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World J Diabetes. Mar 15, 2023; 14(3): 198-208
Published online Mar 15, 2023. doi: 10.4239/wjd.v14.i3.198
Multiple influences of the COVID-19 pandemic on children with diabetes: Changes in epidemiology, metabolic control and medical care
Stefano Zucchini, Andrea Scozzarella, Giulio Maltoni
Stefano Zucchini, Andrea Scozzarella, Giulio Maltoni, Department of Pediatric, IRCCS AOU di Bologna, Bologna 40138, Italy
Author contributions: Zucchini S wrote the introduction and the chapters on epidemiology and metabolic control, and reviewed all sections and built the tables; Scozzarella A wrote the chapter on telemedicine; Maltoni G wrote the chapter on DKA.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stefano Zucchini, MD, PhD, Adjunct Associate Professor, Department of Pediatric, IRCCS AOU di Bologna, 9 Via Massarenti, Bologna 40138, Italy. stefano.zucchini@aosp.bo.it
Received: January 4, 2023
Peer-review started: January 4, 2023
First decision: January 20, 2023
Revised: January 28, 2023
Accepted: February 22, 2023
Article in press: February 22, 2023
Published online: March 15, 2023
Processing time: 69 Days and 21.3 Hours
Abstract

The coronavirus disease 2019 (COVID-19) pandemic has heavily affected health worldwide, with the various forms of diabetes in children experiencing changes at various levels, including epidemiology, diabetic ketoacidosis rates and medical care. Type 1 diabetes showed an apparent increase in incidence, possibly owing to a direct damage of the virus to the β-cell. Diabetic ketoacidosis also increased in association with the general fear of referring patients to the hospital. Most children with diabetes (both type 1 and type 2) did not show a worsening in metabolic control during the first lockdown, possibly owing to a more controlled diet by their parents. Glucose sensor and hybrid closed loop pump technology proved to be effective in all patients with type 1 diabetes during the pandemic, especially because the downloading of data allowed for the practice of tele-medicine. Telemedicine has in fact grown around the world and National Health Systems have started to consider it as a routine activity in clinical practice. The present review encompasses all the aspects related to the effects of the pandemic on the different forms of diabetes in children.

Keywords: Diabetes; COVID-19; Children; Diabetic ketoacidosis; Telemedicine

Core Tip: Children with diabetes were significantly affected by the pandemic. There was a significant incidence increase of type-2 diabetes whereas conflicting results were found in type-1 diabetes. Metabolic control was not affected in the two types of the disease, whereas diabetic ketoacidosis incidence increased significantly, Telemedicine was very helpful in the period of social restrictions and significantly developed during the pandemic.