Endocrine Abstracts

JOINT3415

Introduction: DKA is a serious life-threatening complication of diabetes mellitus, with its incidence increasing over the past decades. Recent evidence suggests that COVID-19 may play a role in the pathophysiology of new-onset diabetes mellitus by triggering islet autoimmunity. The aim of this work is to compare the biological characteristics of new onset DKA before COVID-19 with those during the pandemic.

Patients & Methods: This is a cross-sectional analytical study carried out in the Diabetology & Endocrinology department of Farhat Hached University Hospital of Sousse. The study population included all the patients who had been hospitalized for new onset DKA between the year 2018 and 2022, divided in two groups: Group1(G1):patients hospitalized before COVID-19 since the first of March of 2018 until first of March 2020 and Group2(G2):patients hospitalized during COVID-19 since second of March 2020 until 28^thFebruary 2022. A metabolic, renal, hormonal, and immunological assessment has been requested.

Results: A total of 340 patients were evaluated:137 were registered in G1, while 203 were registered in G2. There was no significant difference in WBC count, hemoglobin or platelets between G1 and G2. Creatinine levels were significantly higher in G2 compared with G1 with a median of 52 [Q1–Q3]=[41.5–63] µmol/l and 56.6 [Q1–Q3]=[46–69] µmol/l respectively (P = 0.006). Urea levels did not differ significantly between the two groups (P = 0.262). CRP was comparable between the two groups with a mean of 5 [Q1–Q3]=[2–14.5]mg/l in G1 and 6 [Q1–Q3]=[2–11.5] mg/l in G2 (P = 0.791). No significant difference was detected regarding Triglycerides, HDL-cholesterol, TC or LDL-cholesterol levels between G1 and G2. Hypertriglyceridemia was present in 32% patients in G1 vs 33% in G2 (P = 0.470). LDL-cholesterol was outside objective range according to cardiovascular risk in 56% of patients in G1 vs 65% patients in G2 (P = 0.214). Anti-GAD antibodies titers significantly increased during the pandemic period compared with the pre-pandemic period with a median value of 92.5 [Q1–Q3]=[22.5–1074] in G1 vs 330 [Q1–Q3]=[58.5–1795] in G2 (P = 0.021). Anti-IA2 antibodies titers significantly increased as well during the pandemic period compared with the pre-pandemic period with a median value of 0 [Q1–Q3]=[0–104.75] in G1 vs 93 [Q1–Q3]=[0–3571] in G2(P = 0.009). No significant difference was found regarding anti-ZNT8 titers between the two groups (P = 0.475)

Conclusions: Our study suggests a potential link between COVID-19 and increased islet autoimmunity, as evidenced by higher anti-GAD and anti-IA2 antibody titers in post-pandemic patients.