How the Pandemic Changed Pediatric Diabetic Ketoacidosis: What a New Study Shows

Diabetic ketoacidosis (DKA) is a serious, life-threatening emergency that can happen when type 1 diabetes is not managed or when someone becomes very ill. Researchers in Chennai, India wanted to understand whether the COVID-19 pandemic changed how severe DKA was in children and what kinds of complications they faced.

The team compared 58 children hospitalized with DKA in 2019 (before the pandemic) with 78 children admitted in 2021 (during the pandemic). They looked at blood sugar levels, kidney function, complications, and how long children stayed in the hospital.

Interestingly, children admitted during the COVID era had lower blood glucose levels at admission than those in 2019. However, their HbA1c—a measure of average blood sugar over the previous three months—was significantly higher during 2021. This suggests their diabetes may have been poorly controlled over weeks and months before they reached crisis point.

The most striking difference was the rate of sepsis, a serious blood infection. During 2021, 35% of children with DKA developed sepsis, compared to just 16% in 2019. Children admitted during the pandemic also had reduced urine output more often, which can signal kidney stress.

While the length of hospital stays and ICU stays were similar in both periods, children admitted during COVID showed higher rates of serious complications. Acute kidney injury, cerebral edema (swelling of the brain), and need for mechanical ventilation were all numerically higher during 2021, though these differences did not reach statistical significance in this study.

The researchers also tested children admitted during 2021 for COVID-19 antibodies to see if prior coronavirus infection affected DKA severity, but the abstract does not detail those findings.

These findings suggest that pandemic-related disruptions to routine care may have affected how well children's type 1 diabetes was managed in the months before they developed DKA. Higher HbA1c levels indicate that blood sugar control had drifted over time, possibly due to limited clinic access, telehealth challenges, or family stress during lockdowns.

The increased rate of sepsis and other complications raises questions about whether children delayed seeking care during the pandemic or whether healthcare systems were stretched during this period. More research is needed to understand the causes and to ensure that children have consistent access to diabetes care, especially during health crises.

Source: Cureus. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.