Type 1 diabetes (T1D) is a disorder of autoimmune-mediated pancreatic β-cell destruction and decreased insulin production. A recent publication in ‘JAMA Pediatrics’ revealed that the incidence of new onset type 1 diabetes is higher during the Covid-19 pandemic.

For this cross-sectional study, the researchers used a self-service reporting tool included in the institutional electronic medical record to survey the patient population. Inclusion criteria included admission to Rady Children’s Hospital San Diego, patient age younger than 19 years, and at least 1 positive T1D antibody titer. Age, sex, hemoglobin A1C, body mass index z score, COVID-19 infection results, DKA as evidenced by use of insulin infusion, and PICU admission were extracted from each patient’s medical record. Patients were tested for acute COVID-19 infection on admission (not for antibodies to diagnose prior infection). Five years of prior data from March 19, 2015, to March 18, 2020, were analyzed to ensure that the increase in new-onset T1D diagnoses was not due to previous annual rates of increase. An autoregressive integrated moving average was performed to forecast the predicted trend of new-onset T1D cases during the COVID-19 year.

The results revealed that the number of new diagnoses of T1D exceeded the number of patients anticipated within the 95% CI based on a quarterly moving average of the preceding 5 years (July 2020: 15 diagnoses; 10 forecasted diagnoses; 95% CI, 6.79-13.89; February 2021: 21 diagnoses; 10 forecasted diagnoses; 95% CI, 6.88-13.54). Only 4 of 187 patients had Covid-19 infection at the time of presentation. There was an increase in the percentage of patients who presented with DKA, but no difference in body mass index z score (−0.39 [1.78] vs −0.43 [1.61]), hemoglobin A1c (11.6% [1.8%] vs 11.7% [1.9%]), or percentage of children requiring PICU admission. Significant increase in the frequency of DKA at the time of T1D diagnosis was observed with 49.7% of the cohort requiring an insulin infusion during the COVID-19 pandemic. The study concluded that the case rate was higher than expected in children during the COVID-19 pandemic.