Severity of new-onset type 1 diabetes in children and adolescents during the coronavirus-19 disease pandemic

INTRODUCTION

ß-pancreatic cells are susceptible to SARS-CoV-2 infection and replication; this could lead to infection-related diabetes or precipitate the onset of type 1 diabetes. This study aimed to determine the severity at diagnosis, analyzing clinical and epidemiological features at debut in children under 16 years of age in the context of the SARS-CoV-2 pandemic.

MATERIAL AND METHODS

A retrospective observational multicenter study was carried out in 7 hospitals of the public health network located in the south of our community. The severity at debut is compared with that of the two previous years (2018 and 2019). The level of statistical significance is set at p<0.05.

RESULTS

In 2020, 61 patients debuted at the 7 hospital centres. The mean age was 10.1 years (SD: 2.6), 50.8% older than 10 years. The clinical profile at diagnosis was ketoacidosis in 52.5% compared to 39.5% and 26.5% in the previous two years (p<0.01). The mean pH (7.24 vs 7.30/7.30) and excess of bases (-11.9 vs -7.43/-7.9) was lower than in the previous two years, and the glycated haemoglobin higher (11.9 vs 11/10.6), p<0.05. At least 10% of the patients had a positive history of SARS-CoV-2 infection.

CONCLUSIONS

There has been an increase in the frequency of diabetic ketoacidosis in type 1 diabetes onset during the first year of the COVID-19 pandemic.

Gravedad al comienzo de la diabetes tipo 1 en niños y adolescentes durante la pandemia por la enfermedad por coronavirus-19

Introducción

Las células ß-pancreáticas son susceptibles a la infección y replicación de SARS-CoV-2, lo que podría conducir a una diabetes relacionada con infección o precipitar el comienzo de una diabetes tipo 1. El objetivo de este estudio ha sido determinar la gravedad al diagnóstico, analizando características clínicas y epidemiológicas en el contexto de la pandemia por SARS-CoV-2 en menores de 16 años.

Material y métodos

Se lleva a cabo un estudio multicéntrico observacional retrospectivo en 7 hospitales de la red pública de sanidad ubicados en el sur de nuestra comunidad. Se compara la gravedad al comienzo con la de los 2 años previos (2018 y 2019). Se fija el nivel de significación estadística en una p < 0,05.

Resultados

En 2020 comenzaron con diabetes 61 pacientes en los 7 centros hospitalarios. La edad media fue 10,1 años (DE: 2,6), un 50,8% mayores de 10 años. La forma clínica del comienzo fue cetoacidosis en el 52,5% frente al 39,5% y 26,5% en los 2 años previos (p < 0,01). El pH medio (7,24 vs. 7,30/7,30) y exceso de bases (–11,9 vs. –7,43/–7,9) fue menor que en los 2 años anteriores y la hemoglobina glicada mayor (11,9 vs. 11/10.6), p < 0.05. Al menos el 10% de los pacientes tenía antecedentes positivos de infección por SARS-CoV-2.

Conclusiones

Durante el primer año de pandemia por la COVID-19 ha habido un aumento en la frecuencia de cetoacidosis diabética como forma de comienzo.

Body Composition as a Mediator between Cardiorespiratory Fitness and Bone Mass during Growth

INTRODUCTION AND PURPOSE

To examine the effect of cardiorespiratory fitness (CRF) and muscle power output (MPO) on bone mass of prepubertal and pubertal children using lean mass (LM) and percentage of fat mass (%FM) as mediator variables. The hypothesis was that both LM and %FM would be independent mediators of the relationships during the sexual maturation period.

METHODS

We analyzed 200 children (88 boys and 112 girls [11.5 ± 2.0 yr]). Body composition was analyzed by bone densitometry, and indirect calorimetry and cycle ergometer were used to calculate V˙O2peak (mL·kg·min) and MPO (W) during an incremental exercise test. Sample was divided by pubertal status.

RESULTS

In the prepubertal group, LM and %FM acted independently as mediators in the relationship between bone mass and CRF or MPO (22%-25% for LM and 37%-50% for %FM, respectively). In pubertal children, LM acted as mediator at 37%.

CONCLUSIONS

Although the independent mediator role of LM and %FM in the associations between CRF or MPO and bone mass was present during the prepubertal stage, only LM remain its mediator role in these associations during the postpubertal period. Therefore, with growth and sexual maturation, the full effect of LM seems to increase, whereas the influence of %FM seems to disappear.