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Updated: Oct 4, 2025

A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
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A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19

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COVID-19-Related Multisystem Inflammatory Syndrome in Children Presenting With New-Onset Type 1 Diabetes in Severe

Hanan H Aly1, Eman M Fouda2, Alyaa A Kotby3

  • 1Division of Pediatric Diabetology, Department of Pediatrics.

Diabetes Care
|February 3, 2022
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) can present with new-onset type 1 diabetes mellitus (T1DM) in severe diabetic ketoacidosis (DKA). Early recognition of this critical overlap is vital for effective patient management.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) can trigger multisystem inflammatory syndrome in children (MIS-C).
  • MIS-C has been associated with various clinical presentations, including cardiac involvement and shock.

Purpose of the Study:

  • To describe cases of pediatric patients with COVID-19-related MIS-C presenting with new-onset type 1 diabetes mellitus (T1DM).
  • To characterize the clinical features and management of children with MIS-C and severe diabetic ketoacidosis (DKA).

Main Methods:

  • Prospective observational study.
  • Inclusion criteria: Children meeting Centers for Disease Control and Prevention and World Health Organization criteria for MIS-C and presenting with new-onset T1DM in DKA.

Main Results:

  • Six critically ill children were identified.
  • All patients presented with severe DKA, non-fluid responsive shock, and cardiac involvement.
  • One patient exhibited a Kawasaki shock-like presentation.
  • Treatment included aggressive fluid management, vasoactive/inotropic support, methylprednisolone, and intravenous immunoglobulins, with immunoglobulins administered after DKA resolution.

Conclusions:

  • Coexistence of MIS-C with new-onset T1DM in DKA requires prompt recognition.
  • Timely and appropriate management is crucial for improving outcomes in these critically ill children.
Abstract

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