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Presentation of newly diagnosed type 1 diabetes in children and young people during COVID-19: a national UK survey.

ABSTRACT: In the UK, there have been reports of significant reductions in paediatric emergency attendances and visits to the general practitioners due to COVID-19. A national survey undertaken by the UK Association of Children's Diabetes Clinicians found that the proportion of new-onset type 1 diabetes (T1D) presenting with diabetes ketoacidosis (DKA) during this COVID-19 pandemic was higher than previously reported, and there has been an increase in presentation of severe DKA at diagnosis in children and young people under the age of 18 years. Delayed presentations of T1D have been documented in up 20% of units with reasons for delayed presentation ranging from fear of contracting COVID-19 to an inability to contact or access a medical provider for timely evaluation. Public health awareness and diabetes education should be disseminated to healthcare providers on the timeliness of referrals of children with T1D.

SUBMITTER: Ng SM

PROVIDER: S-EPMC7607512 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Presentation of newly diagnosed type 1 diabetes in children and young people during COVID-19: a national UK survey.

Ng Sze May SM Woodger Katherine K Regan Fiona F Soni Astha A Wright Neil N Agwu Juliana Chizo JC Williams Eleri E Timmis Alison A Kershaw Melanie M Moudiotis Christopher C Drew Josephine J

BMJ paediatrics open 20201102 1

In the UK, there have been reports of significant reductions in paediatric emergency attendances and visits to the general practitioners due to COVID-19. A national survey undertaken by the UK Association of Children's Diabetes Clinicians found that the proportion of new-onset type 1 diabetes (T1D) presenting with diabetes ketoacidosis (DKA) during this COVID-19 pandemic was higher than previously reported, and there has been an increase in presentation of severe DKA at diagnosis in children and ...[more]

PMID: 34192183

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Project description:ObjectivesTo assess the long term clinical and cost effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) intervention compared with usual care in people with newly diagnosed type 2 diabetes.DesignWe undertook a cost-utility analysis that used data from a 12 month, multicentre, cluster randomised controlled trial and, using the Sheffield type 2 diabetes model, modelled long term outcomes in terms of use of therapies, incidence of complications, mortality, and associated effect on costs and health related quality of life. A further cost-utility analysis was also conducted using current "real world" costs of delivering the intervention estimated for a hypothetical primary care trust.SettingPrimary care trusts in the United Kingdom.ParticipantsPatients with newly diagnosed type 2 diabetes.InterventionA six hour structured group education programme delivered in the community by two professional healthcare educators.Main outcome measuresIncremental costs and quality adjusted life years (QALYs) gained.ResultsOn the basis of the data in the trial, the estimated mean incremental lifetime cost per person receiving the DESMOND intervention is pound209 (95% confidence interval - pound704 to pound1137; euro251, -euro844 to euro1363; $326, -$1098 to $1773), the incremental gain in QALYs per person is 0.0392 (-0.0813 to 0.1786), and the mean incremental cost per QALY is pound5387. Using "real world" intervention costs, the lifetime incremental cost of the DESMOND intervention is pound82 (- pound831 to pound1010) and the mean incremental cost per QALY gained is pound2092. A probabilistic sensitivity analysis indicated that the likelihood that the DESMOND programme is cost effective at a threshold of pound20 000 per QALY is 66% using trial based intervention costs and 70% using "real world" costs. Results from a one way sensitivity analysis suggest that the DESMOND intervention is cost effective even under more modest assumptions that include the effects of the intervention being lost after one year.ConclusionOur results suggest that the DESMOND intervention is likely to be cost effective compared with usual care, especially with respect to the real world cost of the intervention to primary care trusts, with reductions in weight and smoking being the main benefits delivered.

Dataset Information

Presentation of newly diagnosed type 1 diabetes in children and young people during COVID-19: a national UK survey.

Publications

Presentation of newly diagnosed type 1 diabetes in children and young people during COVID-19: a national UK survey.

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