1 - Children’s Hospital Auf Der Bult, Hannover Medical School, Hannover, Germany;
2 - SWEET e.V., Hannoversche Kinderheilanstalt, Hannover, Germany;
3 - Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany;
4 - German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany;
5 - 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary;
6 - Division of Pediatric Endocrinology, Stanford University, Stanford, CA;
7 - Stanford Diabetes Research Center, Stanford, CA;
8 - Diabetes Unit, Bambino GesuChildren’s Hospital, Rome, Italy;
9 - Diabeter, Center for Type 1 Diabetes Care and Research, Rotterdam, the Netherlands;
10 - Department of Diabetes and Endocrinology, Perth Children’s Hospital, Nedlands, Western Australia, Australia;
11 - Changing Diabetes in Children and Life for a Child, Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh;
12 - Pediatric and Adolescent Diabetes Program, Department of Pediatrics, San Camilo Hospital, San Felipe, Chile;
13 - Medicine School, Universidad de Valparaiso, San Felipe, Chile;
14 - The Jesse Z and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel;
15 - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
16 - Unit of Paediatric Endocrinology and Diabetes, Hospital Dona Estefânia, Lisbon, Portugal;
17 - Nova Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- Publicação sob forma de artigo original: texto integral na revista Diabetes Care
OBJECTIVE: To analyze whether the coronavirus disease 2019 (COVID-19) pandemic increased the number of cases or impacted seasonality of new-onset type 1 diabetes (T1D) in large pediatric diabetes centers globally.
RESEARCH DESIGN AND METHODS: We analyzed data on 17,280 cases of T1D diagnosed during 2018–2021 from 92 worldwide centers participating in the SWEET registry using hierarchic linear regression models. RESULTS :The average number of new-onset T1D cases per center adjusted for the total number of patients treated at the center per year and stratified by age-groups in- creased from 11.2 (95% CI 10.1–12.2) in 2018 to 21.7 (20.6–22.8) in 2021 for the youngest age-group, <6 years; from 13.1 (12.2–14.0) in 2018 to 26.7 (25.7–27.7) in 2021 for children ages 6 to <12 years; and from 12.2 (11.5–12.9) to 24.7 (24.0–25.5) for adolescents ages 12–18 years (all P < 0.001). These increases re- mained within the expected increase with the 95% CI of the regression line. How- ever, in Europe and North America following the lockdown early in 2020, the typical seasonality of more cases during winter season was delayed, with a peak during the summer and autumn months. While the seasonal pattern in Europe re- turned to prepandemic times in 2021, this was not the case in North America. Compared with 2018–2019 (HbA1 c 7.7%), higher average HbA1 c levels (2020, 8.1%; 2021, 8.6%; P < 0.001) were present within the first year of T1D during the pandemic.
CONCLUSIONS: The slope of the rise in pediatric new-onset T1D in SWEET centers remained un- changed during the COVID-19 pandemic, but a change in the seasonality at onset became apparent.
Palavras Chave: SWEET; Diabetes; COVID-19