Study Finds Sharp Increase in Diabetic Ketoacidosis Cases Among Pediatric Patients During COVID-19 Pandemic

A study published in Diabetes Care found that there has been a surge in children with type 2 diabetes presenting with diabetic ketoacidosis (DKA). This data could offer additional insights into how the pandemic may be impacting the nation's children, according to the study authors.

“DKA happens when insulin levels in the blood drop too low for too long,” said Lily Chao, MD, MS, interim medical diabetes director at CHLA, in a press release. “Insulin helps the body utilize glucose. So when there's not enough insulin, the body starts breaking down fat as a source of energy.”

DKA causes dangerously high levels of acids in the blood. Left untreated, this can lead to cerebral edema, coma, or even death. The spike in the number of cases of DKA may be due to fear of exposure to SARS-CoV-2 resulting in fewer families taking children to routine well exams, according to the investigators. Additionally, a decrease in physical activity during lockdown and reduced access to healthy foods could be contributing to the increase in pediatric DKA, and there may also be a biological relationship between exposure to the virus and diabetes.

“There is definitely a link between COVID-19 and diabetes,” said Senta Georgia, PhD, an investigator at The Saban Research Institute of Children's Hospital Los Angeles, in the press release. "We don't know whether SARS-CoV-2 infects insulin-secreting cells in the pancreas. There are some reports of a link between COVID-19 and diabetes in adults, but no pediatric studies have been published to date.”

Translational and clinical studies in the future may help determine whether increased DKA in patients could be caused by infection with SARS-CoV-2. The investigators said they hope that their study results lead in an increase in vigilance, as the data point to an emerging trend toward more severe diabetes complications during the global pandemic.

“It's critical for pediatricians to recognize that when a child presents with symptoms of diabetes, the child needs to be evaluated right away,” Chao said. “The sooner we see these kids, the better chance we have to prevent DKA.”


Spike in severe pediatric type 2 diabetes complication during COVID-19 pandemic [news release]. EurekAlert; April 26, 2021. Accessed April 27, 2021.