6533b7d1fe1ef96bd125d69a

RESEARCH PRODUCT

Diabetic ketoacidosis incidence among children withnew-onset type 1 diabetes in Poland and its associationwith COVID-19 outbreak—Two-year cross-sectional nationalobservation by PolPeDiab Study Group

Iwona PietrzakArkadiusz MichalakSebastian SegetMaria BednarskaIwona Beń‐skowronekArtur BossowskiAgata ChobotKatarzyna DżygałoBarbara Głowińska‐olszewskaMartyna GórnickaAnita Horodnicka‐józwaKatarzyna Jakubek‐kipaPrzemysława Jarosz-chobotKatarzyna MarcinkiewiczArtur MazurMałgorzata MyśliwiecJoanna NazimElżbieta NiechciałAnna NoczyńskaEwa RusakMonika SeifertElżbieta Skotarczyk‐kowalskaAnna SkowronekAgnieszka SzypowskaPaulina WaisMieczysław WalczakAnna Wołoszyn‐durkiewiczMarta Wysocka‐mincewiczAgnieszka Zubkiewicz‐kucharskaAgnieszka Szadkowska

subject

MaleCOVID-19; Poland; children; diabetic ketoacidosis; new-onset diabetes; type 1 diabetes.AdolescentIncidenceEndocrinology Diabetes and MetabolismCOVID-19Diabetic KetoacidosisCross-Sectional StudiesDiabetes Mellitus Type 1Child PreschoolPediatrics Perinatology and Child HealthInternal MedicineHumansFemalePolandChildPandemicsRetrospective Studies

description

Background: There are several observations that the onset of coronavirus 19 (COVID-19) pandemic was associated with an increase in the incidence of diabetic ketoacidosis (DKA). However, due to heterogeneity in study designs and country-specific healthcare policies, more national-level evidence is needed to provide generalizable conclusions.Objective: To compare the rate of DKA in Polish children diagnosed with type 1 diabetes (T1D) between the first year of COVID-19 pandemic (15 March 2020 to 15 March 2021) and the preceding year (15 March 2019 to 15 March 2020).Methods: Reference centers in 13 regions (covering ~88% of Polish children) retrospectively reported all new-onset T1D cases in children from assessed periods, including DKA status at admission, administered procedures and outcomes. Secondly, we collected regions' demographic characteristics and the daily-reported number of COVID-19-related deaths in each region.Results: We recorded 3062 cases of new-onset T1D (53.3% boys, mean age 9.5 ± 4.3 years old) of which 1347 (44%) had DKA. Comparing pre- and post-COVID-19 period, we observed a significant increase in the rate of DKA (37.5%-49.4%, p < .0001). The fraction of moderate (+5.4%) and severe (+3.4%) DKA cases increased significantly (p = .0089), and more episodes required assisted ventilation (+2.1%, p = .0337). Two episodes of DKA during 2020/2021 period were fatal. By region, change in DKA frequency correlated with initial COVID-19 death toll (March/April 2020) (R = .6, p = .0287) and change in T1D incidence (R = .7, p = .0080). Conclusions: The clinical picture of new-onset children T1D in Poland deteriorated over a 2-year period. The observed increase in the frequency of DKA and its severity were significantly associated with the overlapping timing of the COVID-19 epidemic.

yearjournalcountryeditionlanguage
2022-01-01Pediatric Diabetes
10.1111/pedi.13379https://doi.org/10.1111/pedi.13379