Has covid-19 delayed the diagnosis and worsened the presentation of type 1 diabetes in children?

I. Rabbone, R. Schiaffini, V. Cherubini, C. Maffeis, A. Scaramuzza, the Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetes

Research output: Contribution to journalArticlepeer-review


OBJECTIVE To evaluate whether the diagnosis of pediatric type 1 diabetes or its acute complications changed during the early phase of the coronavirus disease 2019 (COVID-19) pandemic in Italy. RESEARCH DESIGN AND METHODS This was a cross-sectional, web-based survey of all Italian pediatric diabetes centers to collect diabetes, diabetic ketoacidosis (DKA), and COVID-19 data in patients presenting with new-onset or established type 1 diabetes between 20 February and 14 April in 2019 and 2020. RESULTS Fifty-three of 68 centers (77.9%) responded. There was a 23% reduction in new diabetes cases in 2020 compared with 2019. Among those newly diagnosed patients who presented in a state of DKA, the proportion with severe DKA was 44.3% in 2020 vs. 36.1% in 2019 (P 5 0.03). There were no differences in acute complications. Eight patients with asymptomatic or mild COVID-19 had laboratory-confirmed severe acute respiratory syndrome coronavirus 2. CONCLUSIONS The COVID-19 pandemic might have altered diabetes presentation and DKA severity. Preparing for any “second wave” requires strategies to educate and reassure parents about timely emergency department attendance for non–COVID-19 symptoms. © 2020 by the American Diabetes Association.
Original languageEnglish
Pages (from-to)2870-2872
Number of pages3
JournalDiabetes Care
Issue number11
Publication statusPublished - 2020


  • adolescent
  • Article
  • asymptomatic disease
  • child
  • clinical evaluation
  • coronavirus disease 2019
  • cross-sectional study
  • delayed diagnosis
  • diabetic ketoacidosis
  • disease severity
  • health center
  • health survey
  • human
  • insulin dependent diabetes mellitus
  • Italy
  • major clinical study
  • pandemic
  • Severe acute respiratory syndrome coronavirus 2
  • Betacoronavirus
  • Coronavirus infection
  • female
  • hospital emergency service
  • infant
  • laboratory technique
  • male
  • preschool child
  • virology
  • virus pneumonia
  • Adolescent
  • Child
  • Child, Preschool
  • Clinical Laboratory Techniques
  • Coronavirus Infections
  • Cross-Sectional Studies
  • Delayed Diagnosis
  • Diabetes Mellitus, Type 1
  • Diabetic Ketoacidosis
  • Emergency Service, Hospital
  • Female
  • Humans
  • Infant
  • Male
  • Pandemics
  • Pneumonia, Viral


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