Has COVID-19 Delayed the Diagnosis and Worsened the Presentation of Type 1 Diabetes in Children?
Author:
Rabbone Ivana1, Schiaffini Riccardo2, Cherubini Valentino3, Maffeis Claudio4ORCID, Scaramuzza Andrea5ORCID, Bertelli Enrica, Ferlito Lucia, Bobbio Adriana, Schieven Eleonardo, Delvecchio Maurizio, Maltoni Giulio, Reinstadler Petra, Felappi Barbara, Gallo Francesco, Ripoli Carlo, Pascarella Filomena, Stamati Filomena A., Lo Presti Donatella, Citriniti Felice, Tumini Stefano, Zampolli Maria, De Marco Rosaria, Cavalli Claudio, De Donno Valeria, Toni Sonia, Coccioli Maria Susanna, d’Annunzio Giuseppe, Valin Paola Sogno, Cirillo Dante, Sordelli Silvia, Lombardo Fortunato, Bonfanti Riccardo, Mameli Chiara, Predieri Barbara, Franzese Adriana, Iafusco Dario, Savastio Silvia, Piredda Gavina, Cardella Francesca, Calcaterra Valeria, Randazzo Emioli, Favia Anna, Suprani Tosca, Lasagni Alessandra, Rapini Novella, Rutigliano Irene, Gaiero Alberto, De Sanctis Luisa, Cauvin Vittoria, Minute Marta, Tornese Gianluca, Franco Francesca, Musolino Gianluca, Marigliano Marco, Innaturato Silvia, Arnaldi Claudia,
Affiliation:
1. Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy 2. Diabetes Unit, Bambino Gesù Children’s Hospital, Rome, Italy 3. Department of Women’s and Children’s Health, G. Salesi Hospital, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy 4. Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University City Hospital of Verona, Verona, Italy 5. Division of Pediatrics, Azienda Socio Sanitaria Territoriale Cremona, Ospedale Maggiore di Cremona, Cremona, Italy
Abstract
OBJECTIVE
To evaluate whether the diagnosis of pediatric type 1 diabetes or its acute complications changed during the early phase of the coronavirus disease 2019 (COVID-19) pandemic in Italy.
RESEARCH DESIGN AND METHODS
This was a cross-sectional, web-based survey of all Italian pediatric diabetes centers to collect diabetes, diabetic ketoacidosis (DKA), and COVID-19 data in patients presenting with new-onset or established type 1 diabetes between 20 February and 14 April in 2019 and 2020.
RESULTS
Fifty-three of 68 centers (77.9%) responded. There was a 23% reduction in new diabetes cases in 2020 compared with 2019. Among those newly diagnosed patients who presented in a state of DKA, the proportion with severe DKA was 44.3% in 2020 vs. 36.1% in 2019 (P = 0.03). There were no differences in acute complications. Eight patients with asymptomatic or mild COVID-19 had laboratory-confirmed severe acute respiratory syndrome coronavirus 2.
CONCLUSIONS
The COVID-19 pandemic might have altered diabetes presentation and DKA severity. Preparing for any “second wave” requires strategies to educate and reassure parents about timely emergency department attendance for non–COVID-19 symptoms.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
194 articles.
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