Endocrine Abstracts

JOINT3136

DKA is a potentially life-threatening complication of DM with an increased incidence over the last few decades. Coronavirus disease(COVID-19) has been incriminated in the pathophysiology of new-onset diabetes mellitus via the development of islet autoimmunity. The aim of this work is to compare the epidemiological and clinical characteristics of new onset DKA before COVID-19 with those during the pandemic. 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. A total of 340 patients were evaluated:137 were registered in G1, while 203 were registered in G2. The mean monthly incidence of DKA before COVID-19 pandemic was statistically different from that observed during COVID-19 with a mean of 5.75±4.29 DKA per month in G1 vs 8.42±4.87 DKA per month in G2(P = 0.049).The study of the temporal trend of hospital cases of DKA showed a significant upward trend with a change in the average monthly percent change of +0.2, with P = 0.037.The sex ratio(H/F) remained comparable before and during COVID-19(P = 0.287). The median age of the two populations was 39 [Q1-Q3]=[25–53] years old and 41 [Q1-Q3]=[27– 57] years old with a P = 0.531. Familial history of auto-immunity was comparable between the two groups. The median duration of polyuria and polydipsia before DKA was comparable in the two groups with a median period of 30 [Q1–Q3]=[20.75–60] days in G1 vs 30 [Q1–Q3]=[15–90] days in G2 (P = 0.171). The median weight loss in kilograms before the diagnosis was estimated at 8 [Q1–Q3]=[5–13] Kg in G1 vs 10 [Q1–Q3]=[6–15] Kg in G2(P = 0.688). Clinical presentation of DKA including signs of intracellular and extracellular dehydration, weight loss, blood pressure, heartbeat were comparable between the two groups. Goiter was more significantly reported in G1 with 11.6% in G1 vs 3.4% in G2(P = 0.018). The emergence of COVID-19 occurred amidst a backdrop of an already existing pandemic that is DM, creating a multitude of challenges for the healthcare system worldwide and adding to the burden of an already overstretched health system.