Increased Presentation of Diabetic Ketoacidosis and Changes in Age and Month of Type 1 Diabetes at Onset during the COVID-19 Pandemic in Spain.
Por:
Leiva-Gea I, Fernández CA, Cardona-Hernandez R, Lozano MF, Bahíllo-Curieses P, Arroyo-Díez J, León MC, Martín-Frías M, Barreiro SC, Delgado AM and Sánchez JP
Publicada:
26 jul 2022
Ahead of Print:
26 jul 2022
Resumen:
Objective: To assess the impact of the COVID-19 pandemic and lockdown measures on the presenting characteristics (age at diagnosis, severity, monthly distribution) of newly diagnosed type 1 diabetes in Spanish children. Research Design and Methods: An ambispective observational multicenter study was conducted in nine Spanish tertiary-level hospitals between January 2015 and March 2021. Inclusion criteria: new cases of type 1 diabetes in children (0-14 years) recording age, sex, date of diagnosis, presence of diabetic ketoacidosis (DKA) at onset, and severity of DKA. Data were compared before and during the pandemic. Results: We registered 1444 new cases of type 1 diabetes in children: 1085 in the pre-pandemic period (2015-2019) and 359 during the pandemic (2020-March 2021). There was a significant increase in the group aged =4 years in the pandemic period (chi-squared = 10.986, df 2, p = 0.0041). In 2020-2021, cases of DKA increased significantly by 12% (95% CI: 7.2-20.4%), with a higher percentage of moderate and severe DKA, although this increase was not significant. In 2020, there was a sharp decrease in the number of cases in March, with a progressive increase from May through November, higher than in the same months of the period 2015-2019, highlighting the increase in the number of cases in June, September, and November. The first three months of 2021 showed a different trend to that observed both in the years 2015-2019 and in 2020, with a marked increase in the number of cases. Conclusions: A change in monthly distribution was described, with an increase in DKA at onset of type 1 diabetes. No differences were found in severity, although there were differences in the age distribution, with an increase in the number of cases in children under 4 years of age.
Filiaciones:
Leiva-Gea I:
Pediatric Endocrinology, Department of Pediatrics, Hospital Regional de Málaga, 29010 Málaga, Spain
Instituto de Investigación Biomédica de Málaga (IBIMA), 29590 Malaga, Spain
Fernández CA:
Department of Pediatrics, Hospital Punta de Europa, 11207 Algeciras, Spain
Cardona-Hernandez R:
Division of Pediatric Endocrinology, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950 Barcelona, Spain
Lozano MF:
Pediatric Endocrinology, Department of Pediatrics, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
Bahíllo-Curieses P:
Pediatric Endocrinology, Department of Pediatrics, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
Arroyo-Díez J:
Pediatric Endocrinology, Department of Pediatrics, Hospital Universitario Materno Infantil de Badajoz, 06010 Badajoz, Spain
León MC:
Pediatric Endocrinology, Department of Pediatrics, Institut de Recerca, Hospital Vall d'Hebron, Centre for Biomedical Research on Rare Diseases (CIBERER), 08035 Barcelona, Spain
Barcelona Autonomous University, 08035 Barcelona, Spain
Martín-Frías M:
Pediatric Endocrinology and Diabetes, Department of Pediatrics, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
Barreiro SC:
Pediatrics, Centro de Salud de Barbastro, 22300 Huesca, Spain
:
Pediatric Endocrinology, Department of Pediatrics, Hospital General Universitario de Alicante, 03010 Alicante, Spain
Sánchez JP:
Pediatric Endocrinology, Department of Pediatrics, Consorci Coprporació Sanitaria Parc Tauli, 08208 Sabadell, Spain
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