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Incidence of Type 1 Diabetes in Children and Adolescents During the COVID-19 Pandemic in Germany: Results From the DPV Registry

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posted on 18.01.2022, 17:48 by Clemens Kamrath, Joachim Rosenbauer, Alexander J. Eckert, Kai Siedler, Heike Bartelt, Daniela Klose, Marina Sindichakis, Silke Herrlinger, Valentina Lahn, Reinhard W Holl
Objective: The aim of this study was to investigate the incidence of type 1 diabetes in children and adolescents during the Covid-19 pandemic in Germany compared to previous years.
Research Design and Methods: Based on data from the multicenter German Diabetes Prospective Follow-up Registry (DPV), we analyzed the incidence of type 1 diabetes per 100,000 patient years in children and adolescents from January 1, 2020, through June 30, 2021. Using Poisson regression models, expected incidences for 2020/21 were estimated based on the data from 2011 to 2019, and compared to observed incidences in 2020/21 by estimating incidence rate ratios (IRRs) with its 95% confidence interval (CI).
Results: From January 1, 2020, to June 30, 2021, 5,162 children and adolescents with new-onset type 1 diabetes in Germany were registered. The observed incidence in 2020/21 was significantly higher than the expected incidence (24.4 [95% CI, 23.6–25.2] vs. 21.2 [20.5–21.9]; IRR, 1.15 [1.10–1.20], p<0.001). IRRs were significantly elevated in June 2020 (IRR, 1.43 [1.07–1.90], p=0.003), July 2020 (IRR, 1.48 [1.12–1.96], p<0.001), March 2021 (IRR, 1.29 [95% CI, 1.01–1.65], p=0.028), and June 2021 (IRR, 1.39 [1.04–1.85], p=0.010).
Conclusions: A significant increase in the incidence of type 1 diabetes in children was observed during the Covid-19 pandemic, with a delay in the peak incidence of type 1 diabetes by approximately three months after the peak Covid-19 incidence and also after pandemic containment measures. The underlying causes are yet unknown. However, indirect effects of the pandemic are more likely to be the cause than direct ones.


The DPV is supported through the German Federal Ministry for Education and Research within the German Centre for Diabetes Research (DZD, grant number: 82DZD14A02). Further financial support was received by the German Diabetes Foundation (DDS, grant number: FP-0438-2021), the German Robert Koch Institute (RKI) and the German Diabetes Association (DDG). The funding organization had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.