Increased Risk for Diabetic Ketoacidosis Admissions in Youth with Type 1 Diabetes During the First Wave of COVID-19 in The United States: A 5-Year Analysis.
Sonum Bharill, MD, Scott M Blackman, MD, PhD, Sandra Salsberg, MD, Risa M Wolf, MD.
Background: During COVID-19, an increase in pediatric diabetes diagnoses and incidence of diabetic ketoacidosis (DKA) has been theorized. This study sought to evaluate trends in hospital visits for type 1 diabetes (T1D) and type 2 diabetes (T2D) at a U.S. academic children’s hospital from March to June 2020 compared to 2016-2019, coincident with the first wave of COVID-19. Methods: Diabetes and DKA admissions data from March 11th to June 30th 2020, were compared with the same timeframe in 2016-2019. Results: 313 hospital visits were analyzed, 62 admissions in 2020 compared to 251 admissions from 2016-2019. In 2020, a greater proportion of admissions were due to DKA (56% vs 42%, p=0.04), with a 1.7-fold increased risk of being in DKA compared to prior years (OR= 1.77, 95% CI 1.01-3.11, p= 0.045). A greater proportion of patients with known T1D were admitted in DKA in 2020 (p=0.01), without difference in DKA severity (p=0.2). There was no significant difference in admissions or severity of new-onset T1D, or new or known T2D in 2020. Conclusions: Hospitalizations in known T1D during the first wave of COVID-19 were more likely DKA related, possibly due to delayed care. There was no increase in new onset T1D or T2D during the first wave of COVID-19. Future longitudinal data throughout the pandemic may highlight new trends.
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