Increase in the Diagnosis and Severity of Presentation of Pediatric Type 1 and Type 2 Diabetes during the COVID-19 Pandemic
| Autor: | Jiaxiang Gai, Randi Streisand, Abby G. Meyers, Brynn E. Marks, Myrto E Flokas, Maureen Monaghan, Aneka Khilnani, Elizabeth Estrada |
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| Rok vydání: | 2021 |
| Předmět: |
Male
2019-20 coronavirus outbreak Pediatrics medicine.medical_specialty Adolescent Databases Factual endocrine system diseases Coronavirus disease 2019 (COVID-19) Endocrinology Diabetes and Metabolism Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) MEDLINE Type 2 diabetes Diabetic Ketoacidosis Endocrinology Pandemic Prevalence medicine Humans Child Pandemics Retrospective Studies business.industry Incidence Patient Acuity COVID-19 nutritional and metabolic diseases Pediatric type 2 diabetes medicine.disease Diabetes Mellitus Type 1 Hyperosmolar diabetic ketoacidosis Diabetes Mellitus Type 2 Child Preschool Pediatric type 1 diabetes Pediatrics Perinatology and Child Health Female Presentation (obstetrics) business Research Article |
| Zdroj: | Hormone Research in Pædiatrics |
| ISSN: | 1663-2826 1663-2818 |
| DOI: | 10.1159/000519797 |
| Popis: | Introduction: The impact of the COVID-19 pandemic on the incidence of pediatric type 1 (T1D) and type 2 diabetes (T2D) and severity of presentation at diagnosis is unclear. Methods: A retrospective comparison of 737 youth diagnosed with T1D and T2D during the initial 12 months of the COVID-19 pandemic and in the preceding 2 years was conducted at a pediatric tertiary care center. Results: Incident cases of T1D rose from 152 to 158 in the 2 years before the pandemic (3.9% increase) to 182 cases during the pandemic (15.2% increase). The prevalence of diabetic ketoacidosis (DKA) at T1D diagnosis increased over 3 years (41.4%, 51.9%, and 57.7%, p = 0.003); severe DKA increased during the pandemic as compared to the 2 years before (16.8% vs. 28%, p = 0.004). Although there was no difference in the mean hemoglobin A1c (HbA1c) between racial and ethnic groups at T1D diagnosis in the 2-years pre-pandemic (p = 0.31), during the pandemic HbA1c at T1D diagnosis was higher in non-Hispanic Black (NHB) youth (11.3 ± 1.4%, non-Hispanic White 10.5 ± 1.6%, Latinx 10.8 ± 1.5%, p = 0.01). Incident cases of T2D decreased from 54 to 50 cases (7.4% decrease) over the 2-years pre-pandemic and increased 182% during the pandemic (n = 141, 1.45 cases/month, p < 0.001). As compared to the 2-years pre-pandemic, cases increased most among NHB youth (56.7% vs. 76.6%, p = 0.001) and males (40.4% vs. 58.9%, p = 0.005). Cases of DKA (5.8% vs. 23.4%, p < 0.001) and hyperosmolar DKA (0 vs. 9.2%, p = 0.001) increased among youth with T2D during the pandemic. Conclusions: During the pandemic, the incidence and severity of presentation of T1D increased modestly, while incident cases of T2D increased 182%, with a nearly 6-fold increase in DKA and nearly a 10% incidence of hyperosmolar DKA. NHB youth were disproportionately impacted, raising concern about worsening of pre-existing health disparities during and after the pandemic. |
| Databáze: | OpenAIRE |
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