Rates of Diabetes Diagnoses and Diabetic Ketoacidosis Episodes Before Versus During the COVID-19 Pandemic

ObjectivesTo determine whether the incidence of new-onset diabetes mellitus (DM) differed before and during the COVID-19 pandemic, and to compare the severity of diabetic ketoacidosis (DKA) at diagnosis.We hypothesized that DM incidence increased during the COVID-19 pandemic, with a corresponding rise in DKA severity. MethodsWe performed a retrospective analysis of youth (ages 0-18 years) newly diagnosed with DM at a single, freestanding children's hospital in Orlando, Florida.Patients diagnosed prior to the COVID-19 pandemic (September 2017-March 2020) were compared to those diagnosed during the COVID-19 pandemic (March 2020-September 2022).Outcomes included incidence of DM stratified by type (type 1 versus type 2), DKA rates and severity at diagnosis, and subgroup analyses by ethnicity and insurance status. ResultsThe overall incidence of pediatric DM increased during the COVID-19 pandemic without a significant rise in DKA rates or severity.When stratified, only youth with type 2 diabetes showed a significantly higher incidence during the pandemic.Increases in DM diagnoses also were observed among non-privately insured youth and those of Hispanic background. ConclusionsThe COVID-19 pandemic was associated with higher rates of pediatric DM diagnoses, particularly among socioeconomically vulnerable populations without a corresponding increase in DKA severity.These findings suggest a shift in clinical presentation and highlight the disproportionate impact of the pandemic on disadvantaged groups.Further research is warranted to evaluate the long-term influence of COVID-19 on pediatric DM incidence and presentation.