The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

• DOI: 10.3389/fendo.2022.878634
• Publication Date: 2022-06-17T05:37:20Z
• Authors: Valentino Cherubini; Monica Marino; Andrea E. Scaramuzza; Valentina Tiberi; Adriana Bobbio; Maurizio Delvecchio; Elvira Piccinno; Federica Ortolani; Stefania Innaurato; Barbara Felappi; Francesco Gallo; Carlo Ripoli; Maria Rossella Ri...; Filomena Pascarella; Filomena A. Stamati; Felice Citriniti; Claudia Arnaldi; Sara Monti; Vanna Graziani; Fiorella De Berar...; Cosimo Giannini; Francesco Chiarelli; Maria Zampolli; Rosaria De Marco; Giulia Patrizia B...; Caterina Grosso; Valeria De Donno; Barbara Piccini; Sonia Toni; Susanna Coccioli; Giuliana Cardinale; Marta Bassi; Nicola Minuto; Giuseppe D’Annunzio; Claudio Maffeis; Marco Marigliano; Angela Zanfardino; Dario Iafusco; Assunta S. Rollato; Alessia Piscopo; Stefano Curto; Fortunato Lombardo; Bruno Bombaci; Silvia Sordelli; Chiara Mameli; Maddalena Macedoni; Andrea Rigamonti; Riccardo Bonfanti; Giulio Frontino; Barbara Predieri; Patrizia Bruzzi; Enza Mozzillo; Francesco Rosanio; Adriana Franzese; Gavina Piredda; Francesca Cardella; Brunella Iovane; Valeria Calcaterra; Maria Giulia Berioli; Anna Lasagni; Valentina Pampanini; Patrizia Ippolita...; Riccardo Schiaffini; Irene Rutigliano; Gianfranco Meloni; Luisa De Sanctis; Davide Tinti; Michela Trada; Lucia Paola Guerr...; Roberto Franceschi; Vittoria Cauvin; Gianluca Tornese; Francesca Franco; Gianluca Musolino; Giulio Maltoni; Valentina Talarico; Antonio Iannilli; Lorenzo Lenzi; Maria Cristina Ma...; Erica Pozzi; Carlo Moretti; Stefano Zucchini; Ivana Rabbone; Rosaria Gesuita
• Keywords: Diabetic ketoacidosis; Pandemic

Aim/Hypothesis To compare the frequency of diabetic ketoacidosis (DKA) at diagnosis type 1 diabetes in Italy during COVID-19 pandemic 2020 with DKA 2017-2019. Methods Forty-seven pediatric centers caring for >90% young people recruited 4,237 newly diagnosed children between 2017 and a longitudinal study. Four subperiods were defined based on government-imposed containment measures COVID-19, frequencies severe compared same periods Results Overall, increased from 35.7% (95%CI, 33.5-36.9) 2017-2019 to 39.6% 36.7-42.4) (p=0.008), while 10.4% 9.4-11.5) 14.2% 12.3-16.4, p<0.001). early period by (p=0.004) 8% (p=0.002), respectively, increase continued throughout 2020. Immigrant background high household income decreased probability presenting (OR: 1.55; 95%CI, 1.24-1.94; p<0.001 OR: 0.60; 95 CI, 0.41-0.88; p=0.010, respectively). Conclusions/Interpretation There was an 2020, no apparent association severity infection or measures. has been silent outbreak pandemic, preventive action is required prevent this phenomenon event further generalized lockdowns future outbreaks.