Bilge Koca Serkan, Zahit Takcı Mehmet, Deniz Recep, Özcan Serhan, Çeleğen Mehmet, Dursun Adem
Division of Pediatric Endocrinology, Department of Pediatrics, Health Sciences University, Kayseri City Hospital, Kayseri, Turkey.
Department of Pediatrics, Health Sciences University, Kayseri City Hospital, Kayseri, Turkey.
Turk Arch Pediatr. 2024 Mar;59(2):163-169. doi: 10.5152/TurkArchPediatr.2024.23255.
The number of admissions for severe diabetic ketoacidosis (DKA) in children with newly diagnosed type 1 diabetes (T1D) increased during the coronavirus disease 2019 pandemic. We aimed to investigate whether there has been a change in this situation in recent years.
All children with T1D who were diagnosed in our tertiary hospital between 2019 and 2023 were included. Plasma insulin, C-peptide, hemoglobin A1c (HbA1c), and antibodies against thyroid peroxidase, thyroglobulin, insulin, islet cell, glutamic acid decarboxylase, tissue transglutaminase IgA, and endomysium IgA were measured.
The frequency of moderate-severe acidosis at admission, which increased after pandemic period compared to the pre-pandemic period, returns to its previous levels over time but still shows a statistical difference compared to the pre-pandemic period (P = .012). Age, blood gas pH and HCO3 level, C-peptide, HbA1c, and length of stay of children at the time of admission were compared year by year (years 2019-2023). No statistical differences were observed (P = .509, P = .181, P = .069, P = .469, P = .346, P = .946), respectively. A significant difference was observed in venous glucose (P .001) and insulin (P = .001) according to years. Also, no significant difference was found about the degree of acidosis according to age (P = .334).
Although the frequency of DKA in children with newly-diagnosed T1D increased in the first years of the pandemic, it has been decreasing over t.
在2019年冠状病毒病大流行期间,新诊断为1型糖尿病(T1D)的儿童中重度糖尿病酮症酸中毒(DKA)的入院人数有所增加。我们旨在调查近年来这种情况是否发生了变化。
纳入2019年至2023年在我们三级医院诊断为T1D的所有儿童。检测血浆胰岛素、C肽、糖化血红蛋白(HbA1c)以及抗甲状腺过氧化物酶、甲状腺球蛋白、胰岛素、胰岛细胞、谷氨酸脱羧酶、组织转谷氨酰胺酶IgA和肌内膜IgA抗体。
入院时中度至重度酸中毒的发生率在大流行期后较流行前有所增加,随时间推移恢复到先前水平,但与流行前相比仍有统计学差异(P = 0.012)。逐年比较了儿童入院时的年龄、血气pH值和HCO3水平、C肽、HbA1c以及住院时间(2019 - 2023年)。未观察到统计学差异(分别为P = 0.509、P = 0.181、P = 0.069、P = 0.469、P = 0.346、P = 0.946)。根据年份,静脉血糖(P < 0.001)和胰岛素(P = 0.001)存在显著差异。此外,根据年龄,酸中毒程度未发现显著差异(P = 0.334)。
尽管新诊断为T1D的儿童中DKA的发生率在大流行的头几年有所增加,但随后一直在下降。