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Updated: Jun 11, 2025
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
Increased incidence of pediatric type 1 diabetes during the pandemic in Biscay, Spain
Concepción Fernández-Ramos1, Eunate Arana-Arri2, Amaia Vela3
1Pediatric Endocrinology Unit, Biobizkaia Health Research Institute, Basurto University Hospital, University of the Basque Country (UPV/EHU), Avenida Montevideo 18, 48013 Bilbao, Bizkaia, Spain.
Insights
The incidence of type 1 diabetes mellitus (T1DM) in children aged 0-14 in Biscay, Spain, has increased recently. This rise, particularly in 5-9 year olds, coincides with the COVID-19 pandemic.
Area of Science:
- Pediatrics
- Endocrinology
- Epidemiology
Background:
- Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition affecting children globally.
- Understanding regional incidence rates and trends is crucial for public health planning and resource allocation.
- Previous studies indicated a period of stability in T1DM incidence in Biscay.
Purpose of the Study:
- To determine the incidence rate (IR) and temporal trends of T1DM in children aged 0-14 years in Biscay, Spain, from 2003 to 2022.
- To analyze age-specific incidence rates and identify trends within different pediatric age groups.
- To compare T1DM incidence during the COVID-19 pandemic with pre-pandemic periods.
Main Methods:
- A capture-recapture method was employed, combining data from hospital registries, diabetes associations, and public health databases.
- Primary and secondary case sources were utilized for comprehensive case ascertainment.
- Age- and sex-standardized incidence rates were calculated using the direct method, with comparisons made between pandemic and pre-pandemic periods.
Main Results:
- A total of 378 new T1DM cases were identified in children aged 0-14 years.
- The mean annual age-standardized IR was 12.92 cases per 100,000 children.
- A statistically significant increasing trend in IR was observed, particularly in the 5-9 year-old group, with a notable 44.5% increase during the pandemic years (2020-2022) compared to pre-pandemic levels (2017-2019).
Conclusions:
- The incidence of T1DM in children under 15 in Biscay has shown a significant increase in recent years, following a period of stability.
- The observed rise in T1DM incidence is consistent with the SARS-CoV-2 pandemic period.
- The 5-to-9-year-old age group experienced the most substantial increase in T1DM incidence.
Objective:
To update the incidence rate (IR) and trends of type 1 diabetes mellitus (T1DM) in children aged 0-14 years from 2003 to 2022, in Biscay, Spain.
Subjects And Method:
We used the capture-recapture method: primary cases were prospectively extracted from the hospital registry and a secondary independent data source was obtained from diabetes associations and a public health database. The IRs standardized by age and sex were calculated using the direct method, assuming an equal distribution in each age/sex group. The IR occurring during the various COVID-19 waves was compared with the pre-pandemic IR.
Results:
A total of 378 new cases were identified. The mean age at diagnosis was 9.7 years (5.8-11.9). The completeness of ascertainment was 99.1%. The mean annual age-standardized IR was 12.92 (95%CI, 11.35-13.91). The mean IRs for the 0-4, 5-9, and 10-14 age groups were 7.67, 13.41 and 17.83 cases/100,000 children/year, respectively. The IR trend was statistically significant in the entire group and in the 5-9 year-old group with a mean annual increase of 1.9% (95%CI, 0.1-3.8) and 3.3% (95%CI, 1.002-1.065); p=0.039. The 5-year period analysis confirmed that the increase was significant only in the last 5 years (20%). When 2020-2022 (pandemic) and 2017-2019 (pre-pandemic) periods were compared this difference goes up to 44.5%; p=0.029.
Conclusions:
After a long period of stability in the IR of T1DM in children younger than 15 years of age in Biscay, Spain, an increase in recent years has been reported, which is consistent with the SARS-CoV2 pandemic, with the largest increase being reported in the 5-to 9-year-old age group.
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