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Paediatric critical care referrals of children with diabetic ketoacidosis during the COVID-19 pandemic
  1. Emre Basatemur1,
  2. Andrew Jones1,
  3. Mark Peters2,
  4. Padmanabhan Ramnarayan1
  1. 1Children's Acute Transport Service, Great Ormond Street Hospital for Children, London, UK
  2. 2Department of Paediatric Intensive Care, Great Ormond Street Hospital for Children, London, UK
  1. Correspondence to Dr Emre Basatemur, Children's Acute Transport Service, Great Ormond Street Hospital for Children, London WC1N 3JZ, UK; emre.basatemur{at}

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Child health practitioners in the UK and internationally have voiced concerns that restrictions and measures introduced to combat the COVID-19 pandemic may be causing unintended adverse consequences for the health and social well-being of children. Initial reports suggested a significant reduction in the utilisation of healthcare services by children during the pandemic, raising concerns about late presentation of children with serious illness.1 In a national survey of UK paediatricians, 32% of clinicians reported having witnessed delayed presentations to emergency care over a 2-week period in April 2020.2 The most frequently reported delayed presentation was new diagnosis of diabetes mellitus. Analysis of children newly diagnosed with type 1 diabetes in Germany identified that between March and April 2020, a significantly greater proportion of cases presented with diabetic ketoacidosis (DKA) (45%) when compared with corresponding periods over the previous 2 years (24%).3

Here, we report the frequency of referral of children with DKA to a regional paediatric critical care advice and transport service in the …

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