Agarwal Ashish, Bansal Deepankar, Nallasamy Karthi, Jayashree Muralidharan, William Vijai
Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Division of Pediatric Critical Care, Department of Critical Care, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Pediatric Health Med Ther. 2023 Sep 4;14:281-288. doi: 10.2147/PHMT.S384104. eCollection 2023.
The coronavirus disease (COVID-19) pandemic affected the management and follow-up of several chronic ailments, including pediatric type 1 diabetes mellitus (T1DM). Restricted access to healthcare and fear of contracting the virus during medical facility visits resulted in poor compliance, irregular follow-up visits, treatment, and delayed diagnosis of complications in pediatric diabetes such as diabetic ketoacidosis (DKA). As such, the incidence of complicated DKA in resource-limited settings is high due to delayed presentation, poor compliance with therapy, and associated comorbidities such as malnutrition and sepsis. The pandemic had only added to the woes. The increased surge in DKA, in the face of limited resources, prompted clinicians to find alternative solutions to manage these children effectively. In this narrative review, we discuss the key challenges faced globally while caring for children with T1DM and DKA during the COVID-19 pandemic, and the lessons learned thereof.
冠状病毒病（COVID-19）大流行影响了多种慢性疾病的管理和随访，包括儿童1型糖尿病（T1DM）。获得医疗保健的机会受限以及在医疗机构就诊时感染病毒的恐惧导致依从性差、随访不规律、治疗不及时以及儿童糖尿病并发症（如糖尿病酮症酸中毒（DKA））的诊断延迟。因此，在资源有限的环境中，由于就诊延迟、治疗依从性差以及营养不良和败血症等相关合并症，复杂DKA的发病率很高。大流行只会雪上加霜。面对资源有限的情况，DKA病例的激增促使临床医生寻找替代解决方案，以有效管理这些儿童。在这篇叙述性综述中，我们讨论了在COVID-19大流行期间全球在照顾患有T1DM和DKA的儿童时面临的关键挑战以及从中吸取的教训。
