在土耳其新冠疫情大流行的第一年，因糖尿病酮症酸中毒就诊的儿童中，重症病例和新发1型糖尿病有所增加。
Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey.
作者信息
Kiral Eylem, Kirel Birgul, Havan Merve, Keskin Mehmet, Karaoglan Murat, Yildirim Ahmet, Kangin Murat, Talay Mehmet Nur, Urun Tuba, Altug Umit, Kesici Selman, Tufan Erennur, Kacmaz Ebru, Bozan Gurkan, Azapagasi Ebru, Uysal Yazici Mutlu, Ozturk Zeynelabidin, Yesilbas Osman, Karaguzel Gulay, Kaya Gulay, Barlas Ulkem, Duyu Muhterem, Boyraz Merve, Sevketoglu Esra, Akcay Nihal, Hancili Suna, Guven Ayla, Dursun Oǧuz, Ulgen Tekerek Nazan, Ozcifci Gokçen, Yazici Pinar, Turanli Eda, Kendirli Tanil, Kahveci Fevzi, Yetimakman Ayse Filiz, Citak Agop, Şik Guntulu, Bingol Ibrahim, Aygun Fatih, Durak Cansu, Yilmaz Resul, Bugrul Fuat, Sari Yusuf, Tekguç Hakan, Albayrak Hatice, Yener Nazik, Agin Hasan, Soydan Ekin, Yildizdas Dincer, Dilek Semine Ozdemir, Yalindag Nilufer, Incekoy-Girgin Feyza, Alacakir Nuri, Tutunculer Filiz, Arslanaoglu Mehmet Ozgur, Aydin Can, Bilgin Muzaffer, Simsek Enver, Dinleyici Ener Cagri
机构信息
Pediatric Intensive Care Unit, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
Department of Pediatric Endocrinology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
出版信息
Front Pediatr. 2022 Jun 29;10:926013. doi: 10.3389/fped.2022.926013. eCollection 2022.
INTRODUCTION
There have been some significant changes regarding healthcare utilization during the COVID-19 pandemic. Majority of the reports about the impact of the COVID-19 pandemic on diabetes care are from the first wave of the pandemic. We aim to evaluate the potential effects of the COVID-19 pandemic on the severity of diabetic ketoacidosis (DKA) and new onset Type 1 diabetes presenting with DKA, and also evaluate children with DKA and acute COVID-19 infection.
METHODS
This is a retrospective multi-center study among 997 children and adolescents with type 1 diabetes who were admitted with DKA to 27 pediatric intensive care units in Turkey between the first year of pandemic and pre-pandemic year.
RESULTS
The percentage of children with new-onset Type 1 diabetes presenting with DKA was higher during the COVID-19 pandemic ( < 0.0001). The incidence of severe DKA was also higher during the COVID-19 pandemic ( < 0.0001) and also higher among children with new onset Type 1 diabetes ( < 0.0001). HbA1c levels, duration of insulin infusion, and length of PICU stay were significantly higher/longer during the pandemic period. Eleven patients tested positive for SARS-CoV-2, eight were positive for new onset Type 1 diabetes, and nine tested positive for severe DKA at admission.
DISCUSSION
The frequency of new onset of Type 1 diabetes and severe cases among children with DKA during the first year of the COVID-19 pandemic. Furthermore, the cause of the increased severe presentation might be related to restrictions related to the pandemic; however, need to evaluate the potential effects of SARS-CoV-2 on the increased percentage of new onset Type 1 diabetes.
引言
在新冠疫情期间，医疗保健的利用发生了一些重大变化。关于新冠疫情对糖尿病护理影响的大多数报告来自疫情的第一波。我们旨在评估新冠疫情对糖尿病酮症酸中毒（DKA）的严重程度以及以DKA为表现的新发1型糖尿病的潜在影响，并评估患有DKA和急性新冠感染的儿童。
方法
这是一项回顾性多中心研究，研究对象为997名1型糖尿病儿童和青少年，他们在疫情第一年和疫情前一年期间因DKA入住土耳其27个儿科重症监护病房。
结果
在新冠疫情期间，以DKA为表现的新发1型糖尿病儿童的比例更高（<0.0001）。在新冠疫情期间，严重DKA的发生率也更高（<0.0001），在新发1型糖尿病儿童中也更高（<0.0001）。在疫情期间，糖化血红蛋白水平、胰岛素输注持续时间和儿科重症监护病房住院时间显著更高/更长。11名患者的新冠病毒检测呈阳性，8名新发1型糖尿病呈阳性，9名入院时严重DKA检测呈阳性。
讨论
在新冠疫情的第一年，DKA儿童中1型糖尿病新发和严重病例的频率。此外，严重表现增加的原因可能与疫情相关的限制有关；然而，需要评估新冠病毒对新发1型糖尿病百分比增加的潜在影响。
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