ESPE Abstracts

Background: The incidence rate (IR) of childhood diabetes is increasing globally. These upward trends were also found in Thailand. However, newly diagnosed childhood diabetes incidences are not updated, especially in Northern Thailand. There are possibilities that COVID-19 pandemic affects the development of acute diabetes after infection and the severity of the first clinical presentation of childhood diabetes. However, data are also conflicting regarding the incidence and severity at onset of childhood diabetes during a COVID-19 pandemic. Current information regarding childhood diabetes IR and the effect of COVID-19 on IR and severity at diabetes onset in Thailand is still lacking.

Objectives: To illustrate the incidence and type of newly diagnosed childhood diabetes in Northern Thailand and to compare IR and severity at diabetes onset e.g. DKA, death rate, etc. between the pre-pandemic and pandemic COVID-19 eras.

Methods: We retrospectively collected data on childhood diabetes between 2005-2016 and prospectively registered all incident cases since 2016-2022 in the Thai Type 1 Diabetes diagnosed Age before 30 years Registry, Care and Network(T1DDAR CN). Capture-recapture method was applied to estimate the completeness of ascertainment. The three-tertiary care centers served as primary source followed by hospitals in referral system and schools was secondary and tertiary source, respectively. The data were compiled from four provinces in northern Thailand. The IR, prevalence, and severity of DKA at diabetes onset were compared between the pre-pandemic (2017-2019) and pandemic (2020-2022) eras.

Results: A total of 210 patients were included. Type 1 diabetes (T1D) was identified in 56.2%, type 2 diabetes (T2D) in 39%, and other types in 4.8%. The IR of T1D significantly increased from 0.30 to 2.52/100,000 person/year in 2005 and 2022, respectively (P-value=0.014 [95% CI 0.24-2.68]), similar to the IR of T2D, which increased from 0.30 to 2.68/100,000 person/year (P-value=0.014 [95% CI 0.26-2.88]). The predicted IR of T1D and T2D in 2023 were forecasted to be 2.0 and 2.29/100,000 person/year, respectively. The pre-pandemic IR of newly diagnosed diabetes, prevalence, and severity of DKA at first presentation including death rate were not significantly different from those of the pandemic period in both types of diabetes.

Conclusions: We demonstrate an increased IR of T1D and T2D in Northern Thailand over 18 years. However, the IR, prevalence, and severity of DKA at onset including death rate were not different between the pre-pandemic and pandemic COVID-19 periods.