Table 1 Studies on Changes in the Incidence of New-Onset Diabetes and Diabetic ketoacidosis (DKA) in Children during the Pandemic. (PICU, Pediatric Intensive Care Unit; T1D, type 1 diabetes; NR, not reported)
From: Covid 19 and diabetes in children: advances and strategies
General characteristics of epidemiological studies during the pandemic vs. before | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
Study | Design | Country | Age | Gender, (M) | Data collection period during the pandemic | T1D diagnosis criteria | DKA diagnosis | Â | Outcome | Â |
Group | before | after | ||||||||
Ivana Rabbone(17) | Cross-sectional | Italian | 0– 14 | NR | 20 February 2020-14 April 2020 | Autoantibody positivity | International Society for Pediatric and Adolescent Diabetes criteria | Diabetes | 208 | 160 |
DKA | 86 | 61 | ||||||||
Severe DKA | 31 | 27 | ||||||||
Clemens Kamrath(3) | Cross-sectional | Germany | 9.9 (5.8–12.9) | 327 (61.5) | 13 March 2020-13 May 2020 | NR | DKA: pH level less than 7.3 and/or bicarbonate level less than 15 mmol/L severe: a pH level less than 7.1 and/or bicar- bonate level less than 5 mmol/L | DKA | 24.50% | 44.70% |
Severe DKA | 13.90% | 19.40% | ||||||||
Heli Salmi(61) | Retrospective cohort study | Finland | 10.0 (8.1–12.3) | 11 (55) | 1 April 2020–31 October 2020 | NR | Blood pH < 7.10 | PICU-DKA | 6.25 | 20 |
PICU-Severe DKA | 19 | 15 | ||||||||
Cohort-DKA | 57.75 | 84 | ||||||||
Cohort-Severe DKA | 20 | 13 | ||||||||
Josephine Ho(7) | Retrospective chart review | Alberta, Canada | less than 18 years | 46 (43) | 17 March 17 2020-31 August 2020 | 2018 Diabetes Canada Clinical Practice Guidelines | Hyperglycemia (blood glucose > 11 mmol/L) and blood pH < 7.3 or bicarbonate < 15 mmol/L and ketonemia or ketonuria (based on beta-hydroxybutyrate level or pres- ence of urinary/serum ketones) | Diabetes | 114 | 107 |
DKA | 52 | 73 | ||||||||
Sinéad M. McGlacken-Byrne(89) | Cross-sectional study | North Central London | 10.6 (range 3.2–16.3) | 9 (52.9) | 23 March 2020 − 30 June 2020 | NR | A pH level less than 7.3 and severe DKA as a pH level less than 7.1 | No DKA | 21 | 4 |
Mild DKA | 4 | 1 | ||||||||
Moderate DKA | 2 | 4 | ||||||||
Severe DKA | 3 | 8 | ||||||||
Niels H Birkebaek(6) | International multicentre study | International | 9·9 (6·1–12·8) | 4521 (55.1%) | 2020 | NR | International Society for Pediatric and Adolescent Diabetes (ISPAD) criteria | DKA | 27.30% | 36.60% |
Shira Goldman(90) | Population-based study | Israeli | 9.9 7.5,13.2)0.2] | 87 (59.6) | 15 March 2020-30 June 2020 | ISPAD | pH level less than 7.3 or a bicarbonate level less than 15 nmol/L | Diabetes | 113 | 146 |
Mild DKA | 17 | 27 | ||||||||
Moderate DKA | 12 | 29 | ||||||||
Severe DKA | 15 | 29 | ||||||||
Arzu Jalilova(91) | Cross-sectional study | Turkey | 9.4 (0.8–18) | 105 boys (52.7%) | March 2020-March 2021 | ISPAD | ISPAD criteria | DKA | 55.30% | 58.30% |
Severe DKA | 24.20% | 30.40% | ||||||||
Mikael Knip(16) | Observational cohort study | Finland | 8·41 (3.75) | 458 (58·3%; 54·9 to 64·7%) | 1 March 1 2020-31 Aug 2021 | American Diabetes Association (ADA) criteria | NR | DKA | 22.60% | 30.80% |
Severe DKA | 5.90% | 8.80% | ||||||||
C. Baechle(8) | Cross-sectional study | Germany | 9.8 (6.0–12.9) | 55.90% | 2020 | NR | DKA was defined as pH-value < 7.3 and/or bicarbonate level < 15 mmol/l Severe DKA (sDKA) as pH-value < 7.1 and/or serum bicarbonate level < 5 mmol/l | Diabetes | 19.80% | 24.90% |
DKA | 4.10% | 8.30% | ||||||||
Severe DKA | 1.40% | 3.00% | ||||||||