Abstract
Abstract Disclosure: F.I. Cooper: None. A. Thokalath: None. S. Chalise: None. N. Vyas: None. S. Gurnurkar: None. Introduction: Evidence suggests that during the COVID-19 pandemic, adults had delayed detection of diabetes mellitus (DM) and its complications as well as an increase in the severity of DM symptoms. Our retrospective study aimed to determine the difference in prevalence of new onset DM and to compare the severity of diabetic ketoacidosis (DKA) in these children prior to and during the COVID-19 pandemic at Nemours Children’s Health in Orlando, FL. Methods: Chart review was performed on children with new onset DM (type 1 and 2) pre-pandemic and during the pandemic (9/1/2017-9/1/2022). 509 participants met inclusion criteria. Demographic information and laboratory data were collected. One sample proportions test was used to compare the proportion of new onset DM diagnoses and severity of presentation. Chi square test was used to test association of demographics with DM onset and DKA status. Statistical significance was set at p<0.05 and all analyses were run on IBM SPSS 28.0. Results: A greater number of pediatric DM diagnoses were made during the COVID-19 pandemic when compared to pre-pandemic [295 vs 214 (p<0.001)]. More patients presented in DKA at initial diagnosis during the pandemic compared to pre-pandemic (52% vs 48%, p=0.046). There was no significant difference in DKA severity between the pre-pandemic and pandemic groups (p=0.179). There was a significant difference in the average Hemoglobin A1C at diagnosis between COVID-19 unknown and COVID-19 negative group (12% vs. 10.6%, p<0.05). Conclusion: Our study found that more children were diagnosed with DM during the COVID-19 pandemic compared to an equal length of time pre-pandemic. We also found that the prevalence of DKA among those with new-onset DM was higher during the pandemic period. It is speculated that SARS-CoV-2 can disturb self-tolerance and trigger autoimmune responses through cross-reactivity with host cells. Additional studies are needed to investigate this mechanism specifically among children with new onset DM. Presentation: Friday, June 16, 2023
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