The Impact of the COVID-19 Pandemic on the Diagnosis and Epidemiology of Type 1 Diabetes in Children
DOI:
https://doi.org/10.12775/QS.2026.67.74260Keywords
type 1 diabetes', COVID-19, COVID-19 pandemic, epidemiology, pediatric, euglycemic diabetic ketoacidosisAbstract
Background: The SARS-CoV-2 pandemic strained pediatric networks, disrupting the presentation and monitoring of chronic metabolic conditions.
Aim of the study: This evaluation compiles global evidence on shifts in new-onset pediatric type 1 diabetes (T1D) incidence, DKA severity, seasonal deviations, and entry parameters during the COVID-19 era.
Material and methods: Data were harmonized from 14 global cohorts, capturing clinical profiles for >150,000 pediatric and adolescent subjects across the US, UK, Germany, Italy, Spain, Israel, and Canada.
Results: Multi-country datasets confirmed a significant 9.5% to 35% baseline expansion in new-onset T1D, with acute DKA frequencies peaking between 39.4% and 68.2% at admission. Metabolic decompensation advanced during lockdowns, marked by a downward shift in venous pH, a high frequency of clinical shock, and a substantial rise in glycated hemoglobin (HbA1c) at 13.0 ± 1.71%. Interrupted time-series models confirmed that indirect structural disruptions—such as containment-driven care delays—operated as the primary driver of advanced decompensation, rather than direct viral pathways. Vaccination interventions subsequently lowered post-pandemic trends among adolescent groups.
Conclusions: The pandemic accelerated pediatric diabetes severity due to widespread care delays. Mitigating future global shocks requires optimized screening rules, flexible intensive care insulin protocols, and remote telehealth networks.
References
Rahmati, M., Keshvari, M., Mirnasuri, S., Yon, D. K., Lee, S. W., Shin, J. I., & Smith, L. (2022). The global impact of COVID-19 pandemic on the incidence of pediatric new-onset type 1 diabetes and ketoacidosis: A systematic review and meta-analysis. Journal of Medical Virology, 94(11), 5112-5127. https://doi.org/10.1002/jmv.27996
Schiaffini, R., Deodati, A., Rapini, N., Pampanini, V., & Cianfarani, S. (2022). Increased incidence of childhood type 1 diabetes during the COVID-19 pandemic. Figures from an Italian tertiary care center. Journal of Diabetes, 14(8), 562-563. https://doi.org/10.1111/1753-0407.13298
Birkebaek, N. H., Kamrath, C., Grimsmann, J. M., Aakesson, K., Cherubini, V., Dovc, K., de Beaufort, C., Alonso, G. T., Gregory, J. W., White, M., Skrivarhaug, T., Sumnik, Z., Jefferies, C., Hörtenhuber, T., Haynes, A., De Bock, M., Svensson, J., Warner, J. T., Gani, O., Gesuita, R., Schiaffini, R., Hanas, R., Rewers, A., Eckert, A., Holl, R. W., & Cinek, O. (2022). Impact of the COVID-19 pandemic on long-term trends in the prevalence of diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes: an international multicentre study based on data from 13 national diabetes registries. The Lancet Diabetes & Endocrinology, 10(11), 786-794. https://doi.org/10.1016/S2213-8587(22)00246-7
Hernández Herrero, M., Terradas Mercader, P., Latorre Martinez, E., Feliu Rovira, A., Rodríguez Zaragoza, N., & Parada Ricart, E. (2022). New diagnoses of type 1 diabetes mellitus in children during the COVID-19 pandemic. Regional multicenter study in Spain. Endocrinología, Diabetes y Nutrición, 69(9), 709-714. https://doi.org/10.1016/j.endonu.2022.01.001
Jacobs, J., Kim, S., Sheu, Y. S., Chesbrough, K., Bishop, R. C., & Weinfield, N. S. (2026). Trends in the Incidence of Pediatric Type 1 Diabetes, Type 2 Diabetes, and Prediabetes Before and During the COVID-19 Pandemic. Public Health Reports, 141(3), 1-8. https://doi.org/10.1177/00333549251403376
Wu, Z., Wang, J., Ullah, R., Chen, M., Huang, K., Dong, G., & Fu, J. (2024). Covid 19 and diabetes in children: advances and strategies. Diabetology & Metabolic Syndrome, 16(28), 1-13. https://doi.org/10.1186/s13098-024-01267-2
Blumenfeld, O., Rozenshmidt, M., Eini, I., & Laron, Z. (2024). The COVID-19 Pandemic Increased the Incidence of New-Onset Type One Diabetes in Children. Children, 11(2), 142. https://doi.org/10.3390/children11020142
Unsworth, R., Wallace, S., Oliver, N. S., Yeung, S., Kshirsagar, A., Naidu, H., Kwong, R. M. W., Kumar, P., & Logan, K. M. (2020). New-Onset Type 1 Diabetes in Children During COVID-19: Multicenter Regional Findings in the U.K. Diabetes Care, 43(11), e170-e171. https://doi.org/10.2337/dc20-1551
Fotea, S., Ghiciuc, C. M., Stefanescu, G., Cianga, A. L., Mihai, C. M., Lupu, A., Butnariu, L. I., Starcea, I. M., Salaru, D. L., Mocanu, A., Chisnoiu, T., Thet, A. A., Miron, L., & Lupu, V. V. (2023). Pediatric COVID-19 and Diabetes: An Investigation into the Intersection of Two Pandemics. Diagnostics, 13(14), 2436. https://doi.org/10.3390/diagnostics13142436
McGlacken-Byrne, S. M., Drew, S. E. V., Turner, K., Peters, C., & Amin, R. (2021). The SARS-CoV-2 pandemic is associated with increased severity of presentation of childhood onset type 1 diabetes mellitus: A multi-centre study of the first COVID-19 wave. Diabetic Medicine, 38(9), e14640. https://doi.org/10.1111/dme.14640
Ho, J., Rosolowsky, E., Lemay, J. A., Brockman, N., Pacaud, D., Huang, C., Rath, M., & Doulla, M. (2021). Diabetic ketoacidosis at type 1 diabetes diagnosis in children during the COVID-19 pandemic. Pediatric Diabetes, 22(4), 552-557. https://doi.org/10.1111/pedi.13205
Wolf, R. M., Noor, N., Izquierdo, R., Jett, D., Rewers, A., Majidi, S., Sheanon, N., Breidbart, E., Demeterco-Berggren, C., Lee, J. M., Kamboj, M. K., & Ebekozien, O. (2022). Increase in newly diagnosed type 1 diabetes in youth during the COVID-19 pandemic in the United States: A multi-center analysis. Pediatric Diabetes, 23(4), 433-438. https://doi.org/10.1111/pedi.13328
van den Boom, L., Kostev, K., Kuss, O., Rathmann, W., & Rosenbauer, J. (2022). Type 1 diabetes incidence in children and adolescents during the COVID-19 pandemic in Germany. Diabetes Research and Clinical Practice, 193, 110146. https://doi.org/10.1016/j.diabres.2022.110146
Donbaloğlu, Z., Tuhan, H., Tural Kara, T., Bedel, A., Barsal Çetiner, E., Singin, B., & Parlak, M. (2022). The Examination of the Relationship Between COVID-19 and New-Onset Type 1 Diabetes Mellitus in Children. Turkish Archives of Pediatrics, 57(2), 222-227. https://doi.org/10.5152/TurkArchPediatr.2022.21284
Wasilewska, I., Rezmer, J., & Świątek, Ł. (2022). Diabetes mellitus and COVID-19: current state of knowledge. Journal of Education, Health and Sport, 12(8), 1170-1175. https://doi.org/10.12775/JEHS.2022.12.08.101
Kamińska, M., Jasiewicz, M., Miernik-Skrzypczak, M., Spyra, A., Malicka, M., Dąbrowska, N., Kozioł, A., & Moczyróg, K. (2025). The importance of stem cells in the treatment of type 1 diabetes, type 2 diabetes and diabetes complications: The importance of stem cells in diabetology. Quality in Sport, 37, 57420. https://doi.org/10.12775/OS.2025.37.57420
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Copyright (c) 2026 Klaudia Kapelka, Karolina Pyrtek-Kajzer, Dawid Sobański, Wiktor Jabłoński, Adam Perek, Julia Raszewska, Julia Anna Świerczek Świerczek, Weronika Targosz, Gabriela Mandera, Aleksandra Wesołowska
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