Has the COVID-19 Pandemic Affected the Prevalence of Diabetic Ketoacidosis in Polish Children with Newly Diagnosed Type 1 Diabetes? An Example of the Largest Polish Pediatric Diabetes Center (Upper Silesia—Katowice, Poland)

Rusak, Ewa; Seget, Sebastian; Macherski, Maksymilian; Furgał, Natalia; Dyś, Przemysław; Jarosz-Chobot, Przemysława

doi:10.3390/healthcare10020348

Cited by 8 publications

(4 citation statements)

References 35 publications

(49 reference statements)

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“…Multiple studies have reported a significant increase in the number and severity of T1DM new cases after the beginning of the COVID-19 pandemic [5,6,[14][15][16][17][18]. In our center, the total number of new T1DM cases increased by 30.08% between February 2020 and March 2021, compared to the previous year [19].…”

Section: Introductionmentioning

confidence: 54%

“…There was no significant difference in DKA presence and severity between the groups of patients with positive and negative SARS-CoV-2 serology. Considering the fact that several studies, including one conducted in our clinic, reported an increase in DKA incidence and severity after the beginning of the pandemic, a higher percentage of this complication could have been expected in children with positive SARS-CoV-2 antibodies [5,6,[14][15][16][17][18]]. An explanation for this finding could reside from the fact that we cannot be absolutely certain that children with negative SARS-CoV-2 antibodies did not experience a SARS-CoV-2 infection at some point in their history without it leaving a persistent serological mark, but being able to determine alterations of the islet cells functioning or of the immune processes.…”

Section: Discussionmentioning

confidence: 94%

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SARS-CoV-2 Positive Serology and Islet Autoantibodies in Newly Diagnosed Pediatric Cases of Type 1 Diabetes Mellitus: A Single-Center Cohort Study

Boboc,

Novac,

Marin

et al. 2023

IJMS

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Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, although presenting less severe forms of the disease in children, seems to play a role in the development of other conditions, including type 1 diabetes mellitus (T1DM). After the beginning of the pandemic, an increase in the number of T1DM pediatric patients was observed in several countries, thus leading to many questions about the complex relationship between SARS-CoV-2 infection and T1DM. Our study aimed to highlight possible correlations between SARS-CoV-2 serology and T1DM onset. Therefore, we performed an observational retrospective cohort study that included 158 children diagnosed with T1DM in the period April 2021–April 2022. The presence or absence of SARS-CoV-2 and T1DM-specific antibodies and other laboratory findings were assessed. In the group of patients with positive SARS-CoV-2 serology, a higher percentage had detectable IA-2A antibodies, more children were positive for all three islet autoantibodies determined (GADA, ICA, and IA-2A), and a higher mean HbA1c value was found. No difference existed between the two groups regarding DKA presence and severity. A lower C-peptide level was found in the patients presenting diabetic ketoacidosis (DKA) at T1DM onset. When compared to a group of patients diagnosed before the pandemic, an increased incidence of both DKA and severe DKA, as well as a higher age at diagnosis and higher levels of HbA1c were present in our study group. These findings have important implications for the ongoing monitoring and management of children with T1DM after the COVID-19 pandemic and highlight the need for further research to better understand the complex relationship between SARS-CoV-2 infection and T1DM.

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Section: Introductionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 94%

SARS-CoV-2 Positive Serology and Islet Autoantibodies in Newly Diagnosed Pediatric Cases of Type 1 Diabetes Mellitus: A Single-Center Cohort Study

Boboc,

Novac,

Marin

et al. 2023

IJMS

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“…In Canada, a significant increase in the frequency of ketoacidosis among new patients was recorded in the pandemic compared to the pre-pandemic period (68.2% compared to 45.6% in the pre-pandemic period with p < 0.001) ( 13 ). The largest Polish National Diabetes Center did not record a statistically significant increase in 2020 compared to 2019, but a significant increase in diabetic ketoacidosis was recorded (35.2–47.53%, p < 0.05), which was accompanied by a significant increase in average HbA1c and pH values ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Evidence of increasing incidence of type 1 diabetes and ketoacidosis among children in the Republic of Srpska in period 2017–2022 with special focus on COVID-19 global pandemic years

Bukara-Radujkovic,

Miljkovic,

Ljuboja

2023

Front. Public Health

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Background and objectivesPrimary focus of the research was to determine the incidence of type 1 diabetes mellitus in the period from 2017 to 2022, and whether COVID-19 had an impact on the increase in the number of newly diagnosed children with diabetes type 1 under the age of 15 in the Republic of Srpska (Bosnia and Herzegovina). In the period 2001–2016 the incidence of type 1 diabetes mellitus was 11/100,000, with an annual increasing rate of 14.2%.MethodsAvailable data from pediatric endocrinology clinics, in the Republic of Srpska, on the number of newly diagnosed patients with diabetes mellitus in the period from January 1, 2017 until December 31, 2022 were used. A retrospective analysis was performed, and the capture-recapture method was used for the final assessment, and the obtained result corresponds to about 99% of the population.ResultsThe total number of children in the group of 0–14 years of age diagnosed with type 1 diabetes mellitus in this period was 183, of which 96 (52.46%) were boys, and 87 (47.54%) were girls. The average age at which diabetes mellitus was diagnosed was 8.3 ± 3.9 years. Average incidence of diabetes in the period 2017–2022 was 19/100,000 (95% CI 13.1–25.0). The highest incidence was 28.7/100,000 in 2020, the first year of the global COVID-19 pandemic. Out of a total of 183 newly diagnosed cases in the period 2017–2022, 73 (39.9%) were diagnosed with ketoacidosis upon admission. The largest number of newly diagnosed children was recorded in the group of children aged 10–14 years.ConclusionIn the last 6 years, there has been a significant increase in the incidence of type 1 diabetes mellitus in children under the age of 15. With an incidence of 19.4/100,000 in the Republic of Srpska, we entered the group of countries with high-risk for diabetes. Further steps must focus on the education of the entire society in order to recognize the symptoms of the disease in time and prevent the occurrence of ketoacidosis, which could significantly reduce the burden on health systems, especially in times of global pandemics, such as the COVID-19 pandemic.

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“…In contrast, several articles published have established a significant increase in the incidence of DKA among newly diagnosed patients. A study conducted in Poland demonstrated a significant rise in the percentage of DKA among newly diagnosed patients [ 19 ]. Kamrath et al findings also exhibited a significant increment of around 20% in DKA presentations among newly diagnosed patients [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Severity and Resolution of Diabetic Ketoacidosis in Newly Diagnosed Type 1 Diabetic Children before and During The COVID-19 Pandemic

Al-Qassab

Bukhamseen

Ghanim

et al. 2022

Review of Diabetic Studies

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OBJECTIVES: To epidemiologically assess the influence of COVID-19 pandemic on newly diagnosed type 1 diabetes mellitus presenting with diabetic ketoacidosis at the teaching hospital of the university, Eastern province, Saudi Arabia. METHODS: We enrolled newly diagnosed type 1 diabetes mellitus cases among pediatric patients attending the emergency department and outpatient clinics during 2019-2021. The participants' data were collected from electronic medical records which included patients' age at diagnosis, sex, nationality, height, weight, year of diagnosis, length of stay, presentation, random blood sugar, blood gas readings, electrolyte panel, and time of resolution of the diabetic ketoacidosis if present. RESULTS: 108 patients were included with an average age of 8.87 ± 4.21 years and 53.70% were females. The demographic characteristics of all diabetic pediatric patients prior to COVID-19 and during COVID-19 were studied and the difference was statistically insignificant. Furthermore, initial pH and HCO3 tests were found to be lower in the moderate to severe diabetic ketoacidosis group (7.17 and 11.2, respectively) compared to the mild group (7.27 and 15.50, respectively) and the differences were statically significant (P < 0.001). CONCLUSION: Patients newly diagnosed with type 1 diabetes mellitus during the COVID-19 pandemic tended to have a more severe presentation of diabetic ketoacidosis in terms of PH and HCO3.

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Has the COVID-19 Pandemic Affected the Prevalence of Diabetic Ketoacidosis in Polish Children with Newly Diagnosed Type 1 Diabetes? An Example of the Largest Polish Pediatric Diabetes Center (Upper Silesia—Katowice, Poland)

Cited by 8 publications

References 35 publications

SARS-CoV-2 Positive Serology and Islet Autoantibodies in Newly Diagnosed Pediatric Cases of Type 1 Diabetes Mellitus: A Single-Center Cohort Study

SARS-CoV-2 Positive Serology and Islet Autoantibodies in Newly Diagnosed Pediatric Cases of Type 1 Diabetes Mellitus: A Single-Center Cohort Study

Evidence of increasing incidence of type 1 diabetes and ketoacidosis among children in the Republic of Srpska in period 2017–2022 with special focus on COVID-19 global pandemic years

Severity and Resolution of Diabetic Ketoacidosis in Newly Diagnosed Type 1 Diabetic Children before and During The COVID-19 Pandemic

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