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

Abstract

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. <br>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). <br>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). <br>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.