329dd460ea2455f7ae20b4da814d4501 pmc_9369057.pdf 81d102335182846431bdd033e014b9793cc5bb43 pmc_9369057.pdf ebe307e40686c8fa0e9ce27b237a74ec9dca9e119316d4111d3de12047711414 pmc_9369057.pdf Title: Increased Presentation of Diabetic Ketoacidosis and Changes in Age and Month of Type 1 Diabetes at Onset during the COVID-19 Pandemic in Spain Subject: 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 Design and Methods: 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. +6pt Keywords: type 1 diabetes; COVID-19; diabetes onset; DKA Author: Isabel Leiva-Gea, Cristina Antúnez Fernández, Roque Cardona-Hernandez, Marta Ferrer Lozano, Pilar Bahíllo-Curieses, Javier Arroyo-Díez, María Clemente León, Maria Martín-Frías, Santiago Conde Barreiro, Andrés Mingorance Delgado and Jacobo Pérez Sánchez Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Jul 29 03:43:20 2022 CEST ModDate: Fri Jul 29 04:38:26 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 7 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1319667 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- EIFDAO+VnURWPalladioL Type 1 Custom yes yes no 10 0 KOLAAE+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 RXLMZT+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 PRJADR+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 IKKWKP+CMSY10 Type 1 Builtin yes yes no 28 0 DGBDNV+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 53 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-09-09 02:41:20 CEST RepresentationInformation: pmc_9369057.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-09-08 02:18:52 CEST Size: 1319667 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 182 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Research Design and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Info: Title: Increased Presentation of Diabetic Ketoacidosis and Changes in Age and Month of Type 1 Diabetes at Onset during the COVID-19 Pandemic in Spain Author: Isabel Leiva-Gea, Cristina Antúnez Fernández, Roque Cardona-Hernandez, Marta Ferrer Lozano, Pilar Bahíllo-Curieses, Javier Arroyo-Díez, María Clemente León, Maria Martín-Frías, Santiago Conde Barreiro, Andrés Mingorance Delgado and Jacobo Pérez Sánchez Subject: 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 Design and Methods: 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. 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