Frequency of Autoantibody-Negative Type 1 Diabetes in Children, Adolescents, and Young Adults During the First Wave of the COVID-19 Pandemic in Germany.

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.

• Authors: Clemens Kamrath, Joachim Rosenbauer, Sascha R Tittel, Katharina Warncke, Raphael Hirtz, Christian Denzer, Axel Dost, Andreas Neu, Danièle Pacaud, Reinhard W Holl
• Journal: Diabetes care (Diabetes Care) Vol. 44 Issue 7 Pg. 1540-1546 (07 2021) ISSN: 1935-5548 [Electronic] United States
• PMID: 33990377 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 by the American Diabetes Association.

Topics

• Adolescent
• COVID-19
• Child
• Diabetes Mellitus, Type 1 (epidemiology)
• Diabetic Ketoacidosis (epidemiology)
• Germany (epidemiology)
• Humans
• Pandemics
• Prospective Studies
• SARS-CoV-2
• Young Adult