How did the incidence rate develop during the lockdown with regard to stress factors on the one hand but generally less potential exposure to various viral infections on the other? This was investigated by a Germany-wide research group led by DZD scientist Prof. Dr. Reinhard Holl of the University of Ulm. The results of the research team, which were published in the journal Diabetes Care, showed no significant increase in incidence between mid-March and mid-May 2020.

The fact that psychological stress represents a risk factor for type 1 diabetes was shown by the significant increase in new cases in 1986 after the Chernobyl disaster and in 1994 after the earthquake in Los Angeles. However, contact restrictions, day care and school closings, home schooling and possible family conflicts do not appear to have had any direct effects during the observation period.

During the lockdown period between mid-March and mid-May 2020, the incidence rate was still comparable to that of recent years. In 2019 there were 503 newly recorded cases in this period, 531 in the same interval this year. According to Professor Holl, this corresponds to an annual increase within the normal range. The head of the working group for computer-assisted quality monitoring in medicine at the Institute of Epidemiology and Medical Biometry of the University of Ulm and his team had access to data from 216 diabetes centers in Germany.

However, since the contact restrictions reduced the risk of contracting various infections, this other risk factor for type 1 diabetes was lower than usual during the lockdown. Whether these two effects have possibly balanced each other out cannot be proven by this short-term study. According to the researchers, follow-up studies are therefore necessary to understand the medium and long-term effects of the pandemic on the incidence rate. 

Original Publication:
Tittel, S.R., Rosenbauer, J. et al., Did the COVID-19 lockdown affect the incidence of paediatric type 1 diabetes in Germany? Diabetes Care. https://doi.org/10.2337/dc20-1633