Endocrine Abstracts

Background: There were marked increases in new onset diabetes in adults and children during the COVID-19 pandemic. Studies showed that some adults with COVID-19 and new diabetes went into remission, there are no follow up studies of children who developed diabetes in the pandemic.

Aims and methods: We conducted a medical record review of children with laboratory confirmed SARS-CoV-2 infection and new onset diabetes (n = 13) and compared their outcomes with controls, children diagnosed with new onset diabetes in the pre-pandemic period (n = 26). All participants were recruited from the DIMPLES (Diabetes Mellitus in Children and Young People in the SARS-CoV-2 Pandemic) study. This secondary analysis of the DIMPLES dataset was approved by the HRA (IRAS 287804). For each child with new diabetes in the pandemic period, one random control and one matched control of a child with new diabetes from the pre-pandemic period was chosen. Matching was done for age, gender and ethnicity.

Results: The mean age at diagnosis was 11.1 years (IQR 2.3-15 years). All children had a diagnosis of Type 1 diabetes. 6/13 children with SARS-CoV-2 infection presented with DKA, 8/26 diagnosed in the pre-pandemic period presented with DKA. The mean HbA1c in the COVID-19 group was similar to the control group and tracked at 69 mmol/mol ± 21 mmol at 6 months after diagnosis, 65 mmol/mol ± 19 mmol at 12months, 69 mmol/mol ± 20 mmol at 18 months after diagnosis. The number of hospital admissions for DKA/hypoglycaemia post diagnosis were similar across both groups. One child who was NPA positive for SARS-CoV-2 presented with Grave’s disease and severe DKA at diagnosis. There were no increases in autoimmune conditions in other children who were SARS-CoV-2 positive at 18 months of follow up.

Conclusion: Children who tested positive for SARS-CoV-2 and developed new onset diabetes showed similar outcomes to those who developed diabetes in the pre-pandemic period at 18 months after diagnosis. Unlike adults none of the children had remission of diabetes. All children who developed new onset diabetes had one or more pancreatic autoantibodies suggesting a genetic predisposition to T1DM. Longer term follow up of this cohort is recommended to evaluate for any emerging differences.