{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:42:35Z","timestamp":1761514955377,"version":"3.41.2"},"reference-count":74,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The COVID-19 pandemic led to substantial shifts in pediatric diabetes care delivery to virtual and hybrid models. It is unclear if these changes in care delivery impacted short-term patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to explore glycemic control and other diabetes-related outcomes in children living with Type 1 Diabetes Mellitus (T1DM) during the first year of the COVID-19 pandemic at a tertiary pediatric academic center in Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>Patients &amp;lt;18 years of age with a confirmed diagnosis of T1DM for at least one year were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective chart review. We compared data from two years pre-pandemic (March 15, 2018\u2013March 14, 2020) to the first year of the pandemic (March 15, 2020\u2013March 14, 2021). The data assessed included glycemic control [Hemoglobin A1c (HbA1c)], diabetic ketoacidosis (DKA), hospital attendance and hospitalizations, hypoglycemia, and hyperglycemia. The generalized estimating equation (GEE) analysis was used to model potential factors affecting the HbA1c and diabetes-related morbidities. Multiple imputations were conducted as a sensitivity analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 346 eligible patients included in the study. The HbA1c remained stable during the pandemic compared to the pre-pandemic phase (MD-0.14, 95% CI, \u22120.28, 0.01;<jats:italic>p<\/jats:italic>\u2009=\u20090.058). The pandemic saw an increase in the number of newly diagnosed patients (X<jats:sup>2\u2009<\/jats:sup>=\u200916.52,<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) and a higher number of newly diagnosed patients presenting in DKA (X<jats:sup>2\u2009<\/jats:sup>=\u200912.94,<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). In patients with established diabetes, there was an increase in hyperglycemia (OR1.38, 95% CI, 1.12,1.71;<jats:italic>p<\/jats:italic>\u2009=\u20090.003) and reduced DKA (OR 0.30, 95% CI, 0.12,0.73;<jats:italic>p<\/jats:italic>\u2009=\u20090.009) during the pandemic compared to the pre-pandemic phase. Stable rates of hospitalization (OR0.57, 95% CI, 0.31,1.04,<jats:italic>p<\/jats:italic>\u2009=\u20090.068) and hypoglycemia (OR1.11, 95% CI, 0.83,1.49;<jats:italic>p<\/jats:italic>\u2009=\u20090.484) were noted. These results were retained in the sensitivity analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Glycemic control in children with T1DM remained stable during the first year of the pandemic. There were more newly diagnosed patients during the pandemic compared to the pre-pandemic phase, and more of these new patients presented in DKA. The latter presentation was reduced in those with established diabetes during the same period.<\/jats:p><jats:p>Further studies are needed to assess the ongoing impact of the COVID-19 pandemic on T1DM care pathways and outcomes to allow children, families, and diabetes teams to personalize choices of care models.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.1038345","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T07:54:10Z","timestamp":1668758050000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["An exploratory analysis of the impact of the COVID-19 pandemic on pediatric type 1 diabetes mellitus patient outcomes: A single-center study"],"prefix":"10.3389","volume":"10","author":[{"given":"Raeesha","family":"Rajan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uma","family":"Athale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joycelyne Efua","family":"Ewusie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"McAssey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lehana","family":"Thabane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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