Реферат
OBJECTIVES To epidemiologically assess the influence of COVID-19 pandemic on newly diagnosed type 1 diabetes mellitus presenting with diabetic ketoacidosis at the teaching hospital of the university, Eastern province, Saudi Arabia. METHODS We enrolled newly diagnosed type 1 diabetes mellitus cases among pediatric patients attending the emergency department and outpatient clinics during 2019-2021. The participants' data were collected from electronic medical records which included patients' age at diagnosis, sex, nationality, height, weight, year of diagnosis, length of stay, presentation, random blood sugar, blood gas readings, electrolyte panel, and time of resolution of the diabetic ketoacidosis if present. RESULTS 108 patients were included with an average age of 8.87 ± 4.21 years and 53.70% were females. The demographic characteristics of all diabetic pediatric patients prior to COVID-19 and during COVID-19 were studied and the difference was statistically insignificant. Furthermore, initial pH and HCO3 tests were found to be lower in the moderate to severe diabetic ketoacidosis group (7.17 and 11.2, respectively) compared to the mild group (7.27 and 15.50, respectively) and the differences were statically significant (P < 0.001). CONCLUSION Patients newly diagnosed with type 1 diabetes mellitus during the COVID-19 pandemic tended to have a more severe presentation of diabetic ketoacidosis in terms of PH and HCO3.
Реферат
OBJECTIVE: We evaluated glycemic control among T1DM pediatric patients attending the endocrinology pediatrics clinics at King Fahd Hospital of the University (KFHU) prior to and during COVID-19 restraining regulations. In addition, we assessed the trends and variations in the incidence of T1DM during 2017-2021, including the COVID-19 years by identifying newly diagnosed patients presenting to pediatrics emergency department (ED) in KFHU. METHODS: To estimate the effect of COVID-19 on the incidence of T1DM, we identified newly diagnosed cases of T1DM among pediatric patients attending the ED during the years 2017- 2021. The participants' data were collected through electronic medical records. Information collected included patient age, sex, and HbA1c readings. Three HbA1c readings of interest that were defined and collected are pre-COVID reading, in-COVID reading, and post-COVID reading. RESULTS: The difference of female participants' readings was statistically non-significant (Z= -0.416, p = 0.678), with a pre- and post-COVID median of 10.70 (Q1= 9.00, Q3= 12.15), and 10.50 (Q1= 8.80, Q3= 12.35), respectively. In contrast, the difference was statistically significant among male participants (Z= -2.334, p = 0.02), with a pre- and post-COVID median of 10.20 (Q1= 8.70, Q3= 11.80), and 10.65 (Q1= 9.00, Q3= 12.70), respectively. There was a statistically significant increase in HbA1c of persons > 11 years old (Z= -2.471, p= 0.013), with a pre- and post-COVID median of 10.40 (Q1= 9.00, Q3= 12.10), and 10.90 (Q1= 9.00, Q3= 12.60), respectively. Conversely, persons ≤ 11 years old showed no statistically significant change in HbA1c (Z= -.457, p= 0.648), with a pre- and post-COVID median of 10.45 (Q1= 8.70, Q3= 11.85), and 10.20 (Q1= 8.40, Q3= 12.075), respectively. Disregarding any influence of time, the effect of sex showed no statistically significant difference in HbA1c between males and females [F (1,125) = 0.008, p = 0.930]. Meanwhile, the age effect on HbA1c, regardless of time influence, was statistically significant [F (1,125) = 4.993, p = 0.027]. There was no statistically significant interaction between time and sex on HbA1c levels [F (1.74, 217) = 0.096, p = 0.883] and between age and time [F (3.92,289.57) = 1.693, p = 0.190]. CONCLUSIONS: The number of visits to healthcare facilities dropped significantly during the COVID-19 pandemic, but the rate of newly diagnosed T1DM increased. There was a variable effect on HbA1c levels of those patients, which suggests that each demographic group in the population might have been affected differently by the pandemic. Future research should determine factors associated with better glycemic control and measures to sustain these changes the pandemic might have created.