Higher rates of diabetic ketoacidosis and admission to the paediatric intensive care unit among newly diagnosed children with type 1 diabetes in Kuwait during the COVID-19 pandemic.

Autor: Al-Abdulrazzaq D; Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait., Alkandari A; Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait., Alhusaini F; Department of Pediatrics, Adan Hospital, Ministry of Health, Hadiya, Kuwait., Alenazi N; Department of Pediatrics, New-Ahmadi Hospital, Al Ahmadi, Kuwait., Gujral UP; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA., Narayan KMV; Department of Medicine and Nutrition and Health Sciences Program, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA., Al-Kandari H; Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait.; Department of Pediatrics, Al-Farwaniyah Hospital, Ministry of Health, Al Farwaniyah, Kuwait.
Jazyk: angličtina
Zdroj: Diabetes/metabolism research and reviews [Diabetes Metab Res Rev] 2022 Mar; Vol. 38 (3), pp. e3506. Date of Electronic Publication: 2021 Oct 25.
DOI: 10.1002/dmrr.3506
Abstrakt: Introduction: The COVID-19 pandemic might have a multifaceted effect on children with type 1 diabetes (T1D), either directly through infection itself or indirectly due to measures implemented by health authorities to control the pandemic.
Objective: To compare data on children newly diagnosed with T1D in Kuwait during the COVID-19 pandemic to the pre-pandemic period.
Research Design and Methods: We analysed data on children aged 12 years or less registered in the Childhood-Onset Diabetes electronic Registry (CODeR) in Kuwait. Data were incidence rate (IR), diabetic ketoacidosis (DKA), and its severity and admission to the paediatric intensive care unit (PICU).
Results: The IR of T1D was 40.2 per 100,000 (95% CI; 36.0-44.8) during the COVID-19 pandemic period and was not statistically different from pre-pandemic. A higher proportion of incident T1D cases presented with DKA and were admitted to the PICU during the pandemic (52.2% vs. 37.8%: p ˂ 0.001, 19.8% vs. 10.9%; p = 0.002, respectively). The COVID-19 pandemic was positively associated with presentation of DKA and admission to PICU (AOR = 1.73; 95% CI, 1.13-2.65; p = 0.012, AOR = 2.04; 95% CI, 1.13-3.67; p = 0.018, respectively). Children of families with a positive history for diabetes were less likely to present with DKA and get admitted to the PICU during the COVID-19 pandemic (AOR = 0.38; 95% CI, 0.20-0.74; p = 0.004, AOR = 0.22; 95% CI, 0.08-0.61; p = 0.004, respectively).
Conclusion: High rates of DKA at presentation and admission to PICU in incident T1D cases during the COVID-19 pandemic warrant further studies and effective mitigation efforts through increasing awareness, early detection, and timely intervention.
(© 2021 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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