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BRIEF RESEARCH REPORT article

Front. Disaster Emerg. Med.
Sec. Pediatric Emergency Medicine
Volume 2 - 2024 | doi: 10.3389/femer.2024.1385450

Characteristics of children presenting with new onset diabetes and DKA in the COVID-19 pandemic: a national cohort study Authors

Provisionally accepted
Caroline Ponmani Caroline Ponmani 1*Damian Roland Damian Roland 2Mark Lyttle Mark Lyttle 3Michael J. Barrett Michael J. Barrett 4Tony Hulse Tony Hulse 5Ruud G. Nijman Ruud G. Nijman 6
  • 1 Barking, Havering And Redbridge University Hospitals NHS Trust, Romford, United Kingdom
  • 2 University of Leicester, Leicester, East Midlands, United Kingdom
  • 3 University of Bristol, Bristol, England, United Kingdom
  • 4 University College Dublin, Dublin, County Dublin, Ireland
  • 5 Evelina London Children's Hospital, London, England, United Kingdom
  • 6 Imperial College Healthcare NHS Trust, Faculty of Medicine, Imperial College London, London, England, United Kingdom

The final, formatted version of the article will be published soon.

    Objectives The objective of this study was to evaluate the characteristics of children presenting with new onset diabetes and diabetic ketoacidosis (DKA) in the first COVID pandemic year, compared to pre-pandemic evidence and identify the factors associated with DKA at diagnosis. Design Retrospective medical record review. Setting Forty-nine paediatric Emergency Departments (EDs) across the UK and Ireland. Patients All children aged 6 months to 16 years presenting to EDs with new onset diabetes and DKA, during the COVID-19 pandemic (1 March 2020-28 February 2021) and the preceding year (1 March 2019-28 February 2020). Results There were increases in children presenting with new onset diabetes in DKA (395 to 566, 43%) and severe DKA (141 to 252, 79%) in the first COVID pandemic year, with patient characteristics similar to the pre-pandemic period. Healthcare seeking delay did not appear to be the sole contributing factor to DKA during the COVID pandemic. The median duration of symptoms of 14 days for both children who presented with and without DKA and were similar across both years; those in severe DKA had shorter median duration of 7 days (IQR: 5-21 days). Conclusions There were significant increases in children with new onset diabetes presenting with DKA in the first COVID pandemic year. Increased DKA rates and severity despite a constant median symptom duration suggest a multifactorial process. Studies to determine checkpoints for intervention between symptom onset and diagnosis of diabetes are vital to mitigate the high incidence of DKA in new onset diabetes.

    Keywords: ] MB, BAO, BCH, BMedSci, MRCPI

    Received: 12 Feb 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Ponmani, Roland, Lyttle, Barrett, Hulse and Nijman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Caroline Ponmani, Barking, Havering And Redbridge University Hospitals NHS Trust, Romford, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.