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Updated: Oct 14, 2025
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
SARS-CoV-2 infection in hospitalized children with type 1 and type 2 diabetes
Connie Trieu1, Bhuvana Sunil2, Ambika P Ashraf2
1Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, United States of America.
Insights
The COVID-19 pandemic may have increased new-onset type 1 and type 2 diabetes in children. This includes a rise in diabetic ketoacidosis (DKA), requiring further pediatric research.
Area of Science:
- Pediatric Endocrinology
- Infectious Diseases
- Public Health
Background:
- Diabetes mellitus is a known risk factor for severe illness in adults with SARS-CoV-2.
- Conflicting data exists regarding the impact of SARS-CoV-2 on pediatric diabetes.
- This study investigates the incidence and characteristics of new-onset diabetes in children during the COVID-19 pandemic.
Observation:
- A significant increase in new-onset type 1 diabetes (T1DM) and type 2 diabetes (T2DM) was observed between April-November 2020 compared to 2019.
- Rates of new-onset T1DM increased by 16.3%, and insulin-dependent T2DM by 205.3%.
- A higher proportion of children with new-onset T1DM presented with diabetic ketoacidosis (DKA) in 2020 compared to previous years.
Findings:
- During the study period, 28 children were diagnosed with both COVID-19 and diabetes.
- Two cases of COVID-19 with diabetes and DKA required intensive, prolonged insulin therapy.
- The incidence of new-onset T1DM, T2DM, and DKA in children and adolescents may be elevated due to the COVID-19 pandemic.
Implications:
- The COVID-19 pandemic may be linked to increased rates of new-onset pediatric diabetes and DKA.
- Clinical presentations and outcomes of diabetes in children with COVID-19 may differ from non-pandemic periods.
- Further pediatric-specific research is crucial to understand the role of SARS-CoV-2 in pediatric diabetes.
Context:
While diabetes is a risk factor for severe illness from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in adults, there is conflicting data surrounding the relationship between the virus and diabetic disease process in children.
Objective:
This case series aims to illustrate an increase in the incidence of types 1 and 2 diabetes mellitus (T1DM, T2DM) between April - November 2020 at a large tertiary care children's hospital and examine the characteristics and adverse outcomes in these children. In addition, two children with significant complications from coronavirus disease 2019 (COVID-19) and diabetes are highlighted.
Methods:
Hospitalized children with T1DM or T2DM and SARS-CoV-2 infection were identified, and electronic medical records were reviewed.
Results:
We observed a 16.3% increased rate of new-onset T1DM and 205.3% increased rate of new-onset insulin-dependent T2DM between April and November 2020 when compared to the same observational time frame in 2019. Among children with new-onset T1DM, 56.9% presented with DKA in 2019 and 47.1% in 2018 compared to 64.3% in 2020, which was higher than the national average. Twenty-eight children were diagnosed with COVID-19 and diabetes during this time. The 2 described cases with significant complications from COVID-19 and DKA required large doses of intravenous insulin over a prolonged duration.
Conclusion:
This study highlights that the COVID-19 pandemic might have led to an increased rate of new-onset T1DM, T2DM, and DKA in children and adolescents compared to a similar time frame in the prior 2 years. The clinical phenotypes and outcomes in children with diabetes to COVID-19 infection may be distinct and therefore, future pediatric specific studies are needed to define the role of SARS-CoV-2.
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