RESUMEN
AIM: The effect of COVID-19 on the occurrence of type 1 diabetes and ketoacidosis in children and adolescent. METHODS: In this descriptive-analytical cross-sectional study, the records of all children and adolescents hospitalized due to type1 diabetes for two years ago and during the COVID-19 pandemic and its peaks were investigated (January 2018-2022). Also, the desired variables including the frequency of hospitalized patients (known and new cases), the frequency of DKA, the severity of DKA, the duration of discharge from DKA, age, body mass index, duration of hospitalization, clinical symptoms including cerebral edema, laboratory data and the total daily dose insulin required at the time of discharge were compared and statistically analyzed. RESULTS: Out of the 334 hospitalized T1DM patients, the rate of new T1DM patients was significantly higher (P = 0.006) during the pandemic. Clearly, there were more cases of DKA during the pandemic (P = 0.007). The higher severity of DKA (0.026) and the need for higher doses of insulin (P = 0.005) were also observed. The hospitalization rate was higher during the corona peaks, particularly peaks 1 and 4, compared to the non-peak days of COVID-19. CONCLUSION: The increase in the incidence of diabetes (new cases) in the pandemic can suggest the role of the COVID-19 virus as an igniter. Also, as a trigger for the higher incidence of DKA with higher severities, which is probably caused by more damage to the pancreatic beta cells and requires higher doses of insulin.
RESUMEN
Highlights A persistent glycosuria alongside hypoglycemia in pediatric type 1 diabetes mellitus needs further evaluation. Morning hypoglycemia is a limiting side effect of sodium glucose transporter 2 (SGLT2) inhibitors in children younger than 5 years old. SLC5A2 mutation functioning as a SGLT2 inhibitor can result in acceptable range of glycated hemoglobin in younger children and lower required doses of insulin.
Asunto(s)
Diabetes Mellitus Tipo 1 , Hipoglucemiantes , Insulina , Mutación , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Transportador 2 de Sodio-Glucosa , Humanos , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , Inhibidores del Cotransportador de Sodio-Glucosa 2/efectos adversos , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/genética , Transportador 2 de Sodio-Glucosa/genética , Insulina/uso terapéutico , Preescolar , Hipoglucemiantes/uso terapéutico , Masculino , Glucemia/metabolismo , Glucemia/análisis , Glucemia/efectos de los fármacos , Femenino , Hipoglucemia/inducido químicamente , Hipoglucemia/genética , Hemoglobina Glucada/análisis , Hemoglobina Glucada/metabolismo , Quimioterapia CombinadaRESUMEN
Mini puberty is the important period of infancy life that can have a serious impact on sexual development in both sexes. In the infants born very preterm and with extremely low birth weight, mini puberty changes including changes in clinical, hormonal, and imaging data are severe and long lasting, especially in girls. It can be called "exaggerated mini puberty". In this study, a 6-month preterm infant with bronchopulmonary dysplasia presented with periodic vaginal bleeding, Tanner stage 3 breast development, and Tanner stage 2 pubic hair. We did follow up clinical and para-clinical evaluations for the infant during one year and compared the obtained data with those of similar published articles. During one year of monitoring, the case gradually grew to the normal pre-pubertal state, without any hormonal suppressive treatment. Exaggerated mini puberty is a temporary physiologic state in very low birth weight (VLBW) preterm infants that does not require any extra hormonal and surgical interventions.