COVID‐19 outbreak and pediatric diabetes: Perceptions of health care professionals worldwide

• Published in: Pediatric diabetes Vol. 21; no. 7; pp. 1083 - 1092
• Main Authors: Elbarbary, Nancy Samir, Santos, Tiago Jeronimo, Beaufort, Carine, Agwu, Juliana Chizo, Calliari, Luis Eduardo, Scaramuzza, Andrea Enzo
• Format: Journal Article
• Language: English
• Published: Former Munksgaard John Wiley & Sons A/S 01-11-2020; Wiley Subscription Services, Inc
• Subjects: Adolescent; Child; Children; Coronaviruses; COVID-19; Cross-Sectional Studies; Delayed Diagnosis; Delivery of Health Care - trends; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - therapy; Diabetic ketoacidosis; Diagnosis; Health Personnel; Humans; Incidence; Infectious diseases; Ketoacidosis; Medical supplies; Pandemics; Patients; Pediatrics; Practice Patterns, Physicians' - trends; Reviews and Commentaries; Risk factors; Surveys and Questionnaires; Telemedicine; COVID-19; telemedicine; diabetic ketoacidosis; children; diabetes
• ISSN: 1399-543X; 1399-5448
• DOI: 10.1111/pedi.13084

Background
Coronavirus diasease (COVID‐19) is an infectious disease that started in Wuhan, China in late 2019 and later spread around the world. Diabetes has been recognized as a possible risk factor for COVID‐19 complications.
Objective
International Society for Pediatric and Adolescent Diabetes (ISPAD) investigated perceptions, challenges and experience of health care professionals (HCP) taking care of children and young people with diabetes worldwide during COVID‐19 pandemic.
Methods
From 21st April to 17th May 2020, during COVID‐19 pandemic, a web‐based survey was sent to ISPAD members and former participants of ISPAD conferences by email.
Results
Responders from 215 diabetes centers from 75 countries completed the survey. Majority were from UK (35; 16.3%), USA (20; 9.3%), and India (15; 7%). HCP were mostly pediatric endocrinologists (64%). During COVID‐19 pandemic, 16.5% of responders continued face‐to‐face consultation while most changed to telephone (32%) or video (18%) consultations. 19% reported a shortage of medical supplies. 22% reported a delay in diagnosis of patients with new‐onset diabetes, while 15% reported a higher incidence of DKA. 12% reported having one or more patients with COVID‐19. Most of the 86 children and adolescents with diabetes and COVID‐19 had only mild/moderate symptoms, while 5 required admission to an intensive care unit. No deaths were reported.
Conclusions
This large global survey during COVID‐19 pandemic showed that many HCP adapted to the pandemic by resorting to telemedicine. One fourth of HCP reported delays in diagnosis and an increased rate of DKA. The emergence of COVID‐19 pandemic had an important impact on family's behavior that might have led to increase in diabetic ketoacidosis presentation.