Increase in new-onset type 1 diabetes diagnoses among Brazilian children and adolescents during the COVID-19 pandemic.

Objective: This study aimed to determine if there was a rise in new T1DM cases in children during the pandemic in a large metropolitan area in Brazil.

Methods: The authors conducted a cross-sectional study at five public tertiary care centers that specialize in diabetes in children, comparing all new T1DM cases (ages 0.5-18y) diagnosed from March 2020 to December 2021 (pandemic period, PP) with those from March 2018 to December 2019 (historical period, HP).

Results: There were 167 new cases in the PP compared to 99 in the HP, reflecting a 68.7 % rise, with a notable peak observed in the third quarter of 2020 (p = 0.006). The average age of diagnosis was 8.4 ± 4.2 years in the PP and 7.5 ± 3.6 years in the HP, with no significant difference (p = 0.06). The gender distribution, BMI Z scores, and duration of diabetes symptoms before diagnosis were similar. The incidence of diabetic ketoacidosis (DKA) at onset was elevated but did not increase during the pandemic (62.6 % historical vs. 59.3 % pandemic period). During the PP, 24 % of patients reported symptoms of SARS-CoV-2 infection before the diagnosis of T1DM or at admission, and 13 % (7/53) of tested patients were positive for SARS-CoV-2.

Conclusions: The present findings indicate a significant rise in new T1DM cases among children during the COVID-19 pandemic compared to prior years, without differences in DKA at onset.