Examination of Trends in Diabetes Incidence Among Children During the COVID-19 Pandemic in Ontario, Canada, From March 2020 to September 2021 | Pediatrics | JN Learning | AMA Ed Hub [Skip to Content]
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Examination of Trends in Diabetes Incidence Among Children During the COVID-19 Pandemic in Ontario, Canada, From March 2020 to September 2021

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

A recent study reported an association between COVID-19 infection and new-onset diabetes among people younger than 18 years in the US.1 The resulting media coverage was extensive, although some experts have criticized the study methods and conclusion validity. There is no clear mechanism by which COVID-19 infection might cause new-onset diabetes.2 Kamrath et al3 recently reported an increase in type 1 diabetes incidence among children in Germany during the pandemic. They did not observe an association of COVID-19 and increased type 1 diabetes incidence in the months after infection or an increase in the frequency of autoantibody-negative type 1 diabetes, which prompts the question of whether COVID-19 infection is associated with incident type 1 diabetes.3 Given the challenges of ascertaining a COVID-19 infection history for children with new-onset diabetes, additional population-based studies investigating changes in diabetes incidence among children during the pandemic are needed. Canada has one of the highest incident rates of type 1 diabetes worldwide. Therefore, this study examined whether diabetes incidence increased during the COVID-19 pandemic among children and youths (aged <18 years) in Ontario, Canada.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: June 6, 2022.

Published: July 25, 2022. doi:10.1001/jamanetworkopen.2022.23394

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Shulman R et al. JAMA Network Open.

Corresponding Author: Rayzel Shulman, MD, PhD, Division of Endocrinology, Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada (rayzel.shulman@sickkids.ca).

Author Contributions: Ms Diong and Dr Guttmann 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: Shulman, Cohen, Stukel, Guttmann.

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

Drafting of the manuscript: Shulman.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Stukel, Diong.

Obtained funding: Guttmann.

Supervision: Stukel, Guttmann.

Conflict of Interest Disclosures: Dr Shulman reported receiving personal fees from Dexcom outside the submitted work. Drs Shulman, Cohen, Stukel, and Guttmann reported receiving grants from the Canadian Institutes of Health Research during the conduct of the study and outside the submitted work. No other disclosures were reported.

Funding/Support: This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health. This study was also supported by grant VR4-172730 from the Canadian Institutes of Health Research (Dr Guttmann).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The opinions, results, and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario Ministry of Health is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions, and statements expressed herein are those of the authors, and not necessarily those of CIHI.

References
1.
Barrett  CE , Koyama  AK , Alvarez  P ,  et al.  Risk for newly diagnosed diabetes >30 days after SARS-CoV-2 infection among persons aged <18 years—United States, March 1, 2020-June 28, 2021.   MMWR Morb Mortal Wkly Rep. 2022;71(2):59-65. doi:10.15585/mmwr.mm7102e2 PubMedGoogle ScholarCrossref
2.
Accili  D .  Can COVID-19 cause diabetes?   Nat Metab. 2021;3(2):123-125. doi:10.1038/s42255-020-00339-7 PubMedGoogle ScholarCrossref
3.
Kamrath  C , Rosenbauer  J , Eckert  AJ ,  et al.  Incidence of type 1 diabetes in children and adolescents during the COVID-19 pandemic in Germany: results from the DPV Registry.   Diabetes Care. 2022;dc210969. doi:10.2337/dc21-0969 PubMedGoogle ScholarCrossref
4.
Statistics Canada. Table 13-10-0818-01 SARS-CoV-2 antibody seroprevalence in Canadians, by age group and sex, November 2020 to April 2021. 2021. Accessed January 21, 2021. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310081801
5.
Saunders  N , Guttmann  A , Brownell  M ,  et al.  Pediatric primary care in Ontario and Manitoba after the onset of the COVID-19 pandemic: a population-based study.   CMAJ Open. 2021;9(4):E1149-E1158. doi:10.9778/cmajo.20210161 PubMedGoogle ScholarCrossref
6.
Shulman  R , Miller  FA , Stukel  TA , Daneman  D , Guttmann  A .  Resources and population served: a description of the Ontario Paediatric Diabetes Network.   CMAJ Open. 2016;4(2):E141-E146. doi:10.9778/cmajo.20150006 PubMedGoogle ScholarCrossref
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