ECE2021 Audio Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (223 abstracts)
Effect of coronavirus disease on the clinical course of diabeticketoacidosis (DKA) in people with type 1 and type 2 diabetes
Eka Melson 1 , 2 , Punith Kempegowda 2 , 3 , Agnes Johnson 4 , Lucy Wallett 3 , Lucretia Thomas 4 , Dengyi Zhou 4 , Catherine Holmes 3 , Agata Juszczak 3 , Muhammad Karamat 3 , Sandip Ghosh 3 , Wasim Hanif 3 , Parth Narendran 3 , 5 & Srikanth Bellary 3 & 6
1Ninewells Hospital, NHS Tayside, United Kingdom; 2Institute of Metabolism and Systems Research, University of Birmingham, United Kingdom; 3University Hospitals Birmingham NHS Foundation Trust, United Kingdom; 4College of Medical and Dental Sciences, University of Birmingham, United Kingdom; 5Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom; 6School of Life and Health Sciences, Aston University, United Kingdom
Introduction
Coronavirus disease (COVID-19) in people with diabetes is associated with a disproportionately worse prognosis. DKA is an acute complication of diabetes with a mortality rate of approximately 0.67%. Little is known about natural history of DKA in the presence of COVID-19 infection. This study aimed to explore the effects of COVID-19 infection on presentation, clinical course and outcome in patients presenting with DKA.
Methods
We undertook a retrospective cohort study of all people admitted with DKA in our institution from 01 March 2020 to 30 May 2020. Based on the SARS-Coronavirus-PCR test results, they were categorised into COVID-positive and COVID-negative groups. A pre-COVID group was established using data from 01 March 2019 to 30 May 2019 as an additional control. DKA was diagnosed as per Joint British Diabetes Society guidelines in the UK. For all patients, we recorded demographic data, diabetes type, various biochemical measurements at the time of admission, time to resolution of acidosis, time to resolution of ketosis, need for admission to ITU, length of stay and final outcome. The data were analysed using GraphPad Prism Version 6.07. One-way ANOVA was used to compare the differences between groups. P-values provided are two-tailed, and value of < 0.05 was considered as statistically significant.
Results
A total of 88 DKA episodes were included in this study. There was no significant difference in the severity or duration of DKA between the three groups (12.5 hours vs 14.9 hours vs 17.9 hours for COVID-positive, COVID-negative and pre-COVID groups respectively; COVID-positive vs. negative, P > 0.99; COVID-positive vs. pre-COVID, P = 0.8772; COVID-negative vs. pre-COVID P > 0.99). COVID-positive T1DM ([60 mmol/l (35.9–60.0)] were more hyperglycaemic on admission compared to COVID-negative ([31.4 mmol/l (28.0–39.1)] and pre-COVID groups ([24 mmol/l (20.2–33.75)]. There was an over representation of T2DM in COVID-positive group with DKA (n = 15/20) than in pre-COVID (n = 8/37) or COVID-negative groups (n = 2/31). Six people with COVID and four people without COVID required intensive care. Five (1/31 COVID-negative and 4/20 COVID-positive) died. In patients with T2DM, all deaths occurred in COVID-positive group.
Conclusion
COVID infection appears to influence the natural history of DKA differently in T1DM and T2DM. Patients with T1DM and COVID-19 presented with more hyperglycaemia. Patients with T2DM were unusually presenting in DKA when infected with COVID with more ITU need and higher mortality rates.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more