tetano
Editor, Senior Moderator
Diabetes Care
. 2022 Aug 9;dc220396.
doi: 10.2337/dc22-0396. Online ahead of print.
COVID-19 Exacerbates Insulin Resistance During Diabetic Ketoacidosis in Pediatric Patients With Type 1 Diabetes
Elizabeth S Keiner[SUP] 1 [/SUP], James C Slaughter[SUP] 2 [/SUP], Karishma A Datye[SUP] 3 [/SUP], Alan D Cherrington[SUP] 4 [/SUP], Daniel J Moore[SUP] 3 [/SUP], Justin M Gregory[SUP] 3 [/SUP]
Affiliations
Abstract
Objective: Although mortality from coronavirus disease 2019 (COVID-19) among youth with type 1 diabetes is rare, severe acute respiratory syndrome coronavirus 2 is associated with increased pediatric hospitalizations for diabetic ketoacidosis (DKA). To clarify whether the relationship between COVID-19 and DKA is coincidental or causal, we compared tissue glucose disposal (TGD) during standardized treatment for DKA between pediatric patients with COVID-19 and those without COVID-19.
Research design and methods: We retrospectively compared TGD during standardized therapy for DKA in all children with preexisting type 1 diabetes with or without COVID-19. Cases were assessed beginning with the first case of COVID-19-positive DKA on 19 June 2020 through 2 February 2022.
Results: We identified 93 COVID-19-negative patients and 15 COVID-19-positive patients who were treated for DKA, with similar baseline characteristics between groups. Median TGD was 46% lower among patients who had COVID-19 compared with those who did not (P = 0.013).
Conclusions: These results suggest that COVID-19 provokes a metabolic derangement over and above factors that typically contribute to pediatric DKA. These findings underscore the significant and direct threat posed by COVID-19 in pediatric type 1 diabetes and emphasize the importance of mitigation and monitoring including through vaccination as a primary prevention.
. 2022 Aug 9;dc220396.
doi: 10.2337/dc22-0396. Online ahead of print.
COVID-19 Exacerbates Insulin Resistance During Diabetic Ketoacidosis in Pediatric Patients With Type 1 Diabetes
Elizabeth S Keiner[SUP] 1 [/SUP], James C Slaughter[SUP] 2 [/SUP], Karishma A Datye[SUP] 3 [/SUP], Alan D Cherrington[SUP] 4 [/SUP], Daniel J Moore[SUP] 3 [/SUP], Justin M Gregory[SUP] 3 [/SUP]
Affiliations
- PMID: 35944264
- DOI: 10.2337/dc22-0396
Abstract
Objective: Although mortality from coronavirus disease 2019 (COVID-19) among youth with type 1 diabetes is rare, severe acute respiratory syndrome coronavirus 2 is associated with increased pediatric hospitalizations for diabetic ketoacidosis (DKA). To clarify whether the relationship between COVID-19 and DKA is coincidental or causal, we compared tissue glucose disposal (TGD) during standardized treatment for DKA between pediatric patients with COVID-19 and those without COVID-19.
Research design and methods: We retrospectively compared TGD during standardized therapy for DKA in all children with preexisting type 1 diabetes with or without COVID-19. Cases were assessed beginning with the first case of COVID-19-positive DKA on 19 June 2020 through 2 February 2022.
Results: We identified 93 COVID-19-negative patients and 15 COVID-19-positive patients who were treated for DKA, with similar baseline characteristics between groups. Median TGD was 46% lower among patients who had COVID-19 compared with those who did not (P = 0.013).
Conclusions: These results suggest that COVID-19 provokes a metabolic derangement over and above factors that typically contribute to pediatric DKA. These findings underscore the significant and direct threat posed by COVID-19 in pediatric type 1 diabetes and emphasize the importance of mitigation and monitoring including through vaccination as a primary prevention.