The Challenges of Managing Pediatric Diabetes and Other Endocrine Disorders During the COVID-19 Pandemic: Results From an International Cross-Sectional Electronic Survey

• Published in: Frontiers in endocrinology (Lausanne) Vol. 12; p. 735554
• Main Authors: Elbarbary, Nancy Samir, Dos Santos, Tiago Jeronimo, de Beaufort, Carine, Wiltshire, Esko, Pulungan, Aman, Scaramuzza, Andrea Enzo
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 05-11-2021
• Subjects: adrenal; Child; Child, Preschool; children; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; Cross-Sectional Studies; diabetes; Diabetes Mellitus - epidemiology; Diabetes Mellitus - therapy; Disease Management; Endocrine System Diseases - epidemiology; Endocrine System Diseases - therapy; Endocrinology; Equipment and Supplies, Hospital - trends; Female; Health Personnel - trends; Humans; Internationality; Male; obesity and metabolic syndrome; Online Systems; Surveys and Questionnaires; thyroid; COVID-19; adrenal; thyroid; children; growth; puberty; obesity and metabolic syndrome; diabetes
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2021.735554

Frequency, dimensions, management, and outcomes of the COVID-19 pandemic in children with endocrine disorders and diabetes were assessed.
A cross-sectional electronic survey was distributed to the global network of endocrine societies. Respondents' professional and practice profiles, clinic sizes, their country of practice, and the impact of COVID-19 on endocrine diseases were investigated.
Respondents from 131 pediatric endocrine centers in 51 countries across all continents completed the survey. Routine check-ups and education were altered in most pediatric endocrine clinics. Over 20% of clinics experienced a shortage of critical medications or essential supplies. ICU treatment was required for patients with diabetes and COVID-19 in 21.2% of centers. In diabetes, 44% of respondents reported increased diabetic ketoacidosis episodes in newly diagnosed cases and 30% in established cases. Biopsychosocial and behavioral changes were explicitly reported to be occurring among pediatric patients with endocrine disorders.
This large global survey conducted during the COVID-19 pandemic highlights that diabetes is more challenging to manage than any other pediatric endocrine disorder, with an increased risk of morbidity. Psychological distress due to COVID-19 needs to be recognized and addressed. The importance of close contact with healthcare professionals should be emphasized, and medical supplies should be readily available to all patients.