = 71%) and 76% (RR 1.76, 95%CI 1.33-2.33, I2 = 44%) higher in the during-COVID-19 group compared to the prior-to-COVID-19 group, respectively. Among patients with newly diagnosed type 1 diabetes, the risk of DKA was 44% higher for the during-COVID-19 group compared to the prior-to-COVID-19 group (RR 1.44, 95%CI 1.26-1.65; I2 = 64%). Only two studies reported the risk of DKA among patients with established type 1 diabetes and the cumulative risk was not statistically significant. In the sensitivity analysis, four studies reported an adjusted odds ratio (aOR) of the risk of DKA during COVID-19 compared to the prior-to-COVID-19 period. The fixed estimate from the meta-analysis found an increase in the risk of DKA in the during-COVID-19 group compared to the prior-to-COVID-19 group (aOR 2.04, 95%CI 1.66-2.50).ConclusionsThis study showed that DKA risk, especially the risk of severe DKA, has increased significantly during the pandemic. Healthcare systems must be aware and prepared for such an increase in DKA cases and take all necessary measures to prevent future spikes during the pandemic.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=272775, identifier PROSPERO [CRD42021272775].

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Incidence of Diabetic Ketoacidosis Among Pediatrics With Type 1 Diabetes Prior to and During COVID-19 Pandemic: A Meta-Analysis of Observational Studies

et al. 2022

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“…Die COVID-19-Krise führte weltweit zu Störungen der Routinen in der ambulanten und stationären klinischen Versorgung [9,14,30]. In der gegenwärtigen COVID-19-Pandemie sind Familien von Kindern mit Diabetes besonders auf ihre Diabetestechnologie und Unterstützung durch ihre Diabetesteams angewiesen.…”

Section: Telemedizin In Der Kinderdiabetologieunclassified

COVID-19 („coronavirus disease 2019“) und Typ-1-Diabetes

Danne

Kordonouri

2021

Diabetologe

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COVID-19 ("coronavirus disease 2019") und Typ-1-Diabetes Kinder: Risiko Ketoazidose Die COVID-19-Krise ("coronavirus disease 2019") geht weltweit mit einem Umbruch in den Routinemodellen der Diabetesversorgung einher. Diskutiert wird, ob es einen Unterschied zwischen Typ-1-und Typ-2-Diabetes hinsichtlich des Risikos für tödliche Folgen einer SARS-Cov-2-Infektion (SARS-CoV-2: "severe acute respiratory syndrome coronavirus 2") gibt, welchen Einfluss COVID-19 auf das Outcome von Kindern mit Typ-1-Diabetes (T1D) weltweit hat und ob Menschen mit T1D bei der Impfung bevorzugt werden sollen. Noch unklar ist, ob eine SARS-CoV-2-Infektion zur Entstehung von T1D beiträgt. Diabetes und Risiko der "coronavirus disease 2019" Typ-1-vs. Typ-2-Diabetes Bislang stützt sich oben angeführte Diskussion fast ausschließlich auf die Outcomedaten Erwachsener mit Diabetes [1, Aus Gründen der besseren Lesbarkeit und Verständlichkeit der Texte wird in Springer-Publikationen in der Regel das generische Maskulinum als geschlechtsneutrale Form verwendet. Diese Form impliziert immer alle Geschlechter.

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“…1 , 2 A higher incidence of diabetic ketoacidosis (DKA) and especially severe forms have been observed during the COVID‐19 pandemic. 3 …”

Section: Introductionmentioning

confidence: 99%

“…Diabetic ketoacidosis is a serious but avoidable complication of type 1 diabetes that can be triggered by viral infections. 3 It has a mortality of 0.3%–0.5% in wealthy countries and considerably higher in developing nations (approximately 10%). 3 Electrolyte abnormalities such as hypokalemia and hypernatremia can emerge during DKA and lead to significant morbidity, but they are relatively rare at presentation, before the initiation of therapy.…”

Section: Introductionmentioning

confidence: 99%

Diabetic ketoacidosis with severe hypokalemia and persistent hypernatremia in an adolescent girl with COVID‐19 infection

Badawy

Viswanath

Khetriwal

et al. 2022

Clinical Case Reports

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A Worldwide Perspective on COVID-19 and Diabetes Management in 22,820 Children from the SWEET Project: Diabetic Ketoacidosis Rates Increase and Glycemic Control Is Maintained

Cited by 35 publications

References 29 publications

Incidence of Diabetic Ketoacidosis Among Pediatrics With Type 1 Diabetes Prior to and During COVID-19 Pandemic: A Meta-Analysis of Observational Studies

Incidence of Diabetic Ketoacidosis Among Pediatrics With Type 1 Diabetes Prior to and During COVID-19 Pandemic: A Meta-Analysis of Observational Studies

COVID-19 („coronavirus disease 2019“) und Typ-1-Diabetes

Diabetic ketoacidosis with severe hypokalemia and persistent hypernatremia in an adolescent girl with COVID‐19 infection

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