Has COVID-19 Delayed the Diagnosis and Worsened the Presentation of Type 1 Diabetes in Children?

OBJECTIVETo evaluate whether the diagnosis of pediatric type 1 diabetes or its acute com-plications changed during the early phase of the coronavirus disease 2019(COVID-19) pandemic in Italy.RESEARCH DESIGN AND METHODSThiswasacross-sectional,Web-basedsurveyofallItalianpediatricdiabetescentersto collect diabetes, diabetic ketoacidosis (DKA), and COVID-19 data in patientspresenting with new-onset or established type 1 diabetes between 20 February and14 April in 2019 and 2020.RESULTSFifty-three of 68 centers (77.9%) responded. There was a 23% reduction in newdiabetes cases in 2020 compared with 2019. Among those newly diagnosed patientwho presented in a state of DKA, the proportion with severe DKA was 44.3% in2020 vs. 36.1% in 2019 (P50.03). There were no differences in acute complications.Eight patients with asymptomatic or mild COVID-19 had laboratory-confirmedsevere acute respiratory syndrome coronavirus 2.CONCLUSIONSThe COVID-19 pandemic might have altered diabetes presentation and DKA severity.Preparing for any“second wave”requires strategies to educate and reassure parentsabout timely emergency department attendance for non–COVID-19 symptoms.