Background: Early research suggests during the COVID-19 pandemic there was an increase in new onset diabetes mellitus (DM) and greater severity at presentation. We examined pandemic related trends of new onset DM among patients at a pediatric diabetes center in New York, NY.
Methods: We conducted a retrospective chart review of 168 youth 0-26 years old presenting with new onset DM from January 2019 to October 2021. We used chi-square statistics, t-tests, and ANOVAs to compare aspects of presentation by year of diagnosis, overall and type 2 DM (T2D) versus type 1 DM (T1D) .
Results: The number of patients presenting with new onset DM increased throughout this time, with 43 in 2019, 57 in 2020, and 68 in 2021. This increase was primarily driven by an increase in T2D (8 in 2019, 16 in 2020, 27 in 2021) . Patients with T2D had higher mean BMI percentile at presentation compared to T1D (97.5 vs. 42.9; p<.001) . The mean BMI percentile of all patients increased (p for trend=0.02) and was higher in 2021 (67.8) compared to 2019 (50.1; p=0.02) . These differences, however, were not statistically significant when examined by DM type. There was no significant difference in severity of presentation based on HbA1C, DKA frequency or severity, lowest potassium level, or length of stay (LOS) . For example, among all patients in DKA, the prevalence of severe DKA was 53% in 2019, 62% in 2020, and 55% in 2021 (p=0.89) . Although numbers were small, there was a qualitative increase in LOS and decrease in bicarbonate level in patients with new onset T2D between 2019 and 2021.
Conclusions: In this population, the number of pediatric new onset DM increased during the COVID-19 pandemic. Cases of T2D increased by a greater degree than T1D which may explain the increased mean BMI percentile at diagnosis. There was no change in severity of DM presentation when examining multiple markers of severity. Further research is needed to understand if lifestyle changes during the pandemic may have impacted BMI and how this may relate to new onset pediatric DM, particularly T2D.
K. Citron: None. C. R. Stein: None. J. Ilkowitz: None. J. E. Gonzalez: None. V. Joseph: None. M. Gallagher: None.