Diabetic ketoacidosis incidence among children with new‐onset type 1 diabetes in Poland and its association with
            <scp>COVID</scp>
            ‐19 outbreak—Two‐year cross‐sectional national observation by
            <scp>PolPeDiab</scp>
            Study Group

Pietrzak, Iwona; Michalak, Arkadiusz; Seget, Sebastian; Bednarska, Maria; Beń‐Skowronek, Iwona; Bossowski, Artur; Chobot, Agata; Dżygało, Katarzyna; Głowińska‐Olszewska, Barbara; Górnicka, Martyna; Horodnicka‐Józwa, Anita; Jakubek-Kipa, Katarzyna; Jarosz‐Chobot, Przemysława; Marcinkiewicz, Katarzyna; Mazur, Artur; Myśliwiec, Małgorzata; Nazim, Joanna; Niechciał, Elżbieta; Noczyńska, Anna; Rusak, Ewa; Seifert, Martin; Skotarczyk‐Kowalska, Elżbieta; Skowronek, Anna; Szypowska, Agnieszka; Wais, Paulina; Walczak, Mieczysław; Wołoszyn-Durkiewicz, Anna; Wysocka‐Mincewicz, Marta; Zubkiewicz‐Kucharska, Agnieszka; Szadkowska, Agnieszka

doi:10.1111/pedi.13379

Cited by 10 publications

(10 citation statements)

References 50 publications

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“…In this systematic review and meta-analysis, in 17 studies including 38 149 children and adolescents with newly diagnosed type 1 diabetes, 13, 23, 24, 27, 31, 32, 38, 39, 49-51, 53, 55, 58-60, 63 we found that the incidence rate of type 1 diabetes was 1.14 times higher in the first year and 1.27 times higher in the second year after the onset of the COVID-19 pandemic compared with before the pandemic. In 15 studies including a total of 4324 children and adolescents with DKA, 27,29,36,37,[40][41][42][44][45][46][47]49,50,54,65 we also found that the incidence rate of DKA at diagnosis was 1.26 times higher in the first year after the onset of the COVID-19 pandemic compared with before the pandemic. The magnitude of increase in the incidence rate of type 1 diabetes that we observed after the onset of the pandemic was greater than the expected 3% to 4% annual increase in the incidence rate based on prepandemic temporal trends in Europe.…”

Section: Discussionmentioning

confidence: 86%

“…After the abstract review, we retrieved 81 full-text articles to determine eligibility. Forty-two records met the full inclusion criteria . The manual search of the included studies’ reference lists did not yield additional studies.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-four studies (57.1%) reported DKA incidence at diagnosis. 3, 5, 6, 8, 9, 12, 14, 18, 19, 22, 25, 27-31, 34, 35, 37, 38, 40, 42, 48, 49 Incident cases of type 1 and type 2 diabetes were reported in 36 studies (85.7%) 12,23,24,[27][28][29][30][31][32][33][35][36][37][38][39][40][41][42][44][45][46][47][48][49][50][51][52][53][54][55][56][58][59][60][61]63 and 9 studies (21.4%), 3,33,34,39,43,45,46,55,62 respectively. Two studies (4.8%) did not distinguish between diabetes types.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In a random-effects meta-analysis of pooled data from 15 studies (35.7%) including a total of 4324 children and adolescents with DKA, the incidence rate of DKA was higher during the pandemic period compared with the prepandemic period (IRR, 1.26; 95% CI, 1.17-1.36) (Figure 2C). 27,29,36,37,[40][41][42][44][45][46][47]49,50,54,65 Between-study heterogeneity was minimal (I 2 = 0%).…”

Section: Dka Incidence Rate Meta-analysismentioning

confidence: 99%

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Incidence of Diabetes in Children and Adolescents During the COVID-19 Pandemic

D’Souza,

Empringham,

Pechlivanoglou

et al. 2023

JAMA Netw Open

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ImportanceThere are reports of increasing incidence of pediatric diabetes since the onset of the COVID-19 pandemic. Given the limitations of individual studies that examine this association, it is important to synthesize estimates of changes in incidence rates.ObjectiveTo compare the incidence rates of pediatric diabetes during and before the COVID-19 pandemic.Data SourcesIn this systematic review and meta-analysis, electronic databases, including Medline, Embase, the Cochrane database, Scopus, and Web of Science, and the gray literature were searched between January 1, 2020, and March 28, 2023, using subject headings and text word terms related to COVID-19, diabetes, and diabetic ketoacidosis (DKA).Study SelectionStudies were independently assessed by 2 reviewers and included if they reported differences in incident diabetes cases during vs before the pandemic in youths younger than 19 years, had a minimum observation period of 12 months during and 12 months before the pandemic, and were published in English.Data Extraction and SynthesisFrom records that underwent full-text review, 2 reviewers independently abstracted data and assessed the risk of bias. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline was followed. Eligible studies were included in the meta-analysis and analyzed with a common and random-effects analysis. Studies not included in the meta-analysis were summarized descriptively.Main Outcomes and MeasuresThe primary outcome was change in the incidence rate of pediatric diabetes during vs before the COVID-19 pandemic. The secondary outcome was change in the incidence rate of DKA among youths with new-onset diabetes during the pandemic.ResultsForty-two studies including 102 984 incident diabetes cases were included in the systematic review. The meta-analysis of type 1 diabetes incidence rates included 17 studies of 38 149 youths and showed a higher incidence rate during the first year of the pandemic compared with the prepandemic period (incidence rate ratio [IRR], 1.14; 95% CI, 1.08-1.21). There was an increased incidence of diabetes during months 13 to 24 of the pandemic compared with the prepandemic period (IRR, 1.27; 95% CI, 1.18-1.37). Ten studies (23.8%) reported incident type 2 diabetes cases in both periods. These studies did not report incidence rates, so results were not pooled. Fifteen studies (35.7%) reported DKA incidence and found a higher rate during the pandemic compared with before the pandemic (IRR, 1.26; 95% CI, 1.17-1.36).Conclusions and RelevanceThis study found that incidence rates of type 1 diabetes and DKA at diabetes onset in children and adolescents were higher after the start of the COVID-19 pandemic than before the pandemic. Increased resources and support may be needed for the growing number of children and adolescents with diabetes. Future studies are needed to assess whether this trend persists and may help elucidate possible underlying mechanisms to explain temporal changes.

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Section: Discussionmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Dka Incidence Rate Meta-analysismentioning

confidence: 99%

See 2 more Smart Citations

Incidence of Diabetes in Children and Adolescents During the COVID-19 Pandemic

D’Souza,

Empringham,

Pechlivanoglou

et al. 2023

JAMA Netw Open

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“…The rapid development of telemedicine (mainly consultations by telephone) was not sufficient to meet all of the patient's needs, especially in the case of the elderly [24]. This resulted in worsening the health status of people with diabetes, manifested in an increased number of diagnosed diabetic ketoacidosis cases [25], and a higher share of emergency admissions [26]. The rate of type 1 diabetes-related hospitalizations decreased by more than 37 percentage points among young adults (20-39 age group).…”

Section: State Of Knowledgementioning

confidence: 99%

Diabetes in Poland – public health challenges and opportunities

Sękowski¹,

Grudziąż-Sękowska²,

Pinkas³

et al. 2023

Med Og Nauk Zdr.

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Introduction and Objective. Diabetes, with its medical complications and societal consequences, is one the most difficult concerns for modern society. The purpose of this narrative review is to characterize the selected public health challenges and opportunities resulting from diabetes in Poland, as well as to identify public health measures that may be adopted to lower the diabetes burden in Poland. Review Methods. This narrative review is based on the literature about diabetes in Poland. Scientific papers on diabetes published between 1 January 2010-31 January 2023, available in the PubMed database, were identified using a combination of the following key words: 'diabetes', 'Poland', 'public knowledge', 'management' and 'costs'. Particular attention was paid to the following diabetes-related issues: 1) current and forecast prevalence of diabetes in Poland, 2) diabetic care before and after the COVID-19 pandemic onset, 3) public knowledge of diabetes and diabetes risk factors, and 4) public health interventions to reduce the diabetes burden at the population level. Brief description of the state of knowledge. A continuous growth of both the incidence and the prevalence of diabetes is predicted. Due to insufficient public awareness of diabetes risk factors and symptoms, and the health-debt caused by COVID-19 pandemic, a further rise in the number of diabetic complications is expected, as well as an increase in public spending on health care and social insurance systems. Summary. Public health interventions targeted at preventing diabetes and its complications should not be confined to reducing complications and improving diabetes care, but also include a wide range of initiatives aimed at addressing the fundamental causes of diabetes. Future study should look at the cost-effectiveness of such initiatives in order to mobilize different stakeholders and society.

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