ESPE Abstracts

Introduction: Since the beginning of the coronavirus pandemic, an increase in cases of new-onset type 1 diabetes (T1D) in children and adolescents has been observed in many countries, including Brazil.

Objectives and Methods: In this descriptive study, we aimed to investigate the frequency of new-onset T1DM and the frequency and severity of diabetic ketoacidosis (DKA) in a referral Brazilian University Hospital, 38 months before (from January 2017 to February 2020) and 34 months during the coronavirus pandemic (from March 2020 to December 2022). Clinical and laboratory data from all new T1D cases attended to the paediatric emergency from January 2017 to December 2022 were obtained. The pre-pandemic and pandemic periods were compared using means, percentages, and hypothesis tests when appropriate.

Results: One hundred and thirty-four new-onset T1D cases were diagnosed between 2017 and 2022 (mean age 8.7 years old [1-16]). Compared to the pre-pandemic period, the number of new cases increased by 57% in the pandemic period (52 vs. 82, respectively). The proportion of new T1D cases in the pediatric emergency was 70% higher during the pandemic: from 3.9 to 6.7 T1D for each 1,000 general cases at the paediatric emergency (P=0.005). Considering only the year of 2020, this proportion was 110% higher than the mean of the three years before (8.7: 1,000 during 2020 vs. 4.1:1,000 mean in the pre-pandemic period). The frequency of DKA at diagnosis increased from 42.3% in the pre-pandemic period to 65.8% during the pandemic (P=0.007), and the severe DKA was slightly more common in the pandemic period: 31.8% vs. 40.7% (P=0.24). There was no difference in nutritional status (mean body mass index z-score: pre-pandemic = 0.15; pandemic = -0.27, P=0.14), age (mean age: pre-pandemic = 9 years; pandemic = 8.5, P=0.24), and sex proportion (males: pre-pandemic = 55%; pandemic = 53%). Only six patients were infected by SARS-CoV-2 during the new-onset. Conclusion: There was an increase in the frequency of new-onset T1D during the pandemic, and the higher peak of cases matches with the first coronavirus wave in Brazil. Additionally, there was an increase in the severity of T1D presentation, with a higher frequency of DKA and severe DKA at the diagnosis.