diabetic ketoacidosis before, during, and after the covid-19 pandemic

Background: diabetic ketoacidosis (dka) can be the initial sign of type 1 diabetes in children upon diagnosis. some studies have examined the impact of the coronavirus disease 2019 (covid-19) pandemic on the incidence and severity of dka in children. the aim of this study was to investigate the status of diabetic ketoacidosis before and during covid-19.methods: this cross-sectional study was conducted at akbar pediatric super-specialty hospital in mashhad and included one year before and one year after the start of the covid-19 pandemic. all children under 18 years old admitted with a diagnosis of dka based on the 2018 international society for pediatric and adolescent diabetes (ispad) protocol were included in the study. a checklist was completed for each patient, and the data was entered into spss software for analysis. a significance level of 0.05 was set for all inferential statistical tests.results: a total of 310 patients were included in the study, of which 176 (56.8%) were male and the rest were female. in 2018, only 33% of new cases were diabetic, while in 2020, this rate had reached 57.2% (p=0.006). 18.4% of patients during the covid-19 era had bicarbonate levels less than 5 upon admission, whereas during the pre-covid era, only 5.3% of patients had bicarbonate levels less than 5. the rate of intensive care unit (icu) admission in 2020 was significantly higher than in 2018 (p=0.003), with 15.9% of patients being admitted to the icu in 2020.conclusion: based on the results of our study, the rate of patients diagnosed with diabetes and diabetic ketoacidosis significantly increased during and after the covid-19 pandemic.