%0 Journal Article
%A Leiva-Gea, Isabel
%A Antunez-Fernandez, Cristina 
%A Cardona-Hernandez, Roque
%A Ferrer-Lozano, Marta 
%A Bahillo-Curieses, Pilar
%A Arroyo-Diez, Javier
%A Leon, Maria Clemente
%A Martin-Frias, Maria
%A Conde-Barreiro, Santiago 
%A Mingorance-Delgado, Andres 
%A Perez-Sanchez, Jacobo 
%T Increased Presentation of Diabetic Ketoacidosis and Changes in Age and Month of Type 1 Diabetes at Onset during the COVID-19 Pandemic in Spain.
%D 2022
%@ 2077-0383
%U http://hdl.handle.net/10668/21326
%X Objective: To assess the impact of the COVID-19 pandemic and lockdown measures on the presenting characteristics (age at diagnosis, severity, monthly distribution) of newly diagnosed type 1 diabetes in Spanish children. Research DesignandMethods: An ambispective observational multicenter study was conducted in nine Spanish tertiary-level hospitals between January 2015 and March 2021. Inclusion criteria: new cases of type 1 diabetes in children (0-14 years) recording age, sex, date of diagnosis, presence of diabetic ketoacidosis (DKA) at onset, and severity of DKA. Data were compared before and during the pandemic. Results: We registered 1444 new cases of type 1 diabetes in children: 1085 in the pre-pandemic period (2015-2019) and 359 during the pandemic (2020-March 2021). There was a significant increase in the group aged ≤4 years in the pandemic period (chi-squared = 10.986, df 2, p = 0.0041). In 2020-2021, cases of DKA increased significantly by 12% (95% CI: 7.2-20.4%), with a higher percentage of moderate and severe DKA, although this increase was not significant. In 2020, there was a sharp decrease in the number of cases in March, with a progressive increase from May through November, higher than in the same months of the period 2015-2019, highlighting the increase in the number of cases in June, September, and November. The first three months of 2021 showed a different trend to that observed both in the years 2015-2019 and in 2020, with a marked increase in the number of cases. Conclusions: A change in monthly distribution was described, with an increase in DKA at onset of type 1 diabetes. No differences were found in severity, although there were differences in the age distribution, with an increase in the number of cases in children under 4 years of age.
%K COVID-19
%K DKA
%K Diabetes onset
%K Type 1 diabetes
%K Área de Gestión Sanitaria Campo de Gibraltar Oeste
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