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Multicenter Study
. 2022 Jun;23(4):433-438.
doi: 10.1111/pedi.13328. Epub 2022 Mar 16.

Increase in newly diagnosed type 1 diabetes in youth during the COVID-19 pandemic in the United States: A multi-center analysis

Affiliations
Multicenter Study

Increase in newly diagnosed type 1 diabetes in youth during the COVID-19 pandemic in the United States: A multi-center analysis

Risa M Wolf et al. Pediatr Diabetes. 2022 Jun.

Abstract

Background: An increase in newly diagnosed type 1 diabetes (T1D) has been posited during the COVID-19 pandemic, but data are conflicting. We aimed to determine trends in newly diagnosed T1D and severity of presentation at diagnosis for pediatric and adolescent patients during COVID-19 (2020) as compared to the previous year (2019) in a multi-center analysis across the United States.

Methods: This retrospective study from seven centers in the T1D Exchange Quality Improvement Collaborative (T1DX-QI) included data on new onset T1D diagnosis and proportion in DKA at diagnosis from January 1 to December 31, 2020, compared to the prior year. Chi-square tests were used to compare differences in patient characteristics during the pandemic period compared to the prior year.

Results: Across seven sites, there were 1399 newly diagnosed T1D patients in 2020, compared to 1277 in 2019 (p = 0.007). A greater proportion of newly diagnosed patients presented in DKA in 2020 compared to 2019 (599/1399(42.8%) vs. 493/1277(38.6%), p = 0.02), with a higher proportion presenting with severe DKA (p = 0.01) as characterized by a pH <7.1 and/or bicarbonate of <5 mmol/L. Monthly data trends demonstrated a higher number of new T1D diagnoses over the spring and summer months (March to September) of 2020 compared to 2019 (p < 0.001).

Conclusions: We found an increase in newly diagnosed T1D and a greater proportion presenting in DKA at diagnosis during the COVID-19 pandemic compared to the prior year. Future longitudinal studies are needed to confirm these findings with population level data and determine the long-term impact of COVID-19 on diabetes trends.

Keywords: COVID-19; diabetic ketoacidosis; new onset; newly diagnosed; type 1 diabetes.

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Conflict of interest statement

Dr. Wolf reports financial support from Boehringer Ingelheim and Dexcom, not relevant to this manuscript. Dr. Ebekozien reports being on the Medtronic Diabetes Health Equity Advisory Board and financial support from Medtronic, Dexcom, and Eli Lilly through his organization. Dr. Lee is on the Medical Advisory Board of GoodRx. The other authors received no external funding.

Figures

FIGURE 1
FIGURE 1
% of newly diagnosed T1D patients in 2019 versus 2020 (p‐value = 0.007)
FIGURE 2
FIGURE 2
% of newly diagnosed T1D patients with DKA in 2019 versus 2020 (p‐value = 0.02)

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