Recent studies indicate that the incidence of pediatric type 1 diabetes is increasing.1 However, there is little data on whether the severity of illness at initial diagnosis is increasing. One way to define severity at diagnosis is to review incidence of DKA (Diabetic Ketoacidosis). Patients diagnosed with DKA often present with very high blood sugars and require hospitalization.
In our population of 11,273,734 pediatric patients, there was a slight long-term decrease in the number of patients per month with a new type 1 diabetes diagnosis prior to the COVID-19 pandemic. Early in the pandemic, rates of new pediatric type 1 diabetes decreased alongside the overall drop in healthcare utilization. Rates then rose in the later months of year, as shown in Figure 1.
Figure 2 shows the number of newly diagnosed pediatric type 1 diabetes cases that presented with DKA. During the pandemic, this number increased, indicating a greater severity of diabetes at initial diagnosis. This finding suggests patients might be delaying care during the pandemic until their symptoms become more severe.
In summary, while new diagnoses for pediatric type 1 diabetes did not increase, severity at initial diagnosis did.
