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  • Birkebaek, Niels H.Aarhus Univ Hosp, Denmark; Aarhus Univ Hosp, Denmark (författare)

Impact of the COVID-19 pandemic on long-term trends in the prevalence of diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes: an international multicentre study based on data from 13 national diabetes registries

  • Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

  • ELSEVIER SCIENCE INC,2022
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:liu-190348
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-190348URI
  • https://doi.org/10.1016/S2213-8587(22)00246-7DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

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  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Funding Agencies|German Federal Ministry for Education and Research; German Robert Koch Institute; German Diabetes Association; German Diabetes Foundation; Slovenian Research Agency; Welsh Government; Central Denmark Region; Swedish Association of Local Authorities and Regions; [82DZD14E03]; [FP-0446-2022]; [J3-6798]; [V3-1505]; [P3-0343]
  • Background An increased prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in children was observed in various diabetes centres worldwide during the COVID-19 pandemic. We aimed to evaluate trends in the prevalence of diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes before and during the COVID-19 pandemic, and to identify potential predictors of changes in diabetic ketoacidosis prevalence during the pandemic.Methods For this international multicentre study, we used data from 13 national diabetes registries (Australia, Austria, Czechia, Denmark, Germany, Italy, Luxembourg, New Zealand, Norway, Slovenia, Sweden, USA [Colorado], and Wales). The study population comprised 104 290 children and adolescents aged 6 months to younger than 18 years, who were diagnosed with type 1 diabetes between Jan 1, 2006, and Dec 31, 2021. The observed diabetic ketoacidosis prevalence in 2020 and 2021 was compared to predictions based on trends over the pre-pandemic years 2006-19. Associations between changes in diabetic ketoacidosis prevalence and the severity of the COVID-19 pandemic and containment measures were examined with excess all-cause mortality in the whole population and the Stringency Index from the Oxford COVID-19 Government Response Tracker.Findings 87 228 children and adolescents were diagnosed with type 1 diabetes between 2006 and 2019, 8209 were diagnosed in 2020, and 8853 were diagnosed in 2021. From 2006 to 2019, diabetic ketoacidosis at diagnosis of type 1 diabetes was present in 23 775 (27middot3%) of 87 228 individuals and the mean annual increase in the prevalence of diabetic ketoacidosis in the total cohort from 2006 to 2019 was 1middot6% (95% CI 1middot3 to 1middot9). The adjusted observed prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes was 39middot4% (95% CI 34middot0 to 45middot6) in 2020 and 38middot9% (33middot6 to 45middot0) in 2021, significantly higher than the predicted prevalence of 32middot5% (27middot8 to 37middot9) for 2020 and 33middot0% (28middot3 to 38middot5) for 2021 (p<0middot0001 for both years). The prevalence of diabetic ketoacidosis was associated with the pandemic containment measures, with an estimated risk ratio of 1middot037 (95% CI 1middot024 to 1middot051; p<0middot0001) per ten-unit increase in the Stringency Index for 2020 and 1middot028 (1middot009 to 1middot047; p=0middot0033) for 2021, but was not significantly associated with excess all-cause mortality.Interpretation During the COVID-19 pandemic, there was a marked exacerbation of the pre-existing increase in diabetic ketoacidosis prevalence at diagnosis of type 1 diabetes in children. This finding highlights the need for early and timely diagnosis of type 1 diabetes in children and adolescents.Funding German Federal Ministry for Education and Research, German Robert Koch Institute, German Diabetes Association, German Diabetes Foundation, Slovenian Research Agency, Welsh Government, Central Denmark Region, and Swedish Association of Local Authorities and Regions.Copyright (c) 2022 Elsevier Ltd. All rights reserved.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Kamrath, ClemensJustus Liebig Univ, Germany (författare)
  • Grimsmann, Julia M.Ulm Univ, Germany; German Ctr Diabet Res DZD, Germany (författare)
  • Åkesson, KarinLinköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Cty Hosp Ryhov, Sweden(Swepub:liu)karak14 (författare)
  • Cherubini, ValentinoSalesi Hosp, Italy (författare)
  • Dovc, KlemenUniv Childrens Hosp, Slovenia; Univ Ljubljana, Slovenia (författare)
  • de Beaufort, CarineCtr Hosp Luxembourg, Luxembourg (författare)
  • Alonso, Guy T.Univ Colorado, CO USA (författare)
  • Gregory, John W.Cardiff Univ, Wales (författare)
  • White, MaryRoyal Childrens Hosp, Australia; Royal Childrens Hosp, Australia; Murdoch Childrens Res Inst, Australia; Univ Melbourne, Australia (författare)
  • Skrivarhaug, TorildOslo Univ Hosp, Norway; Univ Oslo, Norway (författare)
  • Sumnik, ZdenekCharles Univ Prague, Czech Republic (författare)
  • Jefferies, CraigStarship Childrens Hlth, New Zealand; Univ Auckland, New Zealand (författare)
  • Hoertenhuber, ThomasKepler Univ Clin, Austria (författare)
  • Haynes, AveniUniv Western Australia, Australia (författare)
  • De Bock, MartinUniv Otago, New Zealand (författare)
  • Svensson, JannetSteno Diabet Ctr Copenhagen, Denmark; Univ Copenhagen, Denmark (författare)
  • Warner, Justin T.Childrens Hosp Wales, Wales (författare)
  • Gani, OsmanOslo Univ Hosp, Norway; Univ Oslo, Norway (författare)
  • Gesuita, RosariaPolytech Univ Marche, Italy (författare)
  • Schiaffini, RiccardoBambino Gesu Pediat Hosp, Italy (författare)
  • Hanas, RagnarNU Hosp Grp, Sweden; Univ Gothenburg, Sweden (författare)
  • Rewers, ArletaUniv Colorado, CO USA (författare)
  • Eckert, Alexander J.Ulm Univ, Germany; German Ctr Diabet Res DZD, Germany (författare)
  • Holl, Reinhard W.Ulm Univ, Germany; German Ctr Diabet Res DZD, Germany (författare)
  • Cinek, OndrejCharles Univ Prague, Czech Republic (författare)
  • Aarhus Univ Hosp, Denmark; Aarhus Univ Hosp, DenmarkJustus Liebig Univ, Germany (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:The Lancet Diabetes and Endocrinology: ELSEVIER SCIENCE INC10:11, s. 786-7942213-85872213-8595

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