Increased Presentation of Diabetic Ketoacidosis and Changes in Age and Month of Type 1 Diabetes at Onset during the COVID-19 Pandemic in Spain

• Published in: Journal of clinical medicine Vol. 11; no. 15; p. 4338
• Main Authors: Leiva-Gea, Isabel, Fernández, Cristina Antúnez, Cardona-Hernandez, Roque, Lozano, Marta Ferrer, Bahíllo-Curieses, Pilar, Arroyo-Díez, Javier, León, María Clemente, Martín-Frías, Maria, Barreiro, Santiago Conde, Delgado, Andrés Mingorance, Sánchez, Jacobo Pérez
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 26.07.2022; MDPI
• Subjects: Age groups; Binding sites; Clinical medicine; Coronaviruses; COVID-19; Diabetes; Diabetic ketoacidosis; Pandemics; Pediatrics; Severe acute respiratory syndrome coronavirus 2; Teenagers; Germany; Spain; COVID-19; diabetes onset; type 1 diabetes; DKA
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11154338

: 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. : 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. : 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, = 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. : 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.