ESPE Abstracts

Background: An increased incidence of Type 1 diabetes has been observed worldwide over the past 30 years. Obesity is a well-documented risk factor for Type 2 diabetes (T2D), but poor studies have postulated an association between the obesity and overweight and the rate of T1D in these age groups. This is known as Accelerator Hypothesis. In addition, a further effect seems to be exerted COVID-19 pandemic which is related to raised rate of T1D onset and obesity. The aim of the study was to evaluate the accelerator hypothesis during pandemic.

Materials and Methods: A retrospective population-based incidence study was performed. Data were obtained from hospital records of 351 patients with new onset type I diabetes admitted to the Department of Pediatrics of “SS. Annunziata Hospital” sited in Chieti, Italy, between 2010 and 2022. The population was divided into two groups according to the period of diabetes onset: Group 1 (252 subjects between January 2010 and December 2019); Group 2 (99 subjects between January 2020 and December 2022). Each group were further divided into three age-group ranges: subgroup 1 aged <5 years, subgroup 2 aged between 5 and 10 years, and subgroup 3 aged > 10 years. Data regarding anthropometric, laboratory analysis and and insulin requirement were analysed.

Results: A significant difference was documented in terms of age showing the Group 2 a lower mean age at onset if compared to the group 1. Weight-SDS and BMI-SDS were significant different between the two study groups displaying the Group 2 an increased Weight-SDS and BMI-SDS values compared to the group 1. A significant difference in terms of glycaemia, C-peptide, and insulin requirement was highlighted between the two study groups. A significant reduction of percentage of onset in the age-group >10 years was documented.

Conclusions: During COVID-19 pandemic the worsening of metabolic parameters at diabetes onset was demonstrated. We hypothesize an influence of BMI and insulin resistance during COVID-19 pandemic which may be related to the lower mean age at onset and the subsequent decrease of disease onset percentage in the age-group >10 years. Further and larger studies are needed to confirm our results, which seem to suggest a new “Accelerator Hypothesis” COVID-19 pandemic-related.