Clinical and Epidemiological Characteristics of New-onset Diabetes Mellitus Type 1 during the COVID -19 Pandemic in Children’s National Health Institute, Lima-Peru

Abstract

Objectives: To describe the clinical-epidemiological characteristics of new-onset Type 1 Diabetes (T1DM) during the first two years of the COVID-19 pandemic at the National Institute of Child Health (INSN). Methods: Cross-sectional and retrospective study in patients under 18 years of age with new-onset T1DM and attended the INSN between March 2020 and April 2022. Data were obtained from medical records and were considered infected by SARS-CoV-2 if they had a positive RT-PCR or antigenic test in nasopharyngeal sample at the time of diagnosis. The frequency and severity were compared with institutional data for the five-year period 2015-2019. The results are shown as mean values ± SD or minimum and maximum ranges, and in frequencies and percentages; in addition, bivariate analysis was performed for the association between T1DM and SARS Cov2 infection. Results: The cases in the two pandemic years showed an increase in contrast the previous five-year period; 69 patients debuted with T1DM (32 females); 46.4% during the first year and 53.6% during the second year; the age of most patients was between 6 and 11 years; most were pre-pubertal; 43.5% reported a time of illness of less than one month; the peaks of cases occurred in the spring months; 72.5% debuted with diabetic ketoacidosis (DKA); HbA1c was higher than 10% in 58% of patients; and, in 26.1% COVID-19 infection was demonstrated; however, due to the small number of cases, no statistical association could be established. Conclusions: There is evidence of an increase in the number of new-onset T1DM cases compared to the five-year period prior to the COVID 19 pandemic; important peaks of cases in the spring months; high average HbA1c values at disease onset; and a very high rate of DKA compared to the pre-pandemic period.