Division of Pediatric Endocrinology, Cukurova University Faculty of Medicine, Adana, Turkey.
J Pediatr Endocrinol Metab. 2021 Jul 22;34(10):1303-1309. doi: 10.1515/jpem-2021-0287. Print 2021 Oct 26.
The COVID-19 pandemic is a global health problem with high morbidity and mortality. This study aimed to investigate patients who were diagnosed with type 1 diabetes during the pandemic and evaluate the effect of the pandemic on the clinical findings of these patients by comparing them with findings from a year prior.
Patients diagnosed with type 1 diabetes mellitus between 2019 and 2021 were separated into two groups: Patients diagnosed prepandemic and those diagnosed during the pandemic.
The number of newly diagnosed diabetes cases increased from 46 in the prepandemic period to 74 in the pandemic period. The number of cases diagnosed with diabetic ketoacidosis (DKA) in the clinic increased from 58.7 to 91.9%. We found that moderate and severe DKA rates from 18.5 and 14.8% to 23.5 and 22.1%, respectively. Besides, the average HbA1c was higher, while the average bicarbonate was lower in cases diagnosed during the pandemic period compared to the prepandemic period (p=0.048 and p<0.001, respectively). We found that celiac autoantibody positivity antibodies to glutamic acid decarboxylase (anti GAD) positivity, and islet cell antibodies (ICA), ICA and anti GAD positivity coexistence were higher (p=0.045, p=0.008, and p=0.007, respectively) among the patients diagnosed during the pandemic.
We observed an increase in the number of patients newly diagnosed with type 1 diabetes mellitus, an increase in autoantibody positivity, and higher rates and severity of DKA during the COVID-19 pandemic period compared to the prepandemic period.
COVID-19 大流行是一个具有高发病率和死亡率的全球性健康问题。本研究旨在调查大流行期间被诊断为 1 型糖尿病的患者,并通过将其与前一年的发现进行比较,评估大流行对这些患者临床发现的影响。
将 2019 年至 2021 年间被诊断为 1 型糖尿病的患者分为两组:大流行前诊断组和大流行期间诊断组。
新诊断的糖尿病病例数从大流行前的 46 例增加到大流行期间的 74 例。在诊所被诊断为糖尿病酮症酸中毒(DKA)的病例数从 58.7%增加到 91.9%。我们发现,中度和重度 DKA 发生率分别从 18.5%和 14.8%上升到 23.5%和 22.1%。此外,与大流行前相比,大流行期间诊断的病例的平均 HbA1c 更高,而平均碳酸氢盐水平更低(p=0.048 和 p<0.001)。我们发现,在大流行期间诊断的患者中,抗谷氨酸脱羧酶(anti GAD)阳性的麸质敏感性抗体阳性、胰岛细胞抗体(ICA)阳性、ICA 和 anti GAD 阳性共存的比例更高(p=0.045、p=0.008 和 p=0.007)。
与大流行前相比,我们观察到在 COVID-19 大流行期间新诊断的 1 型糖尿病患者数量增加、自身抗体阳性率增加以及 DKA 的发生率和严重程度增加。