The Challenges of Managing Pediatric Diabetes and Other Endocrine Disorders During the COVID-19 Pandemic: Results From an International Cross-Sectional Electronic Survey

Elbarbary, Nancy; Santos, Tiago Jeronimo Dos; Beaufort, Carine de; Wiltshire, Esko; Pulungan, Aman B; Scaramuzza, Andrea

doi:10.3389/fendo.2021.735554

Cited by 14 publications

(22 citation statements)

References 48 publications

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“…There were also no significant differences in glycaemic control parameters or in the incidence and severity of DKA between the pre-COVID and COVID populations in our study. This stands in opposition to some reports of an increased incidence of DKA during the pandemic [17,18]. Additionally, although without statistical significance, we observed that the highest blood glucose level readings at admission were all recorded in the pre-COVID group, and the number of DKA incidents in the pre-pandemic population was nearly double that of the COVID group.…”

Section: Discussioncontrasting

confidence: 99%

The incidence and causes of acute hospitalizations and emergency room visits in adolescents with type 1 diabetes mellitus prior to and during the COVID-19 pandemic: a single-centre experience

Nowak¹,

Gawlik²,

Wędrychowicz³

et al. 2023

pedm

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Introduction: Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in childhood. Because acute glycaemic complications account for most concerns in the management of T1DM in children, special attention during the challenging time of the global COVID-19 pandemic is required to prevent deteriorations resulting in acute hospitalization. Aim of the study is to assess how the COVID-19 pandemic influenced the incidence and causes of acute hospitalizations and emergency room visits in adolescents with established type 1 diabetes mellitus, and to characterize the admitted population. Material and methods:The study was conducted as a retrospective evaluation of acute hospitalizations of 39 T1DM patients between 15 and 17 years of age in the period 2018-2021. Results: No difference was noted in the incidence of acute hospitalizations and DKA or the biochemical parameters of adolescents with T1DM between the pre-COVID (23 patients in 2018-2019) and COVID period (16 patients in 2020-2021). It is, however, worth underlying that 6/11 (55%) patients hospitalised in 2021 experienced diabetes deterioration as a result of emotional distressa phenomenon that was not present in the pre-COVID era. After excluding of the hospitalizations due to psychosocial causes, a significant decrease in the number of acute hospitalizations in the COVID period was observed. Conclusions: We suppose that increased parental supervision during the pandemic might have prevented some of the episodes of severe disease decompensation, but this was masked by the sharp increase in hospitalizations due to emotional distress. Our data confirmed that psycho-emotional status is an important factor in the treatment of T1DM.

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Section: Discussioncontrasting

confidence: 99%

The incidence and causes of acute hospitalizations and emergency room visits in adolescents with type 1 diabetes mellitus prior to and during the COVID-19 pandemic: a single-centre experience

Nowak¹,

Gawlik²,

Wędrychowicz³

et al. 2023

pedm

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“…An increase in the incidence of DKA was reported by 17.6% of the surveyed centers during the first few months of the pandemic, and that was slightly higher than what was reported by Elbarbary et al 11 for which 15% of their responders reported an increased incidence of DKA. However, that incidence was lower than another international cross-sectional electronic survey conducted later by Elbarbary et al 14 in which 44% of their respondents reported increased diabetic ketoacidosis episodes in newly diagnosed cases and 30% in established cases. Similarly, Alaqeel et al 15 studied the impact of COVID-19 pandemic lockdown on the incidence of new-onset T1DM and ketoacidosis among Saudi children.…”

Section: Discussionmentioning

confidence: 60%

Pediatric Diabetes Services in Arab Countries during the First 6 Months of the COVID-19 Pandemic

Alsaffar

Abdullah

Ali

et al. 2022

Journal of Diabetes and Endocrine Practice

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Introduction The novel coronavirus disease 2019 (COVID-19) pandemic had an impact on different health services due to the lockdowns, curfews, or reducing provision of some clinical services to infection control. Aims This study looked at the impact of the pandemic on the pediatric diabetes services in Arab countries during the first 6 months of pandemic. Methods and Material An online survey using SurveyMonkey was e-mailed to the pediatric endocrine consultants practicing in Arab countries. The survey was active for the last 2 weeks of August 2020. Results Responses received from 34 consultants. Most responses were from Saudi Arabia, Iraq, and Oman. 18% of consultants have more than 500 pediatric patients with type-1 diabetes mellitus (T1DM) under each of their care. A quarter of responding consultants had suspended their clinics completely during the pandemic period. The median number of children live with diabetes used to be seen in diabetes clinics has dropped significantly from 22 to only 4 patients per week during the pandemic. Half of respondents fed back those virtual clinics were useful. The number of elective and urgent admissions during the studied period were less than before the pandemic. A total of 17.6% of responders reported an increased incidence of Diabetic Ketoacidosis (DKA) during the pandemic. Also, 36.4% thought the research activity had markedly decreased during the COVID-19 pandemic. Conclusion The pandemic has led to reducing the number of patients attending the diabetes clinic in Arab countries. However, virtual clinics and tele-consultations emerged evidently during the pandemic. It is expected to continue using the virtual clinics when the pandemic is over.

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“…Moreover, a regular outpatient follow-up of children and adolescents with obesity, which often requires closely-timed visits to be effective, has been made difficult by the above-mentioned restrictions. Elbarbary et al., in an International Cross-Sectional Electronic Survey distributed to the global network of endocrine societies, estimated a 41.5% delay in obesity diagnosis and a perceived worsening in obesity management in 83% of cases due to the COVID-19 pandemic ( 21 ). Our study showed that, although outpatient follow-up would not appear to have been compromised, its efficacy was lower in obese patients followed during the pandemic period compared with those followed in the pre-pandemic period, due to the increase of an unhealthy lifestyle characterized by a significant reduction in physical activity and increased time spent watching TV, playing video games and using electronic devices, and by an increased consumption of junk food.…”

Section: Discussionmentioning

confidence: 99%

Impact of Covid-19 Pandemic on the Effectiveness of Outpatient Counseling in Childhood Obesity Management

et al. 2022

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The Covid-19 pandemic drastically modified social life and lifestyle, in particular, among children and adolescents, promoting sedentary behaviors and unhealthy eating habits. The aims of this study were to assess the rate and the factors associated with outpatient drop-out in childhood obesity management, and to evaluate how the Covid-19 pandemic influenced weight status and lifestyle of children and adolescents with obesity. One hundred and forty-five children and adolescents with obesity were identified, including 80 subjects evaluated before the Covid-19 pandemic (group A) and 65 subjects in the period straddling the Covid-19 pandemic (group B). Anamnestic (family history of obesity, dietary habits, physical activity, screen time), socio-cultural (economic status, employment and schooling of parents, household composition, place of living) and clinical (weight, height, BMI, waist circumference) data were retrospectively analyzed for each subject in both groups at baseline (V0) and 12-months (V1) at in-person assessment. Glycemic and lipid profiles were assessed at V0. Drop-out rate did not differ significantly between the two groups. BMI SDS at V0 (OR=2.52; p=0.004), female sex (OR=0.41; p=0.035), and the presence of a single parent in the household (OR=5.74; p=0.033) significantly influenced drop-out in both groups. Weight loss between V0 and V1 was significantly greater among group A patients compared to group B (p=0.031). In group B, hours spent in physical activity significantly decreased from V0 to V1, being significantly lower than group A at V1; on the contrary, screen time significantly increased in the same period. The consumption of sugary drinks and snacks was significantly greater in group B than group A at V1. Our study documented that the Covid-19 pandemic, although not affecting the drop-out rate of obese children in a follow-up program, negatively influenced lifestyle and reduced the effectiveness of outpatient counseling in childhood obesity treatment.

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The Challenges of Managing Pediatric Diabetes and Other Endocrine Disorders During the COVID-19 Pandemic: Results From an International Cross-Sectional Electronic Survey

Cited by 14 publications

References 48 publications

The incidence and causes of acute hospitalizations and emergency room visits in adolescents with type 1 diabetes mellitus prior to and during the COVID-19 pandemic: a single-centre experience

The incidence and causes of acute hospitalizations and emergency room visits in adolescents with type 1 diabetes mellitus prior to and during the COVID-19 pandemic: a single-centre experience

Pediatric Diabetes Services in Arab Countries during the First 6 Months of the COVID-19 Pandemic

Impact of Covid-19 Pandemic on the Effectiveness of Outpatient Counseling in Childhood Obesity Management

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