1. In this cross-sectional study, there was a 57% increase in new-onset Type 1 Diabetes diagnoses in children at a tertiary care hospital during a 12-month period of the COVID-19 pandemic.

2. Incidence of diabetic ketoacidosis on presentation increased from 41% to 50%.

Evidence Rating Level: 2 (Good)

Study Rundown: Type 1 diabetes (T1D) is an autoimmune disorder that has been increasing in prevalence worldwide. This cross-sectional study investigated whether incidence of new-onset T1D in children changed during the COVID-19 pandemic at a tertiary care center in San Diego, California. Six years of retrospective data were analyzed, which included one year of the COVID-19 pandemic (March 2020-March 2021) and 5 years prior to the COVID-19 pandemic (March 2015-March 2020). Children younger than 19 years admitted to hospital with new-onset T1D, with at least 1 positive T1D antibody titer, were included in the analysis. Additionally, age, sex, hemoglobin A1C, body-mass index (BMI), COVID-19 infection on admission, evidence of diabetic ketoacidosis (DKA), and admission to the pediatric intensive care unit (PICU) were assessed. In total, 187 children were admitted for new-onset T1D in the COVID-19 pandemic year, compared to 119 in 2019, representing a 57% increase. For the second half of the COVID-19 year, new-onset T1D diagnoses were greater than the anticipated number when compared to trends from the prior 5 years. Additionally, rates of DKA increased during the COVID-19 year (50%, compared to 41% over the prior 5 years). There was no difference in age at presentation, hemoglobin A1C, BMI, or PICU admissions, with low rates of COVID-19 infections. This study provides evidence that the incidence of new-onset T1D in children increased during the first year of the COVID-19 pandemic; however, the mechanism contributing to this increase is unclear, especially given the short follow-up period, and warrants further investigation.

Click to read the study in JAMA Pediatrics

Relevant Reading: Trends in prevalence of Type 1 and Type 2 diabetes in children and adolescents in the US, 2001-2017

Image: PD

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