Endocrine Abstracts

JOINT1317

Objective: Viral infections, as environmental factors, significantly influence the onset and progression of Type 1 Diabetes Mellitus (T1DM). The novel coronavirus, in particular, may cause more complex immune disruptions in children, potentially leading to the development of T1DM. This study aims to analyze the impact of the virus on the onset and progression of T1DM by comparing clinical indicators of newly diagnosed T1DM children in Southwest China before and after the pandemic.

Methods: A retrospective analysis was conducted on children initially diagnosed with diabetes in our hospital in 2019 and 2024. Differences in age of onset, glycated hemoglobin levels, and diabetes antibody levels were examined, and their association with COVID-19 infection was analyzed.

Results: In 2019, 87 children were newly diagnosed, compared to 142 in 2024. The proportion of female children was 59. 78% and 59. 15%, respectively. The age of onset was 7. 40±3. 94 years and 8. 13±4. 18 years, respectively. Glycated hemoglobin levels were 12. 93%±2. 49% and 12. 54%±2. 48%, respectively. The proportion of children presenting with ketoacidosis at diagnosis was 59. 78% and 80. 99%, respectively. Among the 2024 cohort, 61. 27% had a history of COVID-19 infection, with an average of 2 years between infection and diabetes diagnosis; 7. 04% had a history of mumps virus infection. Antibody testing (GADA, IAA, INS, ZnT8, IA-2Ab) revealed that in 2019, 63. 22% of patients tested positive for only one antibody, with 45. 98% positive for GADA alone, 41. 38% positive for two or more antibodies, and 29. 89% positive for IA-2Ab. In 2024, 48. 23% tested positive for only one antibody, with 3. 53% positive for GADA alone, 51. 77% positive for two or more antibodies, and 77. 65% positive for IA-2Ab.

Conclusion: The incidence of newly diagnosed T1DM in children increased significantly before and after the COVID-19 pandemic, closely related to COVID-19 infection. Although there were no significant changes in the age of onset, glycated hemoglobin levels, or gender distribution, there were substantial differences in the types and proportions of antibodies, with a more pronounced coexistence of multiple antibodies. This suggests that viral infections may cause pancreatic islet damage through different immune mechanisms, providing clinical evidence for further research into the immune mechanisms of T1DM.