AUTHOR=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 TITLE=Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey JOURNAL=Frontiers in Pediatrics VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.926013 DOI=10.3389/fped.2022.926013 ISSN=2296-2360 ABSTRACT=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 (p < 0.0001). The incidence of severe DKA was also higher during the COVID-19 pandemic (p < 0.0001) and also higher among children with new onset Type 1 diabetes (p < 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.