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Incidence of New-Onset Type 1 Diabetes Among US Children During the COVID-19 Global Pandemic

Educational Objective
To identify the key insights or developments described in this article

Type 1 diabetes (T1D) is a disorder of autoimmune-mediated pancreatic β-cell destruction and decreased insulin production. Although the incidence of this disease is increasing globally each year,1 our local experience at Rady Children’s Hospital San Diego, the tertiary care center for children in San Diego, California, and surrounding counties, was that the incidence of new-onset T1D during the COVID-19 global pandemic in 2020 and 2021 appeared to have increased compared with previous years. We performed a 6-year retrospective review of the medical record to evaluate whether the perceived increased incidence was significant and whether or not more children had diabetic ketoacidosis (DKA) at presentation or required pediatric intensive care unit (PICU) admission (at our institution for altered mental status or severe acidosis only) as a measure of the severity of illness at diabetes onset.

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Article Information

Accepted for Publication: October 12, 2021.

Published Online: January 24, 2022. doi:10.1001/jamapediatrics.2021.5801

Corresponding Author: Jane J. Kim, MD, Department of Pediatrics, University of California, San Diego, 3020 Children’s Way, MC 5103, San Diego, CA 92123 (janekim@health.ucsd.edu).

Author Contributions: Drs Gottesman and Kim had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Gottesman, Longhurst, Kim.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Gottesman, Yu, Tanaka, Kim.

Critical revision of the manuscript for important intellectual content: Gottesman, Yu, Longhurst, Kim.

Statistical analysis: Gottesman, Yu, Kim.

Administrative, technical, or material support: Gottesman, Longhurst.

Supervision: Longhurst, Kim.

Conflict of Interest Disclosures: None reported.

References:
1.
Lawrence  JM , Divers  J , Isom  S ,  et al; SEARCH for Diabetes in Youth Study Group.  Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001-2017.   JAMA. 2021;326(8):717-727. doi:10.1001/jama.2021.11165 PubMedGoogle ScholarCrossref
2.
Ho  J , Rosolowsky  E , Pacaud  D ,  et al.  Diabetic ketoacidosis at type 1 diabetes diagnosis in children during the COVID-19 pandemic.   Pediatr Diabetes. 2021;22(4):552-557. doi:10.1111/pedi.13205 PubMedGoogle ScholarCrossref
3.
Kamrath  C , Mönkemöller  K , Biester  T ,  et al.  Ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes during the COVID-19 pandemic in Germany.   JAMA. 2020;324(8):801-804. doi:10.1001/jama.2020.13445 PubMedGoogle ScholarCrossref
4.
Beliard  K , Ebekozien  O , Demeterco-Berggren  C ,  et al.  Increased DKA at presentation among newly diagnosed type 1 diabetes patients with or without COVID-19: data from a multi-site surveillance registry.   J Diabetes. 2021;13(3):270-272. doi:10.1111/1753-0407.13141 PubMedGoogle ScholarCrossref
5.
Dżygało  K , Nowaczyk  J , Szwilling  A , Kowalska  A .  Increased frequency of severe diabetic ketoacidosis at type 1 diabetes onset among children during COVID-19 pandemic lockdown: an observational cohort study.   Pediatr Endocrinol Diabetes Metab. 2020;26(4):167-175. doi:10.5114/pedm.2020.101003PubMedGoogle ScholarCrossref
6.
KidsData. Child population, by age group and gender. Accessed September 24, 2021. https://kidsdata.org/topic/34/child-population-age-gender/table
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