Severity of new-onset type 1 diabetes in children and adolescents during the coronavirus-19 disease pandemic.

INTRODUCTION: ß-pancreatic cells are susceptible to SARS-CoV-2 infection and replication; this could lead to infection-related diabetes or precipitate the onset of type 1 diabetes. This study aimed to determine the severity at diagnosis, analyzing clinical and epidemiological features at debut in children under 16 years of age in the context of the SARS-CoV-2 pandemic. MATERIAL AND METHODS: A retrospective observational multicenter study was carried out in 7 hospitals of the public health network located in the south of our community. The severity at debut is compared with that of the two previous years (2018 and 2019). The level of statistical significance is set at p<0.05. RESULTS: In 2020, 61 patients debuted at the 7 hospital centres. The mean age was 10.1 years (SD: 2.6), 50.8% older than 10 years. The clinical profile at diagnosis was ketoacidosis in 52.5% compared to 39.5% and 26.5% in the previous two years (p<0.01). The mean pH (7.24 vs 7.30/7.30) and excess of bases (-11.9 vs -7.43/-7.9) was lower than in the previous two years, and the glycated haemoglobin higher (11.9 vs 11/10.6), p<0.05. At least 10% of the patients had a positive history of SARS-CoV-2 infection. CONCLUSIONS: There has been an increase in the frequency of diabetic ketoacidosis in type 1 diabetes onset during the first year of the COVID-19 pandemic.

[Severity of new-onset type 1 diabetes in children and adolescents during the coronavirus-19 disease pandemic]. / Gravedad al comienzo de la diabetes tipo 1 en niños y adolescentes durante la pandemia por la enfermedad por coronavirus-19.

Introduction: ß-pancreatic cells are susceptible to SARS-CoV-2 infection and replication; this could lead to infection-related diabetes or precipitate the onset of type 1 diabetes. This study aimed to determine the severity at diagnosis, analyzing clinical and epidemiological features at onset in children under 16 years of age in the context of the SARS-CoV-2 pandemic. Material and methods: A retrospective observational multicenter study was carried out in 7 hospitals of the public health network located in the south of our community. The severity at debut is compared with that of the two previous years (2018 and 2019). The level of statistical significance is set at P < .05. Results: In 2020, 61 patients were diagnosed at the 7 hospital centres. The mean age was 10.1 years (SD: 2.6), 50.8% were older than 10 years. The clinical profile at diagnosis was ketoacidosis in 52.5% compared to 39.5% and 26.5% in the previous two years (P < .01). The mean pH (7.24 vs 7.30 / 7.30) and excess of bases (-11.9 vs -7.43 / -7.9) was lower than in the previous two years, and the glycated haemoglobin higher (11.9 vs 11 / 10.6)%, p < 0.05. At least 10% of the patients had a positive history of SARS-CoV-2 infection. Conclusions: There has been an increase in the frequency of diabetic ketoacidosis in type 1 diabetes onset during the first year of the COVID-19 pandemic.

Impacto de la educación diabetológica en el control de la diabetes mellitus tipo 1 en la edad pediátrica / Impact of diabetes education on type 1 diabetes mellitus control in children

Introducción: En la diabetes mellitus tipo1 (DM1) la educación diabetológica es fundamental para lograr los objetivos de tratamiento. El objetivo de este estudio es determinar si el nivel de conocimientos diabetológicos de cuidadores/pacientes o los factores sociodemográficos afectan al control glucémico de niños y adolescentes con DM1. Pacientes y métodos: Se analiza el nivel de conocimientos de 105 cuidadores de niños y adolescentes con DM1 o de los pacientes adolescentes mediante una encuesta adaptada a la modalidad de tratamiento (múltiples dosis de insulina [MDI] o bomba de infusión subcutánea continua de insulina [ISCI]). Se considera la HbA1c media en el último año como marcador del control metabólico. Resultados: La media de HbA1c fue similar en ambos grupos de tratamiento (6,6±0,5 para MDI y 6,5±0,5% para ISCI, p=0,63), siendo discretamente más alta en niños mayores de 12años. Los pacientes con bomba tenían un mayor tiempo de evolución de la diabetes y obtuvieron peores resultados porque además la exigencia teórica de la encuesta fue superior por la mayor complejidad de manejo (p=0,005). Los cuidadores con nivel de estudios más bajos obtuvieron peores puntuaciones, si bien las cifras de HbA1c de sus hijos fueron más bajas, en probable relación con una mayor dedicación al cuidado de la enfermedad. Conclusiones: El nivel de conocimientos analizados fue alto, y esto se asoció con un buen control metabólico. Son necesarios estudios que evalúen la influencia de los conocimientos de los cuidadores en pacientes con diferentes grados de control metabólico (AU)

Introduction: Diabetes education is an essential tool to achieve treatment objectives in type1 diabetes mellitus (T1DM). The aim of this study was to determine if understanding of diabetes by caregivers/patients or sociodemographic factors affect blood glucose control in children and adolescents with T1DM. Patients and methods: The level of knowledge of 105 caregivers of children and adolescents with T1DM was assessed using a survey adapted to the type of treatment used (multiple dose insulin [MDI] or continuous subcutaneous insulin infusion [CSII]). Mean HbA1c levels in the previous year was considered as metabolic control marker. Results: Mean HbA1c levels were similar in both treatment groups, with slightly higher values in children over 12years of age. Patients on CSII had a longer time since disease onset and had poorer results, maybe because the items were more difficult due to the higher level of knowledge required for this treatment modality (P=.005). Caregivers with lower educational levels achieved poorer scores in the survey, but mean HbA1c levels of their children were lower, probably because of their greater involvement in disease care. Conclusions: The level of knowledge of caregivers and/or patients with T1DM was high, and this was associated to good metabolic control. Studies to assess the impact of caregiver knowledge on metabolic control of children are needed (AU)

Impact of diabetes education on type 1 diabetes mellitus control in children. / Impacto de la educación diabetológica en el control de la diabetes mellitus tipo 1 en la edad pediátrica.

INTRODUCTION: Diabetes education is an essential tool to achieve treatment objectives in type1 diabetes mellitus (T1DM). The aim of this study was to determine if understanding of diabetes by caregivers/patients or sociodemographic factors affect blood glucose control in children and adolescents with T1DM. PATIENTS AND METHODS: The level of knowledge of 105 caregivers of children and adolescents with T1DM was assessed using a survey adapted to the type of treatment used (multiple dose insulin [MDI] or continuous subcutaneous insulin infusion [CSII]). Mean HbA1c levels in the previous year was considered as metabolic control marker. RESULTS: Mean HbA1c levels were similar in both treatment groups, with slightly higher values in children over 12years of age. Patients on CSII had a longer time since disease onset and had poorer results, maybe because the items were more difficult due to the higher level of knowledge required for this treatment modality (P=.005). Caregivers with lower educational levels achieved poorer scores in the survey, but mean HbA1c levels of their children were lower, probably because of their greater involvement in disease care. CONCLUSIONS: The level of knowledge of caregivers and/or patients with T1DM was high, and this was associated to good metabolic control. Studies to assess the impact of caregiver knowledge on metabolic control of children are needed.