Leiva-Gea, IsabelAntunez-Fernandez, CristinaCardona-Hernandez, RoqueFerrer-Lozano, MartaBahillo-Curieses, PilarArroyo-Diez, JavierLeon, Maria ClementeMartin-Frias, MariaConde-Barreiro, SantiagoMingorance-Delgado, AndresPerez-Sanchez, Jacobo2023-05-032023-05-032022-07-26Leiva-Gea I, Fernández CA, Cardona-Hernandez R, Lozano MF, Bahíllo-Curieses P, Arroyo-Díez J, et al. Increased Presentation of Diabetic Ketoacidosis and Changes in Age and Month of Type 1 Diabetes at Onset during the COVID-19 Pandemic in Spain. J Clin Med. 2022 Jul 26;11(15):43382077-0383http://hdl.handle.net/10668/21326Objective: 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.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/COVID-19DKADiabetes onsetType 1 diabetesÁrea de Gestión Sanitaria Campo de Gibraltar OesteDiabetes Mellitus, Type 1Diabetic KetoacidosisPandemicsAge DistributionTertiary Care Centersresearch article35893428open accessDiabetes Mellitus Tipo 1PandemiasEstudio MulticéntricoCetoacidosis DiabéticaInvestigación10.3390/jcm11154338PMC9369057https://www.mdpi.com/2077-0383/11/15/4338/pdf?version=1659062306https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369057/pdf