Diabetic Ketoacidosis Before, During, and After The COVID-19 Pandemic

Ghaemi, Nosrat; Alidadi, Kosar; Bagheri, Sepideh; Pourbadakhshan, Nafiseh; Khadem-Rezaiyan, Majid

doi:10.22038/jpp.2025.90034.5579

Diabetic Ketoacidosis Before, During, and After The COVID-19 Pandemic

Document Type : original article

Authors

Nosrat Ghaemi ¹

Kosar Alidadi ¹

Sepideh Bagheri ¹

Nafiseh Pourbadakhshan ¹

Majid Khadem-Rezaiyan ²

¹ Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

² Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/jpp.2025.90034.5579

Abstract

Background: Diabetic ketoacidosis (DKA) can be the initial sign of type 1 diabetes in children upon diagnosis. Some studies have examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on the incidence and severity of DKA in children. The aim of this study was to investigate the status of diabetic ketoacidosis before and during COVID-19.
Methods: This cross-sectional study was conducted at Akbar Pediatric Super-specialty Hospital in Mashhad and included one year before and one year after the start of the COVID-19 pandemic. All children under 18 years old admitted with a diagnosis of DKA based on the 2018 international society for pediatric and adolescent diabetes (ISPAD) protocol were included in the study. A checklist was completed for each patient, and the data was entered into SPSS software for analysis. A significance level of 0.05 was set for all inferential statistical tests.
Results: A total of 310 patients were included in the study, of which 176 (56.8%) were male and the rest were female. In 2018, only 33% of new cases were diabetic, while in 2020, this rate had reached 57.2% (p=0.006). 18.4% of patients during the COVID-19 era had bicarbonate levels less than 5 upon admission, whereas during the pre-COVID era, only 5.3% of patients had bicarbonate levels less than 5. The rate of Intensive care unit (ICU) admission in 2020 was significantly higher than in 2018 (p=0.003), with 15.9% of patients being admitted to the ICU in 2020.
Conclusion: Based on the results of our study, the rate of patients diagnosed with diabetes and diabetic ketoacidosis significantly increased during and after the COVID-19 pandemic.

Keywords

Children

COVID-19

Diabetes

Diabetic ketoacidosis

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