COVID19 and newly diagnosed type1 diabetes mellitus in paediatrics

Abstract

Introduction: Covid 19 has a complex relationship with diabetes. There is anecdotal evidence that it could be causative for new onset diabetes in paediatrics. In this audit, we aim to study our cohort of new onset diabetes in children and young people (CYP) during the Covid pandemic in a DGH setting. We sought to identify any causative or associational link between Covid 19 and new onset diabetes. Method: We reviewed the handwritten notes, e-notes and investigations available on the pathology server for our newly diagnosed diabetes CYP from February 2020 to January 2022. We compared the number of new diagnosis and DKA presentation, with the previous two years (February 2018 till Jan 2020), which was pre-Covid. Results: A total of 65* cases were included in this audit, of which 39 boys and 26 girls. Age ranged from 9 months to 17 years. 47 were White British. The most common presenting symptom was polyuria followed by polydipsia and weight loss. 55% of patients presented to the hospital within three weeks of the beginning of their symptoms. 40% of patients were in DKA at presentation. GAD and/or IA2 antibodies were present in 60 (90%) cases. Only four patients were positive for Covid-19, 40 cases were negative at the time of presentation and rest were not tested. In comparison to the two years pre-Covid, the newly diagnosed type1 diabetes cases number increased by 25%. DKA at presentation in this time increased by 3% and was not attributed to delayed presentation. Conclusion: We have demonstrated a 25% increase in new onset diabetes during the 2 years of pandemic, with a 3% increase in rate of DKA. 90% of the newly diagnosed CYP were autoantibody positive, hence had the immune predisposition. However, we have not been able to prove a direct link between Covid-19 infection and new onset diabetes in CYP. Hence whether Covid 19 is causative or associational, begs further studies