Sharp Rise in New-Onset Pediatric Diabetes During the COVID-19 Pandemic.

Introduction: Recent studies report a significant impact of the COVID-19 pandemic on the incidence, severity, and management of diabetes.

Objective: To determine the incidence of new onset pediatric diabetes prepandemic versus during the pandemic and to analyze the presentation based on age, severity, HbA1c, body mass index, and COVID testing.

Methods: We conducted a retrospective review of all pediatric patients admitted with newly diagnosed type 1 and type 2 diabetes mellitus admitted to the American Family Children's Hospital (Madison, Wisconsin) from 2018 through 2021. Data included age at diagnosis, body mass index, hemoglobin A1c percent and pH at presentation, presence of autoimmune pancreatic antibodies, and COVID-19 polymerase chain reaction (PCR) results at admission in pre-COVID (January 2018-February 2020) versus during COVID (March 2020-December 2021). Statistical analysis was performed using SAS software with the incidences analyzed using univariate and multivariate Poisson regression analyses.

Results: During the pandemic, the incidence of both type 1 and type 2 diabetes mellitus increased significantly (69% and 225%, P < 0.001, respectively), and a higher number of patients had diabetic ketoacidosis. Type 1 diabetes patients with a body mass index greater than the 95th percentile increased from 11.1% to 16.9% (OR 0.62; 95% CI, 0.29-1.29; P = 0.19). Almost all patients were COVID-19 PCR negative at the time of diagnosis.

Conclusions: A dramatic increase in number and severity of newly diagnosed pediatric diabetes cases was seen during the pandemic. The increase was not explained by factors such as changes in referral patterns or insurance coverage. Further work is needed to understand the impact of societal factors and the direct diabetogenic effect of SARS-CoV-2.