If children and young people have already developed metabolic imbalances (diabetic ketoacidosis) on the time of diagnosis of type 1 diabetes (T1D), this can lead to complications equivalent to prolonged stays in hospital, poorer long-term control of blood sugar levels, brain edema, and even the next mortality rate.

Throughout the COVID-19 pandemic, diabetes centers internationally observed an increased prevalence of diabetic ketoacidosis in diagnosed cases of T1D. DZD researchers, along with international colleagues, investigated whether the variety of diabetic ketoacidosis cases related to the diagnosis of pediatric T1D increased greater than expected. To realize this, they analyzed the variety of diabetic ketoacidosis cases before and in the course of the pandemic.

The team evaluated data from 13 national diabetes registers (Australia, Austria, Denmark, Germany, Italy, Luxemburg, Latest Zealand, Norway, Sweden, Slovenia Czech Republic, USA [Colorado], and Wales). The study cohort consisted of 104,290 children and young people aged between 6 months and 18 years old who were diagnosed with T1D between 1 January 2006 and 31 December 2021. The observed prevalence of diabetic ketoacidosis during 2020 and 2021 was compared with predictions based on the years before the pandemic (2006–2019).

Between 2006 and 2019, 23,775 of 87,228 children had diabetic ketoacidosis when diagnosed with T1D (27.3%). The mean annual increase within the prevalence of diabetic ketoacidosis for the whole cohort between 2006 and 2019 was 1.6%. Throughout the pandemic, the numbers were significantly above the expected prevalences. In 2020, the adjusted observed prevalence of diabetic ketoacidosis was 39.4% (predicted prevalence 32.5%) and 38.9% in 2021 (predicted prevalence 33.0%).

The increasing prevalence of diabetic ketoacidosis related to the diagnosis of type 1 diabetes in children is a worldwide problem. There was already a rise in prevalence before the COVID-19 pandemic. Throughout the pandemic, this increase was even greater.”

Reinhard W. Holl, Scientist and Professor, Ulm University

The authors of the study indicate that providing a comprehensive explanation of the classic symptoms of T1D in childhood to most of the people, those lively within the childcare or daycare settings, and first care physicians could help raise awareness of the symptoms of T1D. Moreover, public health measures may very well be used, e.g., implementing a general islet-cell autoantibodies screening program for kids to cut back the variety of dangerous metabolic imbalances.

Source:

Deutsches Zentrum fuer Diabetesforschung DZD

Journal reference:

Birkebaek, N. H., et al. (2022) Impact of the COVID-19 pandemic on long-term trends within the prevalence of diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes: a global multicentre study based on data from 13 national diabetes registries. The Lancet Diabetes & Endocrinology. doi.org/10.1016/S2213-8587(22)00246-7.