Impact of COVID-19 on the scientific course of diabetic ketoacidosis (DKA) in individuals with kind 1 and kind 2 diabetes


This article was originally published here

Endocr Connect. 2021 March 1st: EC-20-0567.R2. doi: 10.1530 / EC-20-0567. Online before printing.


OBJECTIVE: COVID-19 in people with diabetes is associated with a disproportionately poor prognosis. DKA is an acute complication of diabetes with a mortality rate of approximately 0.67%. Little is known about the natural history of DKA in the presence of COVID-19. The aim of this study was to investigate the effects of COVID-19 on presentation, clinical course and outcome in patients with DKA.

DESIGN: Retrospective cohort study.

METHODS: All patients treated for DKA between March 1, 2020 and May 30, 2020 were included. Patients were rated COVID positive or COVID negative based on the swab test. A pre-COVID group was established as an external control using data from March 1, 2019 to May 30, 2019. Data was collected on demographics, type of diabetes, pH, bicarbonate, lactate, glucose, DKA duration, complications, and outcome.

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. COVID-positive T1DM was more hyperglycemic at admission than COVID-negative and pre-COVID patients. There was an overrepresentation of T2DM in COVID positive patients with DKA than in pre-COVID or COVID negative groups.

CONCLUSION: COVID-19 appears to affect the natural history of DKA differently in T1DM and T2DM. Patients with T1DM and COVID-19 showed a higher hyperglycaemia (60 mmol / l (35.9-60.0) versus 31.4 mmol / l (28.0-39.1) versus 24 mmol / l (20.2 -33.75)). Patients with T2DM showed up unusually in DKA when infected with COVID-19 with higher ICU needs and higher mortality rates. A collaborative multicenter study is required for more definitive results.

PMID: 33666571 | DOI: 10.1530 / EC-20-0567