incidence of type 1 diabetes before and during the covid-19 pandemic in isfahan, iran

Background: studies suggest a potential global increase in the incidence rate of type 1 diabetes (t1d) following the sars-cov-2 pandemic. this study aimed to assess the incidence of t1d in isfahan province before and during the pandemic to better understand the situation in this population.methods: in this cross-sectional study, we determined the incidence rate of new-onset t1d for the two years preceding the covid-19 pandemic (2018-2019) and during the two years of the pandemic (2020-2021). we also calculated incidence rates each year by sex and age groups (0–4 years, 5–9 years, 10–14 years, and 15–18 years).results: the age-adjusted incidence rates (95% ci) of t1d in isfahan were as follows: 16.38 (16.27-16.49) in 2018, 13.94 (13.51-14.35) in 2019, 13.17 (12.44-13.90) in 2020, and 18.09 (17.17-19.00) in 2021 per 100,000 children. the average annual percent change (apc) was 9.7%, with the highest apc of 37.34% in 2021. there was no statistically significant trend in t1d incidence during the study period (p > 0.05). the frequency of diabetic ketoacidosis (dka) was higher during the covid-19 period in 2020 and 2021 compared to 2018, with rates of 54.89% in 2021, 52.82% in 2020, 52.68% in 2019, and 32.49% in 2018 (p < 0.005).conclusion: this research observed an increasing incidence rate of t1d, particularly in the second year of the covid-19 outbreak. while other studies have also reported an increase in t1d cases, the complex nature of t1d development makes it challenging to draw definitive conclusions about the impact of sars-cov-2 infection on t1d onset.