Uncovering the alarming rise of diabetic ketoacidosis during COVID-19 pandemic: a pioneer African study and review of literature

Gorchane, A.; Ach, Taïeb; Sahli, Jihène; Abdelkrim, A. Ben; Mallouli, Manel; Bellazreg, F.; Hachfi, W.; Chaieb, Molka Chadli; Ach, K.

doi:10.3389/fendo.2023.1234256

Cited by 11 publications

(8 citation statements)

References 34 publications

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“…50 In a study from Tunisia, that investigated the incidence of new onset DKA between March 2018 and February 2022, investigators reported a 48% increase during the pandemic with the frequency of T1D and T2D rising by 50% and 40% respectively. 51 By contrast, a study from Belgium found that the prevalence of anti-SARS-CoV-2 antibodies in people of the same age with new-onset T1D was similar to that found in children without diabetes. 52 Nevertheless, retrospective data from 27,292,879 patients from a national US database (Cerner Real-World Data) showed that COVID-19 diagnosis was associated with a significantly increased risk of new-onset T1D with specific ethnicities being more susceptible.…”

Section: Discussionmentioning

confidence: 87%

COVID-19 induced type 1 diabetes: A systematic review of case reports and series

Stathi,

Triantafyllidis,

Zafeiri

et al. 2023

J Int Med Res

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Aims To provide an overview of reported cases of new-onset type 1 diabetes mellitus (T1D) following COVID-19 infection. Methods PubMed and Scopus library databases were screened for relevant case reports published between January 2020 and June 2022. Study design, geographic region or language were not restricted. Results Twenty studies were identified and involved 37 patients (20 [54%] male, 17 [46%] female). Median age was 11.5 years (range 8 months–33 years) and 31 (84%) patients were aged ≤17 years. Most patients (33, 89%) presented with diabetic ketoacidosis (DKA). In total, 23 (62%) patients presented at the time of positive COVID-19 testing and 14 (38%) had symptoms consistent with COVID-19 infection or a previous positive test (1–56 days). Diabetes symptomatology was provided in 22 cases and (19, 86%) reported polyuria, polydipsia, polyphagia, fatigue, or weight loss or a combination of the aforementioned in the preceding weeks (3 days–12 weeks). Of the 28 patients that had data on acute and long-term treatment, all recovered well and most were managed with basal bolus insulin regimens. Quality assessment showed that most reports were either ‘good’ or ‘moderate quality’. Conclusions Although uncommon, new-onset T1D is a condition healthcare professionals may expect to see following a COVID-19 infection.

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Section: Discussionmentioning

confidence: 87%

COVID-19 induced type 1 diabetes: A systematic review of case reports and series

Stathi,

Triantafyllidis,

Zafeiri

et al. 2023

J Int Med Res

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“…Secondly, the virus itself had been shown in the literature to be responsible for triggering inflammatory and autoimmune diseases. 24 , 25 The expression of ACE2 in the hypothalamus was confirmed, making it a probable target for SARS-CoV-2. 26 A COVID-19-infected patient may present with panhypopituitarism or pituitary apoplexy.…”

Section: Discussionmentioning

confidence: 87%

Hypophysitis after COVID-19 vaccination in a patient with Rathke’s cleft cyst: A case report

Yu,

Zhou,

et al. 2024

Human Vaccines & Immunotherapeutics

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With the widespread vaccination of COVID-19 vaccine, a few cases have been reported that COVID-19 vaccine may cause endocrine disorders. A 59-y-old man presented with a loss of appetite after the first COVID-19 vaccination, which resolved spontaneously after 3 d. After the second COVID-19 vaccination, the symptoms including the loss of appetite, nausea, and vomiting reappeared and worsened along with loss of vision. He was found to have severe hyponatremia, and further investigations revealed secondary adrenal insufficiency, secondary hypothyroidism and Rathke’s cleft cyst. The patient responded well to glucocorticoid and levothyroxine supplementation, and at 1-y follow-up the patient developed hypogonadism. We hypothesize that hypophysitis is probably induced by COVID-19 vaccine and report the rare but serious adverse reactions for early recognition and intervention.

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“…During the pandemic, while emergency room visits decreased, an increasing number of admissions to hospitals due to DKA have been reported from different parts of the world [6,7,[15][16][17][18][19]. The impact of the pandemic on the incidence and seasonal variability of T1DM continues to be investigated with different results from many regions [9,10,[20][21][22][23][24][25][26][27]. In our study, in which the effect of the pandemic process on the diagnosis and presentation of T1DM was evaluated, it was observed that they presented with a more severe clinical picture during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Increased Severity of Presentation Signs in Children with Newly Diagnosed Type 1 Diabetes during the COVID-19 Pandemic: A Tertiary Center Experience

İzci Güllü,

Akin,

Gökler

et al. 2024

Ann Nutr Metab

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Introduction: Diabetic ketoacidosis (DKA) is an important complication of type 1 diabetes mellitus (T1DM) which is worsened when the diagnosis of T1DM is delayed. The aim of this study was to evaluate the presentation patterns, severity, autoantibody status, and seasonal variability of newly diagnosed T1DM patients during the pandemic period of 2 years compared to those in the pre-pandemic period. Methods: In this single tertiary center retrospective cohort study, newly diagnosed T1DM patients were grouped as pre-pandemic and pandemic period. Age, gender, the month of diagnosis, hemoglobin A1c, venous blood gas parameters, duration of symptoms, glutamic-acid-decarboxylase-antibody (anti-GAD), islet-cell antibody (ICA), and insulin autoantibody levels were recorded. The data obtained were compared between the groups. Results: Number of patients presenting with DKA was significantly higher during the pandemic period (92 [65.7%] vs. 62 [40.8%] patients, p < 0.001). In terms of clinical severity of DKA, pH, and HCO3 levels were lower during the pandemic period (p < 0.001), while the number of patients presenting with severe DKA was significantly higher during the pandemic period (41 [44.6%] vs. 17 [27.4%] patients, p = 0.031). ICA positivity was significantly higher in patients admitted during the pandemic period (47 [36.4%] vs. 21 patients [16.9%], p < 0.001), especially in the second year of the pandemic (p < 0.001). Anti-GAD-ICA co-positivity was significantly higher in patients admitted during the pandemic period and also in second year of the pandemic (p < 0.001). Conclusion: DKA rates increased in newly diagnosed T1DM cases during the pandemic. Despite the relaxation of bans, the second year of the pandemic also saw increased rates of DKA and severe DKA compared to the pre-pandemic period. The significantly increased ICA positivity in the pandemic may support the effects of COVID-19 on autoimmune T1DM.

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Uncovering the alarming rise of diabetic ketoacidosis during COVID-19 pandemic: a pioneer African study and review of literature

Cited by 11 publications

References 34 publications

COVID-19 induced type 1 diabetes: A systematic review of case reports and series

COVID-19 induced type 1 diabetes: A systematic review of case reports and series

Hypophysitis after COVID-19 vaccination in a patient with Rathke’s cleft cyst: A case report

Increased Severity of Presentation Signs in Children with Newly Diagnosed Type 1 Diabetes during the COVID-19 Pandemic: A Tertiary Center Experience

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