Cross-sectional studyindependent cross-checkabstract checked★ key study I-INS-115 in-depth review
Ketoacidosis in Egyptian children with type 1 diabetes during COVID-19
Presentations, Complications, and Challenges Encountered During Management of Type 1 Diabetes in Egyptian Children During COVID-19 Pandemic: A Single-Center Experience.
Overview
Abdou M et al.. Front Endocrinol (Lausanne) 2022 · PMID 35360079 · DOI 10.3389/fendo.2022.814991
43% of 324 children arrived with severe ketoacidosis, often at first diagnosis; delays made it worse.
Does the study support the specific claim? No · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Describe DKA in Egyptian children during COVID-19.
- How was the study done?
Hospital records, Cairo.
- How many people, animals or samples were studied?
324 children.
- What was actually found?
43% severe DKA; two-thirds new diagnoses.
- How large was the observed effect?
43.2% severe DKA.
- What do the results mean in everyday life?
Late arrival at hospital makes ketoacidosis more dangerous.
- What are the study's limitations?
Single centre.
- What does it say about Elawady's specific claim?
Contradicts delaying insulin and hospital care.
- Do the results apply to Germany and Europe?
Egyptian setting.
- What can explicitly not be concluded from this study?
Cannot give death rates.
Scientific in-depth review
1. Full reference
- Authors
- Abdou M et al.
- Journal
- Front Endocrinol (Lausanne)
- Year
- 2022
- Identifier
- PMID 35360079 DOI 10.3389/fendo.2022.814991
- Verification
- verified – PubMed efetch 2026-10-26; Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
No commercial conflicts (record).
2. Research question
What were DKA frequency, severity and complications in Egyptian children with T1D during COVID-19?
3. Study design and population
- Study design
- Cross-sectional study – Single-centre cross-sectional record study with comparison to pre-COVID period
- Population
Children and adolescents with T1D presenting to the emergency department, Abo El Rish Children's Hospital, Cairo University
- Country
Egypt
- Period
First and second COVID-19 waves vs pre-COVID
- Sample size
324
- Inclusion and exclusion criteria
T1D presenting to emergency unit
4. Methods and endpoints
- Exposure / intervention
Pandemic period
- Comparator
Pre-COVID period
- Endpoints
DKA severity, new diagnoses, hypokalaemia, ICU stay
- Statistical methods
Descriptive and comparative
5. Actual results
- Results
140 of 324 (43.2%) presented with severe DKA; about 66% were newly diagnosed; about 18% developed hypokalaemia during treatment; more severe DKA and new diagnoses than pre-COVID, probably due to delayed presentation; DKA severity associated with longer ICU stay.
- Absolute risks
not reported
- Authors' conclusion
Delayed presentation during the pandemic was associated with more severe DKA.
6. Strengths
- Egyptian data
- Large paediatric sample
7. Weaknesses
- Single centre
- Retrospective
- Mortality not reported in abstract
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Descriptive.
9. Assessment of the statistical interpretation
Descriptive proportions.
10. Relevance to the specific claim
In Egypt, T1D in children frequently presents as severe DKA, and delay increases severity; advice to avoid insulin and hospitals would add delay.
11. Independent contrary findings
12. Transferability to Germany and Europe
Egypt-specific burden; mechanism universal.
13. Overall methodological judgement
Regional evidence of DKA burden and the danger of delay.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |