Pediatric Diabetes and Diabetic Ketoacidosis After COVID-19: Challenges Faced and Lessons Learnt.

IF 1.7 Q2 PEDIATRICS Pediatric health, medicine and therapeutics Pub Date : 2023-01-01 DOI:10.2147/PHMT.S384104
Ashish Agarwal, Deepankar Bansal, Karthi Nallasamy, Muralidharan Jayashree, Vijai William
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Abstract

The coronavirus disease (COVID-19) pandemic affected the management and follow-up of several chronic ailments, including pediatric type 1 diabetes mellitus (T1DM). Restricted access to healthcare and fear of contracting the virus during medical facility visits resulted in poor compliance, irregular follow-up visits, treatment, and delayed diagnosis of complications in pediatric diabetes such as diabetic ketoacidosis (DKA). As such, the incidence of complicated DKA in resource-limited settings is high due to delayed presentation, poor compliance with therapy, and associated comorbidities such as malnutrition and sepsis. The pandemic had only added to the woes. The increased surge in DKA, in the face of limited resources, prompted clinicians to find alternative solutions to manage these children effectively. In this narrative review, we discuss the key challenges faced globally while caring for children with T1DM and DKA during the COVID-19 pandemic, and the lessons learned thereof.

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COVID-19后儿童糖尿病和糖尿病酮症酸中毒:面临的挑战和经验教训。
冠状病毒病(COVID-19)大流行影响了包括儿童1型糖尿病(T1DM)在内的几种慢性疾病的管理和随访。获得医疗保健的机会有限,以及在就诊时担心感染病毒,导致儿童糖尿病患者不遵守规定、不定期随访、治疗以及糖尿病酮症酸中毒(DKA)等并发症诊断延迟。因此,在资源有限的情况下,由于延迟出现、治疗依从性差以及营养不良和败血症等相关合并症,复杂性DKA的发病率很高。大流行只是雪上加霜。面对有限的资源,DKA的激增促使临床医生寻找其他解决方案来有效地管理这些儿童。在这篇叙述性综述中,我们讨论了2019冠状病毒病大流行期间全球在照顾T1DM和DKA儿童方面面临的主要挑战,以及从中吸取的经验教训。
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