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Severe DKA in type 1 diabetes diagnosis doubles during a pandemic

April 23, 2021

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The incidence of severe diabetic ketoacidosis in children with emerging type 1 diabetes doubled during the COVID-19 pandemic compared to 2019 data, as published in Pediatric Diabetes.

“Children with emerging type 1 diabetes during the COVID-19 pandemic in Alberta, Canada saw significant increases in DKA and severe DKA.” Manpreet Doulla, MD, FRCPC, said Healio, assistant professor of pediatric endocrinology at the University of Alberta. “This underscores the need to educate health professionals and families about the symptoms of hyperglycemia and the importance of early diagnosis and treatment, including during public health interventions for COVID-19.”

The incidence of severe DKA in children with type 1 diabetes was twice as high in 2020 as it was in 2019. The data are from Ho J, et al. Pediatric Diabetes. 2021; doi: 10.1111 / pedi.13205.

In a retrospective chart analysis, Doulla and colleagues analyzed data from children with emerging type 1 diabetes from March to August in two children’s tertiary care hospitals in Alberta, Canada. The rates of DKA and severe DKA were compared to the same period in 2019.

The researchers found that the number of children with newly diagnosed type 1 diabetes was similar in pandemic year 2020 (n = 107) compared to 2019 (n = 114). However, the incidence of DKA in the occurrence of type 1 diabetes was higher during the pandemic (68.2% versus 45.6%; P <0.001). The incidence of severe DKA was also higher in 2020 compared to before the pandemic (27.1% vs 13.2%; P = 0.01).

“Our study gives cause for concern about the high rates of DKA in type 1 diabetes in children, which have continued to gain weight during the COVID-19 pandemic,” said Doulla. “Targeted awareness campaigns to identify the symptoms of type 1 diabetes by patients, family members and providers are needed. Children with emerging type 1 diabetes during the pandemic reported more abdominal pain and weight loss. Early symptoms of diabetes include polyuria, polydipsia, enuresis, nocturia, and weight loss. Recognizing these symptoms and having timely access to medical care can prevent further metabolic decompensation to DKA, a potentially serious and life-threatening complication of diabetes. “

Doulla said more research is needed into the usefulness of targeted awareness campaigns aimed at identifying signs and symptoms of type 1 diabetes early on, particularly in terms of their scalability, sustainability and impact on patients, family members and providers Presentation by DKA.

For more informations:

Manpreet Doulla, MD, FRCPC, can be reached at doulla@ualberta.ca.

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