The Impact of COVID‐19 Pandemic on Diabetic Children: A Systematic Review on the Current Evidence
Bibliographic record
Abstract
Coronavirus disease 2019 (COVID-19) pandemic is a worldwide public health emergency. Children seem less likely to be infected with COVID-19 and develop milder symptoms than adults if infected. However, there is limited data regarding the impact of COVID-19 pandemic on diabetic children. Objective: This systematic review aims to summarize and compile the available evidence of COVID-19 pandemic on the pediatric diabetic population, including the incidence of newly diagnosed patients, the risk of DKA and disturbed glycemic control, the use of telemedicine, the impact of lockdown on the daily dietary and physical activity routine, and the management of diabetes during the pandemic. Method: We conducted a comprehensive search of literature published in PubMed, Google Scholar, and Cochrane databases for studies published in English language within the last year as of October 1st, 2020 on the impact of COVID-19 pandemic on diabetic children. Results: We included 20 studies (7 incidence studies, 5 cross sectional, 2 observational, 4 case reports and 2 case series) with a total population of 1989 diabetic children and adolescents. The current evidence suggesting increased incidence of newly diagnosed type 1 diabetes (T1DM) during the COVID-19 pandemic is still weak. Several studies identified delayed diagnosis of children and adolescents with new-onset T1DM leading to presentation with severe DKA. Underlying causes contributed to this observation include reduced access to primary care services, limited availability of healthcare providers, and parental fear from infection during the pandemic period. Moreover, the current pandemic affected the availability of Insulin and glucose measuring supplies leading to poor glycemic control and increasing the risk of DKA among diabetic children especially in resource limited countries. Diabetic children and adolescents had shown good coping skills as a considerable number of them maintained their eating habits and regularly practiced physical activity at home during the lockdown period. In addition, the results of studies on the use of telemedicine for diabetic children and adolescents were positive regarding the effectiveness and patient satisfaction. Conclusion: More studies are required to document the association between COVID-19 infection and the development of T1DM, and to evaluate the physical and psychological impact of the current pandemic on diabetic children and adolescents. In preparation for any potential second wave, specific strategies are essential to alleviate the negative impact of the current pandemic on the management of diabetic children. In order to avoid delayed diagnosis of patients with new onset diabetes, countries should reopen the access to essential non-COVID-19 services, and families should be encouraged about timely attendance at the ED for children with symptoms that are not related to COVID-19. Telemedicine is a promising approach for the management of diabetic patients as it provides a safe, fast and effective way of communication between patients and their diabetic teams. Keywords: adolescents; children; COVID-19; diabetes mellitus and DKA; pediatrics; SARSCoV2
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.007 |
| Bibliometrics | 0.009 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".