Incidence of COVID-19 and Risk of Diabetic Ketoacidosis in New-Onset Type 1 Diabetes.


Journal

Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422

Informations de publication

Date de publication:
09 2021
Historique:
accepted: 13 05 2021
pubmed: 21 5 2021
medline: 11 9 2021
entrez: 20 5 2021
Statut: ppublish

Résumé

With this study, our aim was to quantify the relative risk (RR) of diabetic ketoacidosis at diagnosis of type 1 diabetes during the year 2020 and to assess whether it was associated with the regional incidence of coronavirus disease 2019 (COVID-19) cases and deaths. Multicenter cohort study based on data from the German Diabetes Prospective Follow-up Registry. The monthly RR for ketoacidosis in 2020 was estimated from observed and expected rates in 3238 children with new-onset type 1 diabetes. Expected rates were derived from data from 2000 to 2019 by using a multivariable logistic trend regression model. The association between the regional incidence of COVID-19 and the rate of ketoacidosis was investigated by applying a log-binomial mixed-effects model to weekly data with Germany divided into 5 regions. The observed versus expected frequency of diabetic ketoacidosis was significantly higher from April to September and in December (mean adjusted RRs, 1.48-1.96). During the first half of 2020, each increase in the regional weekly incidence of COVID-19 by 50 cases or 1 death per 100 000 population was associated with an increase in the RR of diabetic ketoacidosis of 1.40 (95% confidence interval, 1.10-1.77; These findings suggest that the local severity of the pandemic rather than health policy measures appear to be the main reason for the increase in diabetic ketoacidosis and thus the delayed use of health care during the pandemic.

Identifiants

pubmed: 34011636
pii: peds.2021-050856
doi: 10.1542/peds.2021-050856
pii:
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2021 by the American Academy of Pediatrics.

Déclaration de conflit d'intérêts

POTENTIAL CONFLICT OF INTEREST: Prof Raile is an advisory board member of Lilly Diabetes and Abbott Diabetes Care and reports paid talks for Sanofi, Dexcom Continuous Glucose Monitoring, Novo Nordisk, and Springer Healthcare outside the submitted work. Dr Mönkemöller received educational fees from Medtronic outside the submitted work; the other authors have indicated they have no potential conflicts of interest to disclose.

Auteurs

Clemens Kamrath (C)

Division of Pediatric Endocrinology and Diabetology, Centre of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany clemens.kamrath@paediat.med.uni-giessen.de.

Joachim Rosenbauer (J)

Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich Heine University Dusseldorf, Dusseldorf, Germany.
German Centre for Diabetes Research, Munich-Neuherberg, Germany.

Alexander J Eckert (AJ)

German Centre for Diabetes Research, Munich-Neuherberg, Germany.
Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.

Angeliki Pappa (A)

Department of Pediatrics, University Hospital Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen, Germany.

Felix Reschke (F)

Diabetes Centre for Children and Adolescents, Children's Hospital Auf der Bult, Hannover, Germany.

Tilman R Rohrer (TR)

Department of Pediatrics, Saarland University, Homburg, Saarland, Germany.

Kirsten Mönkemöller (K)

Department of Pediatrics, Kinderkrankenhaus Amsterdamer Strasse, Cologne, Germany.

Michael Wurm (M)

Department of Pediatrics, Klinik St. Hedwig, University Hospital Regensburg, Krankenhaus Barmherzige Brüder, Regensburg, Germany.

Kathrin Hake (K)

Department of Pediatrics, Müritz Klinikum, Waren, Germany.

Klemens Raile (K)

Department of Pediatric Endocrinology and Diabetology, Charité, University Medicine Berlin, Germany.

Reinhard W Holl (RW)

German Centre for Diabetes Research, Munich-Neuherberg, Germany.
Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.

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