PT - JOURNAL ARTICLE AU - Ponmani, Caroline AU - Nijman, Ruud G AU - Roland, Damian AU - Barrett, Michael AU - Hulse, Tony AU - Whittle, Victoria AU - Lyttle, Mark D ED - , TI - Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study AID - 10.1136/archdischild-2022-325280 DP - 2023 Oct 01 TA - Archives of Disease in Childhood PG - 799--807 VI - 108 IP - 10 4099 - http://adc.bmj.com/content/108/10/799.short 4100 - http://adc.bmj.com/content/108/10/799.full SO - Arch Dis Child2023 Oct 01; 108 AB - Objectives To describe the incidence of new onset paediatric diabetes mellitus, clinical characteristics and patterns of presentation to emergency departments (ED) during the COVID-19 pandemic, and to assess whether this increase was associated with SARS-CoV-2 infection.Design Retrospective medical record review.Setting Forty nine paediatric EDs across the UK and Ireland.Patients All children aged 6 months to 16 years presenting to EDs with (1) new onset diabetes or (2) pre-existing diabetes with diabetic ketoacidosis (DKA), during the COVID-19 pandemic (1 March 2020–28 February 2021) and the preceding year (1 March 2019–28 February 2020).Results There were increases in new onset diabetes (1015 to 1183, 17%), compared with background incidence of 3%–5% in the UK over the past 5 years. There were increases in children presenting with new onset diabetes in DKA (395 to 566, 43%), severe DKA (141 to 252, 79%) and admissions to intensive care (38 to 72, 89%). Increased severity was reflected in biochemical and physiological parameters and administration of fluid boluses. Time to presentation from symptom onset for children presenting with new onset diabetes and DKA were similar across both years; healthcare seeking delay did not appear to be the sole contributing factor to DKA during the pandemic. Patterns of presentation changed in the pandemic year and seasonal variation was lost. Children with pre-existing diabetes presented with fewer episodes of decompensation.Conclusions There were increases in new onset diabetes in children and a higher risk of DKA in the first COVID pandemic year.Data are available upon reasonable request. Not applicable.