Impact of COVID-19 on New – onset Type 1 diabetes mellitus: A six-year retrospective review from two Paediatric clinics, Kampala, Uganda

Abstract

Background Type 1 Diabetes Mellitus is one of the most common chronic diseases in children, yet data from low-income countries remains scarce. Recent reports suggest a rising global incidence of new-onset T1DM, projected to double by 2045. The COVID-19 pandemic is believed to have further influenced T1DM onset and severity at presentation, with several studies reporting increased incidence and higher rates of diabetic ketoacidosis (DKA). This study aimed to assess the impact of COVID-19 pandemic on paediatric type 1 diabetes mellitus onset. Methods We conducted a retrospective review of medical records for children aged 6 months to 19 years diagnosed with new-onset T1DM between March 2017 and February 2023 at Mulago and Nsambya hospital’s paediatric diabetes clinics. Clinical and demographic characteristics were compared between the pre-COVID- 19 (March 2017–February 2020) and COVID-19 (March 2020–February 2023) periods using Chi-square and Fisher’s exact tests. Trends in new onset type 1 diabetes were analyzed using interrupted time series with 12 six-month intervals. STATA 17.0 was used for the analysis. Results A total of 245 children were included. The mean age at diagnosis was 10.9 years (SD ± 4.5), with 56% being female. More cases were diagnosed during the COVID-19 period (60.4%, n = 148) compared to the pre-COVID-19 period (39.6%, n = 97), representing a 52% increase, although it was not statistically significant (p = 0.1997). Overall, 66% (n = 162) presented with DKA at diagnosis, with similar proportions in both periods (pre-COVID: 61%, COVID-19: 69%). Conclusion There was a rising trend in T1DM among Ugandan children at Mulago and Nsambya pediatric diabetic clinics, from 2.7 new cases/month during pre-COVID to 4.1/month during the pandemic.