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2019年冠状病毒病大流行前后土耳其安纳托利亚中部地区新诊断1型糖尿病儿童糖尿病酮症酸中毒发生率的变化:单中心经验

Change in the Frequency of Diabetic Ketoacidosis in Children with Newly Diagnosed Type 1 Diabetes in the Central Anatolia Region of Turkey over the Years Before and After the Coronavirus Disease 2019 Pandemic: A Single-Center Experience.

作者信息

Bilge Koca Serkan, Zahit Takcı Mehmet, Deniz Recep, Özcan Serhan, Çeleğen Mehmet, Dursun Adem

机构信息

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.

出版信息

Turk Arch Pediatr. 2024 Mar;59(2):163-169. doi: 10.5152/TurkArchPediatr.2024.23255.

Abstract

OBJECTIVE

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.

MATERIALS AND METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

材料与方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/129a/11059482/0d776130c15a/tap-59-2-163_f001.jpg

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