3 articles found by citation matching
Increase in the Number of Pediatric New-Onset Diabetes and Diabetic Ketoacidosis Cases During the COVID-19 Pandemic.
Endocr Pract. 2022.
PMID: 35189332
Free PMC article.
Abstract
Objective:
Infection with SARS-CoV-2 induces a proinflammatory state that
causes hyperglycemia and may precipitate diabetic ketoacidosis (DKA) in
patients with known or new-onset diabetes. We examined the trends in
new-onset diabetes and DKA prior to and following the onset of the
COVID-19 pandemic.Methods:
This single-center retrospective observational study included
pediatric patients (aged 0 to <18 years) hospitalized with new-onset
type 1 diabetes or type 2 diabetes (T2D) before (March 1, 2018, to
February 29, 2020) and after (March 1, 2020 to December 31, 2020) the
pandemic onset. Demographic, anthropometrics, laboratory and clinical
data, and outcomes were obtained. Results:
Among 615 children admitted with new-onset diabetes during the
entire study period, 401 were admitted before the pandemic onset, and
214 were admitted after the pandemic onset. Children admitted with
new-onset diabetes in the postpandemic period were significantly more
likely to present with DKA (odds ratio, 1.76; 95% confidence interval,
1.24-2.52) than in the prepandemic phase. Children with DKA after the
pandemic onset had higher lengths of hospitalization and were
significantly more likely to experience severe DKA (odds ratio, 2.17;
95% confidence interval, 1.34-3.52). A higher proportion of children
with DKA admitted to the pediatric intensive care unit required oxygen
support after the pandemic onset than before the pandemic onset (8.85%
vs 1.92%). Most cases of T2D with DKA occurred following the onset of
the pandemic (62.5%). Conclusion:
A significant increase in T2D cases occurred following the onset
of the COVID-19 pandemic with a greater risk of DKA and severe
ketoacidosis. Racial disparity was evident with a higher proportion of
Black and American Indian children presenting with ketoacidosis
following the pandemic onset.
Keywords:
COVID-19; children; diabetes; disparity; ketoacidosis.
Increased Severe Cases and New-Onset Type 1 Diabetes Among
Children Presenting With Diabetic Ketoacidosis During First Year of
COVID-19 Pandemic in Turkey.
Front Pediatr. 2022.
PMID: 35844756
Free PMC article. 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.
The Value of Telemedicine for the Follow-up of Patients with New
Onset Type 1 Diabetes Mellitus During COVID-19 Pandemic in Turkey: A
Report of Eight Cases.
J Clin Res Pediatr Endocrinol. 2021.
PMID: 33084289
Free PMC article.The current Coronavirus disease-2019 (COVID-19) pandemic has forced
health care teams to look for alternative approaches to manage a great
number of children with diabetes, not only in rural but also in urban
locations. The aim was to assess the provision of information about
follow-up of new-onset pediatric type 1 diabetes (T1D) patients, and to
investigate the integration of telemedicine into routine clinical care
in the long term. The changes in coefficient of variation (CV), standard
deviation and percentages of time in range (TIR), time below range
(TBR) and time above range were evaluated in eight children with
new-onset T1D, diagnosed during the COVID-19 pandemic. The study period
was two-months of follow-up using a telemedicine system. Median
follow-up time was 51 (24-66) days. Two of the patients were using low
glucose suspend system and six were on multiple daily injection therapy.
Target TIR values were achieved in seven patients in the last televisit
and, in line with recent guidelines, a TBR <70 mg/dL (<3.9
mmol/L) (level 1 hypoglycemia) of <4% and a TBR <54 mg/dL (<3.0
mmol/L) (level 2 hypoglycemia) of <1% were achieved in all patients.
Seven patients achieved a CV of <36% at their last televisit.
Telemedicine as an alternative follow-up tool during unusual
circumstances such pandemics, even in countries where it is not
routinely used, could be beneficial to achieve optimum glycemic control
in patients with new-onset T1D.
COVID-19-Induced New-Onset Diabetes: Trends and Technologies.
Diabetes. 2021 Dec;70(12):2733-2744. doi: 10.2337/dbi21-0029. Epub 2021 Oct 22.
PMID: 34686519
Free PMC article.
Review.
The coronavirus disease 2019 (COVID-19) global pandemic continues to spread worldwide with approximately 216 million confirmed cases and 4.49 million deaths to date. ...Likewise, an increased frequency of diabetes onset and diabetes compl …The coronavirus disease 2019 (COVID-19) global pandemic continues to
spread worldwide with approximately 216 million confirmed cases and 4.49
million deaths to date. Intensive efforts are ongoing to combat this
disease by suppressing viral transmission, understanding its
pathogenesis, developing vaccination strategies, and identifying
effective therapeutic targets. Individuals with preexisting diabetes
also show higher incidence of COVID-19 illness and poorer prognosis upon
infection. Likewise, an increased frequency of diabetes onset and
diabetes complications has been reported in patients following COVID-19
diagnosis. COVID-19 may elevate the risk of hyperglycemia and other
complications in patients with and without prior diabetes history. It is
unclear whether the virus induces type 1 or type 2 diabetes or instead
causes a novel atypical form of diabetes. Moreover, it remains unknown
if recovering COVID-19 patients exhibit a higher risk of developing
new-onset diabetes or its complications going forward. The aim of this
review is to summarize what is currently known about the epidemiology
and mechanisms of this bidirectional relationship between COVID-19 and
diabetes. We highlight major challenges that hinder the study of
COVID-19-induced new-onset of diabetes and propose a potential framework
for overcoming these obstacles. We also review state-of-the-art
wearables and microsampling technologies that can further study diabetes
management and progression in new-onset diabetes cases. We conclude by
outlining current research initiatives investigating the bidirectional
relationship between COVID-19 and diabetes, some with emphasis on
wearable technology.
Irene Leal-Berumen
Ernesto Rodriguez-Ayala
Raul A. Bastarrachea