DIABETES AUTOANTIBODIES STATUS IN NEWLY DIAGNOSED CHILDREN AND YOUTH WITH TYPE 1 DIABETES MELLITUS DURING COVID-19 PANDEMIC AT SINGLE SETTING (2020-2021)

ABSTRACT

Background and Aims: Four pancreatic islet cell autoantibodies (Abs) mostly associate with Type 1 diabetes (T1D) - glutamic acid decarboxylase antibodies (anti-GAD65), tyrosine phosphatase antibodies (IA 2-Ab), insulin autoantibody (anti- IAA) and zinc transporter 8 antibody. Aim: To evaluate the frequency of positive islet autoantibodies at T1D diabetes onset in youth at Varna's diabetes center during COVID-19 pandemic (2020-2021). Methods: A total of 66 newly-diagnosed patients were tested for anti-GAD65, anti-IA2 and anti-IAA (2020-2021) by ELISA. Results: The mean age of the participants was 9.0±4.3 years (52% boys), 63.6% were prepubertal. At the onset of T1D, 83.3% were with at least one positive diabetes related autoantibody while 16.7 % were with negative Abs (p < 0.0001). At diagnosis, 6.1% of patients were with 3 positive Abs, 39.3% had 2 Abs and 37.9% had 1 positive Ab. of all positive, 89.1% had anti- GAD65, followed by 60% anti-IA2, and 16.4% anti-IAA positive, resp. (p < 0.01). of all participants, 81.8% had low level of C-peptide. Weak significant correlations were found between positivity for Abs, gender (r = -0.325, p = 0.008) and age (r = 0.259, p = 0.036);as well as between C-peptide levels and age (r = 0.483, p < 0.001), anti-GAD65 (r = -0,210, p = 0.018), and anti-IA2 (r = -0.259, p = 0.036). Four patients were positive for COVID-19 at diagnosis. All of them had low C-peptide levels and at least one positive Ab. Conclusions: Most frequent diabetes associated antibody at our setting was anti-GAD65, followed by anti-IA2 and anti- IAA as reported worldwide. No Abs differences were found between those who were COVID-19 positive at diagnosis, compared to the rest, although the numbers were too small to conclude.