Does SARS-COV-2 outbreak increase diabetic ketoacidosis in new onset T1DM

Arzu Jalilova; Gunay Demir Aysun Ata; Hafize Işıklar; Altınok Yasemin Atik; Samim Ozen; Şukran Darcan; Damla Gokşen

Introduction: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of type 1 diabetes mellitus (T1DM) and infection is the most common precipitating factor for DKA and is responsible for more than 50% of cases.

Aim: We evaluated the frequency and severity of DKA in children with T1DM, before and during the coronavirus disease 2019 (COVID-19) outbreak, in order to identify its indirect effects on DKA incidence.

Method: A single-center, retrospective study; including children with new onset T1DM < 18 years of age was carried out. The COVID-19 pandemic group comprised those presenting from March 2020 to March 2021. The control groups included those newly diagnosed with T1DM from March 2016 to March 2020. DKA was defined according to ISPAD criteria.

Results: Whole study group consists of 199 newly onset T1DM. Demographics and clinical characteristics of patients were specified in table1. The rate of DKA at presentation was similar during the pandemic period compared to the pre-pandemic years (58,3% in 2020 vs 55.3% in 2019,45.5% in 2018,44.8% in 2017,64.3% in 2016, P = 0. 393). The rate of severe DKA in the last 2 years was higher than previous years (30.4% in 2020 vs 45.7% in 2019, 24.2% in 2018, 18.5% in 2017, 17.1% in 2016, P = 0. 027).


		2020-2021	2019-2020	2018-2019	2017-2018	2016-2017
Newly diagnosed T1DM	(n)	48	47	33	29	42
Sex	MaleFemale	28(58,3%) 20(41,7%)	24(51,1%) 23(48,9%)	14(42,4%) 19(57,6%)	15(51,7%) 14(48,3%)	24 (57,1%) 18(42,9%)
BMI (SDS)	-0.78 ± 1.69	-0.51 ± 1.59	-0.25 ± 1.25	-0.52 ± 1.72	-0.21 ± 1.34
Age at diagnosis (years)	Mean ± SDS	8,94± 4.65	7,62± 4,54	9,53±4.27	8,88± 4,16	9,21± 4.86
Duration of symptom (day)	Median(min-max)	30 (2-90)	10 (1-90)	10 (1-90)	8.5 (4-90)	20 (0-90)
Age group (n)	<5 years	11(23.4%)	14(30.4%)	6 (18.2%)	6 (20.7%)	12(28.6%)
	6-11 years	19(40.4%)	21(45.7%)	14(42.4%)	14(48.3%)	12(28.6%)
	12-18 years	17 (36.2%)	11(23.9%)	13(39.4%)	9 (31.0%)	18(42.9%)
Treatment Modalities	CSII	11(22.9%)	13(27.7%)	4 (12.5%)	7 (25%)	5 (12.5%)
	MDI	37(77.1%)	34(72.3%)	28(87.5%)	21 (75%)	35(87.5%)
CSII: Continuous Subcutaneous Insulin InfusionMDI: Multiple Dose Insulin

Conclusion: No increase in DKA percentage and severity was detected during pandemic period when compared to previous 4 years. We thought that pandemic measures and lock-down did not delay the diagnosis of diabetes and did not cause disruption in the functioning of the healthcare system.

ESPE Abstracts

P2-134