Clemens Kamrath1, Joachim Rosenbauer2,3, Sascha R Tittel3,4, Katharina Warncke5, Raphael Hirtz6, Christian Denzer7, Axel Dost8, Andreas Neu9, Danièle Pacaud10,11, Reinhard W Holl3,4. 1. Center of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany clemens.kamrath@paediat.med.uni-giessen.de. 2. Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Dusseldorf, Germany. 3. German Center for Diabetes Research (DZD) , Munich-Neuherberg, Germany. 4. Institute of Epidemiology and Medical Biometry, Zentralinstitut für Biomedizinische Technik, Ulm University, Ulm, Germany. 5. Department of Pediatrics, Technical University of Munich School of Medicine, Munich, Germany. 6. Department of Pediatrics II, University Hospital Essen, Essen, Germany. 7. Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany. 8. Department of Pediatrics, University Hospital Jena, Jena, Germany. 9. University Children's Hospital Tuebingen, Tuebingen, Germany. 10. Department of Pediatrics, Cummings School of Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada. 11. Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
Abstract
OBJECTIVE: The aim of this study was to investigate the frequency of newly diagnosed type 1 diabetes without evidence of autoimmunity and the respective frequencies of ketoacidosis in children, adolescents, and young adults during the coronavirus disease 2019 (COVID-19) pandemic in Germany compared with the previous decade. RESEARCH DESIGN AND METHODS: Based on data from the German Diabetes Prospective Follow-up Registry (DPV), we compared data from 715 children, adolescents, and young adults, newly diagnosed with type 1 diabetes during the COVID-19 pandemic in Germany between 1 March and 30 June 2020, with data from 5,428 children, adolescents, and young adults of the same periods from 2011 to 2019. Adjusted differences and relative risks (RRs) of negative β-cell autoantibody test results and diabetic ketoacidosis were estimated using multivariable log-binomial regression analysis. An upper noninferiority test (margin 1%) was applied to evaluate whether the autoantibody-negativity rate in 2020 was not higher than that in 2011 to 2019. RESULTS: The estimated frequencies of autoantibody negativity in 2020 and 2011-2019 were 6.6% (95% CI 5.1-8.4) and 7.2% (95% CI 6.5-8.0), respectively, with an absolute difference of -0.68% (90% CI -2.07 to 0.71; P upper noninferiority = 0.023). The increase of the estimated frequency of diabetic ketoacidosis during the COVID-19 pandemic was similar between autoantibody-negative and -positive type 1 diabetes (adjusted RRs 1.28 [95% CI 0.80-2.05] and 1.57 [1.41-1.75], respectively). CONCLUSIONS: This study found no evidence that the COVID-19 pandemic leads to a significantly increased number of new cases with autoantibody-negative type 1 diabetes in children, adolescents, and young adults. In addition, autoantibody-negative type 1 diabetes showed no particular susceptibility to ketoacidosis, neither before nor during the pandemic.
OBJECTIVE: The aim of this study was to investigate the frequency of newly diagnosed type 1 diabetes without evidence of autoimmunity and the respective frequencies of ketoacidosis in children, adolescents, and young adults during the coronavirus disease 2019 (COVID-19) pandemic in Germany compared with the previous decade. RESEARCH DESIGN AND METHODS: Based on data from the German Diabetes Prospective Follow-up Registry (DPV), we compared data from 715 children, adolescents, and young adults, newly diagnosed with type 1 diabetes during the COVID-19 pandemic in Germany between 1 March and 30 June 2020, with data from 5,428 children, adolescents, and young adults of the same periods from 2011 to 2019. Adjusted differences and relative risks (RRs) of negative β-cell autoantibody test results and diabetic ketoacidosis were estimated using multivariable log-binomial regression analysis. An upper noninferiority test (margin 1%) was applied to evaluate whether the autoantibody-negativity rate in 2020 was not higher than that in 2011 to 2019. RESULTS: The estimated frequencies of autoantibody negativity in 2020 and 2011-2019 were 6.6% (95% CI 5.1-8.4) and 7.2% (95% CI 6.5-8.0), respectively, with an absolute difference of -0.68% (90% CI -2.07 to 0.71; P upper noninferiority = 0.023). The increase of the estimated frequency of diabetic ketoacidosis during the COVID-19 pandemic was similar between autoantibody-negative and -positive type 1 diabetes (adjusted RRs 1.28 [95% CI 0.80-2.05] and 1.57 [1.41-1.75], respectively). CONCLUSIONS: This study found no evidence that the COVID-19 pandemic leads to a significantly increased number of new cases with autoantibody-negative type 1 diabetes in children, adolescents, and young adults. In addition, autoantibody-negative type 1 diabetes showed no particular susceptibility to ketoacidosis, neither before nor during the pandemic.
Authors: Osamah M Alfayez; Kholood S Aldmasi; Nada H Alruwais; Nouf M Bin Awad; Majed S Al Yami; Omar A Almohammed; Abdulaali R Almutairi Journal: Front Endocrinol (Lausanne) Date: 2022-03-09 Impact factor: 5.555