Author:
Cherubini Valentino,Marino Monica,Scaramuzza Andrea E.,Tiberi Valentina,Bobbio Adriana,Delvecchio Maurizio,Piccinno Elvira,Ortolani Federica,Innaurato Stefania,Felappi Barbara,Gallo Francesco,Ripoli Carlo,Ricciardi Maria Rossella,Pascarella Filomena,Stamati Filomena A.,Citriniti Felice,Arnaldi Claudia,Monti Sara,Graziani Vanna,De Berardinis Fiorella,Giannini Cosimo,Chiarelli Francesco,Zampolli Maria,De Marco Rosaria,Bracciolini Giulia Patrizia,Grosso Caterina,De Donno Valeria,Piccini Barbara,Toni Sonia,Coccioli Susanna,Cardinale Giuliana,Bassi Marta,Minuto Nicola,D’Annunzio Giuseppe,Maffeis Claudio,Marigliano Marco,Zanfardino Angela,Iafusco Dario,Rollato Assunta S.,Piscopo Alessia,Curto Stefano,Lombardo Fortunato,Bombaci Bruno,Sordelli Silvia,Mameli Chiara,Macedoni Maddalena,Rigamonti Andrea,Bonfanti Riccardo,Frontino Giulio,Predieri Barbara,Bruzzi Patrizia,Mozzillo Enza,Rosanio Francesco,Franzese Adriana,Piredda Gavina,Cardella Francesca,Iovane Brunella,Calcaterra Valeria,Berioli Maria Giulia,Lasagni Anna,Pampanini Valentina,Patera Patrizia Ippolita,Schiaffini Riccardo,Rutigliano Irene,Meloni Gianfranco,De Sanctis Luisa,Tinti Davide,Trada Michela,Guerraggio Lucia Paola,Franceschi Roberto,Cauvin Vittoria,Tornese Gianluca,Franco Francesca,Musolino Gianluca,Maltoni Giulio,Talarico Valentina,Iannilli Antonio,Lenzi Lorenzo,Matteoli Maria Cristina,Pozzi Erica,Moretti Carlo,Zucchini Stefano,Rabbone Ivana,Gesuita Rosaria
Abstract
Aim/HypothesisTo compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019.MethodsForty-seven pediatric diabetes centers caring for >90% of young people with diabetes in Italy recruited 4,237 newly diagnosed children with type 1 diabetes between 2017 and 2020 in a longitudinal study. Four subperiods in 2020 were defined based on government-imposed containment measures for COVID-19, and the frequencies of DKA and severe DKA compared with the same periods in 2017-2019.ResultsOverall, the frequency of DKA increased from 35.7% (95%CI, 33.5-36.9) in 2017-2019 to 39.6% (95%CI, 36.7-42.4) in 2020 (p=0.008), while the frequency of severe DKA increased from 10.4% in 2017-2019 (95%CI, 9.4-11.5) to 14.2% in 2020 (95%CI, 12.3-16.4, p<0.001). DKA and severe DKA increased during the early pandemic period by 10.4% (p=0.004) and 8% (p=0.002), respectively, and the increase continued throughout 2020. Immigrant background increased and high household income decreased the probability of presenting with DKA (OR: 1.55; 95%CI, 1.24-1.94; p<0.001 and OR: 0.60; 95 CI, 0.41-0.88; p=0.010, respectively).Conclusions/InterpretationThere was an increase in the frequency of DKA and severe DKA in children newly diagnosed with type 1 diabetes during the COVID-19 pandemic in 2020, with no apparent association with the severity of COVID-19 infection severity or containment measures. There has been a silent outbreak of DKA in children during the pandemic, and preventive action is required to prevent this phenomenon in the event of further generalized lockdowns or future outbreaks.
Subject
Endocrinology, Diabetes and Metabolism