Abstract
Background
Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of type 1 diabetes mellitus (T1DM) that has increased during the COVID-19 pandemic. This study will not only shed light on such life-threatening complications but also be a step to increase the awareness of healthcare providers about such complications in the upcoming pandemic waves and increased dependence on telemedicine. Thus, we aimed to further investigate the increase of DKA in pediatrics.
Methods
PubMed, Web of Science, and Scopus were broadly searched for studies assessing the incidence of DKA in pediatrics during the COVID-19 pandemic.
Results
Our study included 24 papers with a total of 124,597 children with diabetes. A statistically significant increase occurred in the risk of DKA among newly diagnosed T1DM patients during the pandemic (RR 1.41; 95% CI 1.19, 1.67; pā<ā0.01; I2ā=ā86%), especially in the severe form of DKA (RR 1.66: 95% CI 1.3, 2.11) when compared to before.
Conclusion
DKA in newly diagnosed children with T1DM has increased during the pandemic and presented with a severe form. This may reflect that COVID-19 may have contributed not only to the development but also the severity of DKA.
Impact
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Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM) that has increased during the COVID-19 pandemic.
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Our study included 25 papers with a total of 124,597 children with diabetes. A statistically significant increase occurred in the risk of DKA among newly diagnosed T1DM patients during the pandemic.
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Our findings reflect that COVID-19 may have an altered presentation in T1DM and can be related to DKA severity.
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Data availability
The data supporting this studyās findings are available from the corresponding author upon reasonable request.
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Acknowledgements
The authors would like to thank Dr. Dina Khaled for her support.
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K.S., A.E., H.H.E.-L., M.A., and A.E. designed the study and analyzed the data. E.M.H., A.M.A., F.-A.A., S.F.T., and A.A.O. drafted the manuscript. All authors were involved in the critical analysis of the final version of the manuscript. All authors approved the manuscript as submitted and agree to be accountable for all aspects of the work.
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Elgenidy, A., Awad, A.K., Saad, K. et al. Incidence of diabetic ketoacidosis during COVID-19 pandemic: a meta-analysis of 124,597 children with diabetes. Pediatr Res 93, 1149ā1160 (2023). https://doi.org/10.1038/s41390-022-02241-2
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DOI: https://doi.org/10.1038/s41390-022-02241-2
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