Severe DKA at type 1 diabetes diagnosis doubles during pandemic
The incidence of severe diabetic ketoacidosis among children presenting with new-onset type 1 diabetes doubled during the COVID-19 pandemic period compared with data from 2019, according to data published in Pediatric Diabetes.
“There was a significant increase in DKA and severe DKA in children presenting with new-onset type 1 diabetes during the COVID-19 pandemic in Alberta, Canada,” Manpreet Doulla, MD, FRCPC, assistant clinical professor of pediatric endocrinology at the University of Alberta, told Healio. “This emphasizes the need for educating health care professionals and families to be aware of the symptoms of hyperglycemia and the importance of early diagnosis and treatment even during public health measures for COVID-19.”
In a retrospective chart review, Doulla and colleagues analyzed data from children presenting with new-onset type 1 diabetes from March to August at two tertiary care pediatric hospitals in Alberta, Canada. Rates of DKA and severe DKA were compared with the same period in 2019.
Researchers found that the number of children presenting with newly diagnosed type 1 diabetes was similar during the pandemic year of 2020 (n = 107) compared with 2019 (n = 114). However, the frequency of DKA at type 1 diabetes onset was higher during the pandemic period (68.2% vs. 45.6%; P < .001). The incidence of severe DKA was also higher in 2020 compared with the pre-pandemic period (27.1% vs. 13.2%; P = .01).
“Our study raises concern about the high rates of DKA at presentation of type 1 diabetes in children, which were further increased during the COVID-19 pandemic,” Doulla said. “Targeted awareness campaigns aimed at patient, family and provider recognition of the symptoms of type 1 diabetes are necessary. Children presenting with new-onset 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. Recognition of these symptoms and timely access to medical care can prevent further metabolic decompensation to DKA, a potentially severe and life-threatening complication of diabetes.”
Doulla said more research is needed regarding the usefulness of targeted awareness campaigns aimed at patient, family and provider recognition of early signs and symptoms of type 1 diabetes, particularly with regard to their scalability, sustainability and impact on presentations of DKA.
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Manpreet Doulla, MD, FRCPC, can be reached at email@example.com.