[Skip to Content]
[Skip to Content Landing]

Ketoacidosis in Children and Adolescents With Newly Diagnosed Type 1 Diabetes During the COVID-19 Pandemic in Germany

Educational Objective
To understand the rate of ketoacidosis in children and adolescents With Newly Diagnosed Type 1 Diabetes During the COVID-19
1 Credit CME

During the coronavirus disease 2019 (COVID-19) pandemic, a significantly lower rate of health care use has been reported, potentially leading to delayed medical care.1 Diabetic ketoacidosis is an acute life-threatening complication of a delayed diagnosis of type 1 diabetes.2 We investigated the frequency of diabetic ketoacidosis in children and adolescents at diagnosis of type 1 diabetes in Germany during the first 2 months of the COVID-19 pandemic.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

Article Information

Corresponding Author: Clemens Kamrath, MD, Center of Child and Adolescent Medicine, Justus Liebig University, Feulgenstr 12, 35385 Giessen, Germany (clemens.kamrath@paediat.med.uni-giessen.de).

Accepted for Publication: July 8, 2020.

Published Online: July 20, 2020. doi:10.1001/jama.2020.13445

Author Contributions: Dr Holl had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Kamrath and Mönkemöller contributed equally to this work.

Concept and design: Kamrath, Mönkemöller, Holl.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Kamrath, Holl.

Critical revision of the manuscript for important intellectual content: Mönkemöller, Biester, Rohrer, Warncke, Hammersen, Holl.

Statistical analysis: Kamrath, Holl.

Supervision: Kamrath, Biester, Warncke, Holl.

Conflict of Interest Disclosures: Dr Mönkemöller reported receiving personal fees from Medtronic outside the submitted work. Dr Biester reported receiving personal fees from Medtronic, Sanofi, Ypsomed, Novo Nordisk, AstraZeneca, DexCom, and Roche outside the submitted work. No other disclosures were reported.

Funding/Support: The German Diabetes Prospective Follow-up Registry (DPV) is supported through the German Federal Ministry for Education and Research within the German Center for Diabetes Research (DZD, grant 82DZD14A02). Further financial support was received by the German Robert Koch Institute (RKI, diabetes surveillance) and the German Diabetes Association (DDG).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Katharina Fink (Institute of Epidemiology and Medical Biometry [ZIBMT], Ulm University, Ulm, Germany), Klemens Raile, MD, PhD (Department of Pediatric Endocrinology and Diabetology, Charité, University Medicine Berlin, Germany), and Angeliki Pappa, MD (Department of Pediatrics, University Hospital RWTH Aachen, Aachen, Germany), for their contribution to this work for methodology (Ms Fink), data analysis (Ms Fink), data collection (Drs Raile and Pappa), scientific discussion of the results (Ms Fink and Drs Raile and Pappa), and editing of the manuscript (Ms Fink and Drs Raile and Pappa). Andreas Hungele and Ramona Ranz developed the DPV software, Esther Bollow aggregated the DPV data, and Alexander Eckert, MSc, helped with the analysis (all clinical data managers, Ulm University). We thank Marianne Rohrer (Homburg) for language editing. None of the persons named received compensation for their contributions. We thank all centers participating in the DPV initiative (a list is available at www.d-p-v.eu).

References
1.
Baum  A , Schwartz  MD .  Admissions to Veterans Affairs hospitals for emergency conditions during the COVID-19 pandemic.   JAMA. 2020;324(1):96-99. doi:10.1001/jama.2020.9972PubMedGoogle ScholarCrossref
2.
Cherubini  V , Grimsmann  JM , Åkesson  K ,  et al.  Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents.   Diabetologia. 2020;63(8):1530-1541. doi:10.1007/s00125-020-05152-1PubMedGoogle ScholarCrossref
3.
Karges  B , Schwandt  A , Heidtmann  B ,  et al.  Association of insulin pump therapy vs insulin injection therapy with severe hypoglycemia, ketoacidosis, and glycemic control among children, adolescents, and young adults with type 1 diabetes.   JAMA. 2017;318(14):1358-1366. doi:10.1001/jama.2017.13994PubMedGoogle ScholarCrossref
4.
Lazzerini  M , Barbi  E , Apicella  A , Marchetti  F , Cardinale  F , Trobia  G .  Delayed access or provision of care in Italy resulting from fear of COVID-19.   Lancet Child Adolesc Health. 2020;4(5):e10-e11. doi:10.1016/S2352-4642(20)30108-5PubMedGoogle ScholarCrossref
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_LoginSubscribe_Purchase
Close
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_LoginSubscribe_Purchase
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
jn-learning_Modal_SaveSearch_NoAccess_Purchase
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close