Araştırma Çıktıları
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Item Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey(FRONTIERS MEDIA SA, 2022-01-01) Kiral, Eylem; Kirel, Birgul; Havan, Merve; Keskin, Mehmet; Karaoglan, Murat; Yildirim, Ahmet; Kangin, Murat; Talay, Mehmet Nur; Urun, Tuba; Altug, Umit; Kesici, Selman; Tufan, Erennur; Kacmaz, Ebru; Bozan, Gurkan; Azapagasi, Ebru; Uysal Yazici, Mutlu; Ozturk, Zeynelabidin; Yesilbas, Osman; Karaguzel, Gulay; Kaya, Gulay; Barlas, Ulkem; Duyu, Muhterem; Boyraz, Merve; Sevketoglu, Esra; Akcay, Nihal; Hancili, Suna; Guven, Ayla; Dursun, Oguz; Tekerek, Nazan Ulgen; Ozcifci, Gokcen; Yazici, Pinar; Turanli, Eda; Kendirli, Tanil; Kahveci, Fevzi; Yetimakman, Ayse Filiz; Citak, Agop; Sik, Guntulu; Bingol, Ibrahim; Aygun, Fatih; Durak, Cansu; Yilmaz, Resul; Bugrul, Fuat; Sari, Yusuf; Tekguc, Hakan; Albayrak, Hatice; Yener, Nazik; Agin, Hasan; Soydan, Ekin; Yildizdas, Dincer; Dilek, Semine Ozdemir; Yalindag, Nilufer; Incekoy-Girgin, Feyza; Alacakir, Nuri; Tutunculer, Filiz; Arslanaoglu, Mehmet Ozgur; Aydin, Can; Bilgin, Muzaffer; Simsek, Enver; Dinleyici, Ener CagriIntroductionThere have been some significant changes regarding healthcare utilization during the COVID-19 pandemic. Majority of the reports about the impact of the COVID-19 pandemic on diabetes care are from the first wave of the pandemic. We aim to evaluate the potential effects of the COVID-19 pandemic on the severity of diabetic ketoacidosis (DKA) and new onset Type 1 diabetes presenting with DKA, and also evaluate children with DKA and acute COVID-19 infection. MethodsThis is a retrospective multi-center study among 997 children and adolescents with type 1 diabetes who were admitted with DKA to 27 pediatric intensive care units in Turkey between the first year of pandemic and pre-pandemic year. ResultsThe percentage of children with new-onset Type 1 diabetes presenting with DKA was higher during the COVID-19 pandemic (p < 0.0001). The incidence of severe DKA was also higher during the COVID-19 pandemic (p < 0.0001) and also higher among children with new onset Type 1 diabetes (p < 0.0001). HbA1c levels, duration of insulin infusion, and length of PICU stay were significantly higher/longer during the pandemic period. Eleven patients tested positive for SARS-CoV-2, eight were positive for new onset Type 1 diabetes, and nine tested positive for severe DKA at admission. DiscussionThe frequency of new onset of Type 1 diabetes and severe cases among children with DKA during the first year of the COVID-19 pandemic. Furthermore, the cause of the increased severe presentation might be related to restrictions related to the pandemicItem The Distribution of Different Types of Diabetes in Childhood: A Single Center Experience(GALENOS YAYINCILIK, 2018-01-01) Haliloglu, Belma; Abali, Saygin; Bugrul, Fuat; Celik, Enes; Bas, Serpil; Atay, Zeynep; Guran, Tulay; Turan, Serap; Bereket, AbdullahObjective: Type I diabetes (T1D) is the most common cause of diabetes in childhood but type 2 diabetes (T2D) and maturity onset diabetes of the young (MODY) are emerging as noteworthy causes of diabetes at young ages. The aim is to determine the distribution, trends and clinical features of the different types of diabetes in childhood in one tertiary center. Methods: The records of children and adolescents aged 0-18 years who were diagnosed as ``diabetes/persistent hyperglycemia{''} between January 1999 and December 2016, were reviewed. Clinical and laboratory characteristics of the patients at diagnosis and type of diabetes were recorded. Results: The mean +/- standard deviation age of 835 patients (48.7\% females) at diagnosis was 8.8 +/- 4.4 years. Eighty-four percent of the patients were diagnosed as T1D, 5.7\% as T2D, 5.3\% as clinical MODY and 5\% as being cases of other types of diabetes. The frequency of diabetic ketoacidosis (DKA) and severe DKA in T1D were 48.4\% and 11.6\%, respectively. Fourteen patients (29.2 \%) with T2D presented with ketosis and two of them (4.2 \%) had DKA at diagnosis. Antibody positivity was 83.1 \% in T1D and 14.8\% in T2D. A statistically significant increase in the frequency of T2D has clearly been demonstrated in recent years with a frequency of 1.9\%, 2.4\% and 7.9\% in 1999-2004, 2005-2010 and 2011-2016, respectively (p <0.001). In MODY, genetic analysis was performed in 26 (59\%) patients and NNF1A and GCK gene mutations were detected in 3 (11.5\%) and 14 (53.8\%) patients, respectively. Conclusion: Although the most frequent cause of DM is T1D in childhood, a trend towards increase in the frequency of T2D in recent years is notable in our population.