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The COVID-19 pandemic affects seasonality with increasing cases of new-onset type 1 diabetes in children from the worldwide SWEET registry

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posted on 2022-09-27, 18:19 authored by Felix Reschke, Stefanie Lanzinger, Vivien Herczeg, Priya Prahalad, Riccardo Schiaffini, Dick Mul, Helen Clapin, Bedowra Zabeen, Julie Pelicand, Moshe Phillip, Catarina Limbert, Thomas Danne, the SWEET Study Group

  

Aims: To analyze whether the COVID-19 pandemic increased the number of cases or impacted seasonality of new-onset type 1 diabetes (T1D) in large pediatric diabetes centers globally. 

Methods: 17.280 cases of T1D diagnosed 2018 – 2021 from 92 worldwide centers participating in the SWEET registry were analysed using hierarchic linear regression models. 

Results: The average number of new-onset T1D per center adjusted for the total number of patients treated at the center per year and stratified by age groups increased from 11.2 [95%-confidence interval: 10.1-12.2] in 2018 to 21.7 [20.6-22.8] in 2021 in the youngest age group <6 years, from 13.1 [12.2-14.0] in 2018 to 26.7 [25.7-27.7] in 2021 in children 6 to <12 year and from 12.2 [11.5-12.9] to 24.7 [24.0-25.5] in adolescents 12 to 18 years (all p<0.001). These increases remained within the expected increase with the 95%-confidence interval of the regression line. However, in Europe and North America following the lockdown early in 2020, the typical seasonality of more cases during winter season was delayed with a peak during the summer and autumn months. While the seasonal pattern in Europe returned to pre-pandemic times in 2021 this was not the case in North America. Compared to 2018-2019 (HbA1c 7.7%), higher average A1c levels (2020: 8.1%, 2021: 8.6%, p<0.001) were present within the first year of T1D during the pandemic.

Conclusions: The slope of the rise in pediatric new-onset T1D in SWEET centers remained unchanged during the COVID pandemic but a change in the seasonality at onset became apparent. 

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