Journal of Clinical and Translational Endocrinology最新文献

{"title":"Association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital: A retrospective cohort study","authors":"Eddy Lopez-Huamanrayme ,&nbsp;Dioni D. Garate-Chirinos ,&nbsp;Frank Espinoza-Morales ,&nbsp;Sharon Del-Castillo-Ochoa ,&nbsp;Andrés Gomez-Noronha ,&nbsp;Elizabeth Salsavilca-Macavilca ,&nbsp;Alvaro Taype-Rondan ,&nbsp;Francisco J. Pasquel","doi":"10.1016/j.jcte.2021.100265","DOIUrl":"10.1016/j.jcte.2021.100265","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the association between hyperglycemia treatment and mortality in patients with diabetes and COVID-19 in a Peruvian hospital.</p></div><div><h3>Methods</h3><p>A retrospective cohort study was conducted between March and July 2020. Individual-level data were extracted from an implemented virtual platform. We included patients with type 2 diabetes hospitalized with COVID-19. The assessed outcome was in-hospital mortality. The Independent variable of interest was hyperglycemic treatment. We used Poisson regressions with robust variance to obtain crude and adjusted relative risks (RR) and their 95% confidence intervals (95% CI).</p></div><div><h3>Results</h3><p>Out of 1635 patients hospitalized for COVID-19 during the study period, 248 patients with diabetes mellitus were included. The majority were men (66.9%), the median age was 62 years. Ninety-seven patients died in the hospital (39.1%). The median glycemia on admission was 222.5 mg/dL. At 48 h after hospital admission, 125 patients (50.4%) received sliding scale insulin alone (SSI), 46 (18.5%) received a fixed-dose insulin regimen. In the adjusted analysis, the group with SSI at 48 h of hospitalization had higher mortality than those with fixed-dose insulin (adjusted RR: 1.69; 95% CI: 1.01 – 2.83), and those and who continued with SSI in the following days had higher mortality compared to the group that switched to fixed-dose insulin (adjusted RR: 1.64; 95% CI: 1.17 – 2.32).</p></div><div><h3>Conclusion</h3><p>Among assessed patients with diabetes and COVID-19, more than a third died during hospitalization. Early and continuous use of the sliding scale was associated with higher mortality compared to fixed-dose insulin regimens.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/19/main.PMC8455160.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39452765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired glucose tolerance and indeterminate glycemia in cystic fibrosis","authors":"Nader Kasim ,&nbsp;Swapnil Khare ,&nbsp;Zahre Sandouk ,&nbsp;Christine Chan","doi":"10.1016/j.jcte.2021.100275","DOIUrl":"10.1016/j.jcte.2021.100275","url":null,"abstract":"<div><p>Oral glucose tolerance testing (OGTT) is the primary method to screen for and diagnose cystic fibrosis-related diabetes (CFRD). Diagnostic thresholds as currently defined are based on microvascular complications seen in type 2 diabetes. Abnormal glucose tolerance (AGT) refers to OGTT glucose elevations outside the normal range and encompasses both impaired and indeterminate glucose tolerance. Current guidelines define impaired glucose tolerance (IGT) as a 2-hour glucose of 140–199 mg/dL (7.8–11 mmol/L) and indeterminate glucose tolerance (INDET) as any mid-OGTT glucose ≥ 200 mg/dL (11.1 mmol/L) with a normal fasting and 2 h glucose. There is growing evidence that AGT also has associations with CF-centered outcomes including pulmonary decline, hospitalizations, and weight loss. Here we aim to review the historical emergence of glucose tolerance testing, review relevance to risk stratification for CFRD, discuss alternate cutoffs for identifying AGT earlier, and highlight the need for larger, future studies to inform our understanding of the implications of IGT and INDET on CF health.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8626567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39695848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amino acid sequence homology between thyroid autoantigens and central nervous system proteins: Implications for the steroid-responsive encephalopathy associated with autoimmune thyroiditis","authors":"Salvatore Benvenga ,&nbsp;Alessandro Antonelli ,&nbsp;Poupak Fallahi ,&nbsp;Carmen Bonanno ,&nbsp;Carmelo Rodolico ,&nbsp;Fabrizio Guarneri","doi":"10.1016/j.jcte.2021.100274","DOIUrl":"10.1016/j.jcte.2021.100274","url":null,"abstract":"<div><p>A few patients with Hashimoto’s thyroiditis or Graves’ disease develop a multiform syndrome of the central nervous system (CNS) termed Hashimoto’s encephalopathy or steroid-responsive encephalopathy associated with autoimmune thyroid disease (HE/SREAT). They have high levels of thyroid autoantibodies (TgAb, TPOAb and/or TSH-R-Ab) in blood and cerebrospinal fluid. Autoantibodies against alpha-enolase, aldehyde reductase-I (AKRIA) and/or dimethylargininase-I (DDAHI), proteins expressed in the CNS among other tissues, were detected in the blood and, when searched, in the cerebrospinal fluid of HE/SREAT patients. Recently, we reported that alpha-enolase, AKRIA and DDAHI share local sequence homology with each of the three autoantigens (TgAb, TPOAb, TSH-R-Ab), often in epitope-containing segments of the thyroid autoantigens. We hypothesized that there might be additional CNS-expressed proteins homologous to thyroid autoantigens, possibly overlapping known epitopes of the thyroid autoantigens. We used bioinformatic methods to address this hypothesis.</p><p>Six, 27 and 47 of 46,809 CNS-expressed proteins share homology with TSH-R, Tg and TPO, respectively. The homologous regions often contain epitopes, and some match regions of thyroid autoantigens which have homology with alpha-enolase, AKRIA and/or DDAHI. Several of the aforementioned proteins are present in CNS areas that show abnormalities at neuroimaging in HE/SREAT patients. Furthermore, autoantibodies against some of the said six, 27 and 47 proteins were reported to be associated with a number of autoimmune diseases.</p><p>Not only we validated our hypothesis, but we think that such a variety of potential CNS targets for thyroid Ab against epitopes contained in regions that have local homology with CNS proteins may explain the polymorphic phenotypes of HE/SREAT. Only when elevated amounts of these Ab are synthesized and trespass the blood-brain barrier, HE/SREAT appears. This might explain why HE/SREAT is so relatively rare.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39680505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine in cystic fibrosis","authors":"Marisa E. Desimone ,&nbsp;Jordan Sherwood ,&nbsp;Sarah C. Soltman ,&nbsp;Antoinette Moran","doi":"10.1016/j.jcte.2021.100270","DOIUrl":"10.1016/j.jcte.2021.100270","url":null,"abstract":"<div><p>Cystic Fibrosis (CF) requires lifetime multidisciplinary care to manage both pulmonary and extra pulmonary manifestations. The median age of survival for people with CF is rising and the number of adults with CF is expected to increase dramatically over the coming years. People with CF have better outcomes when managed in specialty centers, however access can be limited. Telemedicine and technology-based care solutions may help to overcome barriers to availability and improve access. This review outlines the use of telehealth for CF management. Telehealth has been utilized for CF across a broad variety of indications, even prior to the COVID-19 pandemic, and in general has been well accepted by patients and providers. There are a paucity of data, however, related to health outcomes, and the healthcare utilization specific to CF and its related comorbidities. Future studies are needed to address the questions of health outcomes, cost, burdens of telehealth and barriers to implementation.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/b7/main.PMC8571077.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39866333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic fibrosis related diabetes (CFRD) prognosis","authors":"Zahrae Sandouk ,&nbsp;Farah Khan ,&nbsp;Swapnil Khare ,&nbsp;Antoinette Moran","doi":"10.1016/j.jcte.2021.100278","DOIUrl":"10.1016/j.jcte.2021.100278","url":null,"abstract":"<div><p>Cystic fibrosis related diabetes (CFRD) occurs in at least 40–50% of adults with CF. With other forms of diabetes, microvascular and macrovascular disease are the major causes of morbidity and mortality. Macrovascular disease is rare in CF. While microvascular disease does occur in this population, there are CF-specific diabetes complications that have a more important impact on prognosis. The additional diagnosis of diabetes in CF is associated with decreased lung function, poor nutritional status, and an overall increase in mortality from lung disease. These negative findings start even before the clinical diagnosis of CFRD, during the period when patients experience abnormal glucose tolerance related to insulin insufficiency. The main mechanisms by which CFRD negatively affects prognosis are thought to be a combination of 1) protein catabolism, decreased lean body mass and undernutrition resulting from insulin insufficiency, and 2) an increased pro-inflammatory and pro-infectious state related to intermittent hyperglycemia. With the introduction of CFTR modulators, the care of CF patients has been revolutionized and many aspects of CF health such as BMI and lung function are improving. The impact of these drugs on the adverse prognosis related to the diagnosis of diabetes in CF, as well as the potential to delay or prevent onset of CFRD remain to be determined.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39616407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic fibrosis-related diabetes: The patient perspective","authors":"Kelly A. Mason ,&nbsp;Brynn E. Marks ,&nbsp;Colleen L. Wood ,&nbsp;Trang N. Le","doi":"10.1016/j.jcte.2021.100279","DOIUrl":"10.1016/j.jcte.2021.100279","url":null,"abstract":"<div><p>Cystic fibrosis-related diabetes (CFRD) affects nearly 20% of adolescents and 40–50% of adults. However, the impact on patients and their families is poorly understood. Here, we examine how patients perceive CFRD and identify gaps in our understanding of the patient experience.</p><p>Despite its relatively high prevalence, data suggest that many individuals are not aware of the possibility of developing CFRD or compare it to other types of diabetes. Annual oral glucose tolerance testing (OGTT) may serve as an opportunity to provide education and prepare individuals for the possibility of developing abnormalities in glucose tolerance.</p><p>Many cite lack of awareness of CFRD as the most difficult part of the diagnosis. While factors such as older age and a strong support system promote acceptance, most individuals view the diagnosis negatively and struggle to balance the demands of diabetes with other obligations, including airway clearance, nebulizer therapies, supplementation nutrition, and administration of vitamins and medications. Relatively few people with CFRD monitor their blood glucoses consistently, which is attributed to time constraints or an attempt to avoid pain. In addition, many feel that they are not prone to hypoglycemia and are not concerned with long-term complications, anticipating that they will succumb to their pulmonary disease before these become problematic. The adolescent period presents unique challenges for adherence as children work to develop autonomy.</p><p>Factors that promote CFRD adherence include incorporating management into daily CF routines and the support of knowledgeable providers to help develop an individualized approach to management. Diabetes technology has the potential to reduce treatment burden and improve glycemic control, but data in CFRD are limited, and additional study is needed.</p><p>Given that CFRD is associated with a decline in health-related quality of life, it is critical that providers understand patients’ perspectives and address gaps in understanding and barriers to management.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/12/main.PMC8649788.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39616408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis","authors":"Colleen Wood ,&nbsp;Sana Hasan ,&nbsp;Amy Darukhanavala ,&nbsp;Vin Tangpricha","doi":"10.1016/j.jcte.2021.100273","DOIUrl":"10.1016/j.jcte.2021.100273","url":null,"abstract":"<div><p>Vitamin D deficiency is common in the general population, and even more so in patients with cystic fibrosis. Deficiency is exacerbated in cystic fibrosis patients because of a myriad of causes including malabsorption, decreased fat mass, reduced 25-hydroxylation of vitamin D, reduced exposure to sunlight, decreased vitamin D binding protein, and exposure to drugs that increase catabolism. In turn, vitamin D deficiency can contribute to poor bone health. Additionally, it may contribute to pulmonary decline in the form of worsening pulmonary function, increased colonization with pathogens, and increased pulmonary exacerbation. Because vitamin D deficiency is correlated with negative clinical effects in multiple organ systems of patients with cystic fibrosis, it is important to screen for and treat deficiency in these patients. The Cystic Fibrosis Foundation has issued guidelines for the treatment of vitamin D deficiency, targeting serum levels of 25-hydroxyvitamin D of at least 30 ng/ml. The guidelines offer age-specific escalating dose regimens depending on serum vitamin D levels, with monitoring at 12- week intervals after changing therapy. They address the literature on alternative vitamin D sources, such as UV lamps, ideal formulations (cholecalciferol in preference to ergocalciferol), and optimal vehicles of administration. Despite these detailed recommendations, most centers are still unable to achieve in-target serum vitamin D levels for many of their patients. Future research examining ideal treatment regimens to achieve serum targets and maximize clinical effects are needed. Moreover, it is unknown whether vitamin D sufficiency will be easier to achieve on new triple therapy cystic fibrosis drug combinations, and how these drugs will contribute to vitamin D-related clinical outcomes.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/41/main.PMC8593649.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39653413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gynecologic health care for females with cystic fibrosis","authors":"Andrea H. Roe ,&nbsp;Lina Merjaneh ,&nbsp;Rachael Oxman ,&nbsp;Kara S. Hughan","doi":"10.1016/j.jcte.2021.100277","DOIUrl":"10.1016/j.jcte.2021.100277","url":null,"abstract":"<div><p>As females with cystic fibrosis (CF) increasingly reach their reproductive years, gynecologic issues have become an important area of clinical care and research. First, females with CF may have disease-specific gynecologic problems, including cyclic pulmonary symptoms, vaginal yeast infections, and urinary incontinence. Next, contraceptive methods are thought to be overall safe and effective, however further research is needed to confirm this and to understand the lower rates of uptake among females with CF compared to the general population. Further, females with CF have reduced fertility, although the etiology of this is unknown and under investigation. While assisted reproductive technologies may help achieve pregnancy, decision-making around parenthood remains complex. Finally, while patients and providers agree on the importance of sexual and reproductive health care, females with CF underutilize basic preventive services such as cervical cancer screening, and better approaches are needed to bridge the gap with gynecology. In this review, we discuss the current state of gynecologic care for females with CF, as well as clinical and research opportunities for improvement.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/e5/main.PMC8607192.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9619907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19: Pathophysiology and implications for cystic fibrosis, diabetes and cystic fibrosis-related diabetes","authors":"Kelly Mason ,&nbsp;Sana Hasan ,&nbsp;Amy Darukhanavala ,&nbsp;Katherine Kutney","doi":"10.1016/j.jcte.2021.100268","DOIUrl":"10.1016/j.jcte.2021.100268","url":null,"abstract":"<div><p>The novel SARS-CoV-2 coronavirus (COVID-19) has become a global health crisis since its initial outbreak in Wuhan, China in December 2019. On January 30, 2020, the WHO recognized the COVID-19 outbreak as a Public Health Emergency, and on March 11, 2020, it was declared a pandemic. Although all age groups have been affected, patients with cystic fibrosis (CF) and patients with type 1 or type 2 diabeteshave been categorized as highly vulnerable to SARS-CoV-2 infection. Thus far, studies have found that the incidence of SARS-CoV-2 in the CF population is lower than the general population. We review the underlying protective mechanisms which may reduce inflammation and lung damage in CF patients, thus decreasing their risk of severe COVID-19. While the effect of SARS-CoV-2 in those with <em>diabetes</em> related to CF is unknown, other forms of diabetes have been associated with more severe disease. To further understand the potential impact of SARS-CoV-2 in cystic fibrosis-related diabetes, we provide a comprehensive overview of the potential factors contributing to COVID-19 severity in other forms of diabetes, including direct viral effect on the pancreas and indirect effects related to hyperglycemia and immune dysregulation.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/92/main.PMC8545686.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 infection in hospitalized children with type 1 and type 2 diabetes","authors":"Connie Trieu ,&nbsp;Bhuvana Sunil ,&nbsp;Ambika P. Ashraf ,&nbsp;Joshua Cooper ,&nbsp;April Yarbrough ,&nbsp;Swetha Pinninti ,&nbsp;Suresh Boppana","doi":"10.1016/j.jcte.2021.100271","DOIUrl":"10.1016/j.jcte.2021.100271","url":null,"abstract":"<div><h3>Context</h3><p>While diabetes is a risk factor for severe illness from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in adults, there is conflicting data surrounding the relationship between the virus and diabetic disease process in children.</p></div><div><h3>Objective</h3><p>This case series aims to illustrate an increase in the incidence of types 1 and 2 diabetes mellitus (T1DM, T2DM) between April – November 2020 at a large tertiary care children’s hospital and examine the characteristics and adverse outcomes in these children. In addition, two children with significant complications from coronavirus disease 2019 (COVID-19) and diabetes are highlighted.</p></div><div><h3>Methods</h3><p>Hospitalized children with T1DM or T2DM and SARS-CoV-2 infection were identified, and electronic medical records were reviewed.</p></div><div><h3>Results</h3><p>We observed a 16.3% increased rate of new-onset T1DM and 205.3% increased rate of new-onset insulin-dependent T2DM between April and November 2020 when compared to the same observational time frame in 2019. Among children with new-onset T1DM, 56.9% presented with DKA in 2019 and 47.1% in 2018 compared to 64.3% in 2020, which was higher than the national average. Twenty-eight children were diagnosed with COVID-19 and diabetes during this time. The 2 described cases with significant complications from COVID-19 and DKA required large doses of intravenous insulin over a prolonged duration.</p></div><div><h3>Conclusion</h3><p>This study highlights that the COVID-19 pandemic might have led to an increased rate of new-onset T1DM, T2DM, and DKA in children and adolescents compared to a similar time frame in the prior 2 years. The clinical phenotypes and outcomes in children with diabetes to COVID-19 infection may be distinct and therefore, future pediatric specific studies are needed to define the role of SARS-CoV-2.</p></div>","PeriodicalId":46328,"journal":{"name":"Journal of Clinical and Translational Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/5e/main.PMC8553361.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39585097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}