Highlights
- •Comparison of incidence/frequency 2020/2021 with long-term trends (2011–2019)
- •The observed diabetes incidence in 2020/2021 was 13%/20% higher than predicted.
- •The prevalence of autoantibody-negative diabetes was not higher than predicted.
- •Ketoacidosis incidence in 2020/2021 was 34%/37% higher than expected.
- •Seasonal patterns have substantially changed during the COVID-19 pandemic.
Abstract
Aims
To determine whether the incidence of type 1 diabetes mellitus (T1D), autoantibody-negative
diabetes, and diabetic ketoacidosis (DKA) at diabetes onset in 2020 and 2021 changed
when compared to long-standing trends.
Methods
Our study is based on diabetes manifestation data of the 0.5–<18-year-old children/adolescents
from the German multicenter Diabetes Prospective Follow-up Registry. Based on long-term
pre-pandemic trends from 2011 to 2019, we estimated adjusted incidence rate ratios
(IRR) for T1D and DKA, and prevalence rate ratios (PRR) regarding autoantibody status
with 95 % confidence intervals (CI) for the years 2020 and 2021 (observed versus predicted
rates), using multivariable negative binomial or beta-binomial regression, respectively.
Results
We analyzed data of 30,840 children and adolescents with new-onset T1D. The observed
incidences were significantly higher than the predicted incidences (IRR2020 1.13 [1.08–1.19]; IRR2021 1.20 [1.15–1.26]). The prevalence of autoantibody-negative diabetes did not change
(PRR2020 0.91 [0.75–1.10]; PRR2021 1.03 [0.86–1.24]). The incidence of DKA during the pandemic was higher than predicted
(IRR2020 1.34 [1.23–1.46]; IRR2021 1.37 [1.26–1.49]).
Conclusions
An increase in the incidences of T1D and DKA, but not of autoantibody-negative diabetes
was observed during both pandemic years. Further monitoring and efforts for DKA prevention
at onset are necessary.
Keywords
Abbreviations:
BMI-SDS (body mass index standard deviation score), COVID-19 (coronavirus disease 2019), DKA (diabetic ketoacidosis), Diff (difference(s)), DPV (German Diabetes Prospective Follow-up Registry, i.e. “Diabetes-Patienten-Verlaufsdokumentation”), GADA (glutamic acid decarboxylase autoantibodies), IA2A (tyrosine phosphatase autoantibodies), IAA (insulin autoantibody), ICA (islet cell antibody), IRR (incidence rate ratio), PRR (prevalence rate ratio), PY (person-years), sDKA (severe diabetic ketoacidosis), SARS-CoV-2 (severe acute respiratory syndrome coronavirus2), ZnT8A (zinc transporter 8 autoantibodies)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 07, 2023
Accepted:
January 30,
2023
Received in revised form:
January 16,
2023
Received:
October 7,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
