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The incidence of Type 1 diabetes among children and adolescents rose significantly as a result of Covid-19 pandemic, according to a large study.

The study, published in the JAMA Network Open, was conducted as a systematic review and meta-analysis of 42 studies including 1,02,984 youths younger than 19 years.

The results showed that the incidence rate of Type 1 diabetes was 1.14 times higher in the first year and 1.27 times higher in the second year after the onset of the Covid pandemic compared with before the pandemic. There was also an increase in Type-2 diabetes cases among the children and adolescents.

The study also found a higher rate of diabetic ketoacidosis (DKA) incidence -- 1.26 times higher -- during the pandemic compared with before the pandemic.

DKA is most common and a serious complication of type 1 diabetes that can be life-threatening. It develops when the body doesn't have enough insulin to allow blood sugar into the cells for use as energy.

"This study found that incidence rates of Type 1 diabetes and DKA at diabetes onset in children and adolescents were higher after the start of the Covid-19 pandemic than before the pandemic. Increased resources and support may be needed for the growing number of children and adolescents with diabetes," said a team of researchers including from the University of Toronto in Canada.

"We found an increased incidence rate of DKA at diabetes diagnosis among children and adolescents during the pandemic. This is concerning because DKA is preventable and an important cause of morbidity and mortality and is associated with long-term poor glycemic management," they added.

While the researchers said it is unclear what has triggered the surge in cases, there are some theories including that Covid infection can trigger a reaction in some children which increases the risk of diabetes.

Others include changes in lifestyle, change in the pattern of paediatric non-Covid infections, and increased stress and social isolation.

It has also been proposed that frequent respiratory or enteric infections in children are potential triggers for islet autoimmunity, promote progression to overt Type 1 diabetes, or are precipitating stressors.

"Our findings underscore the need to dedicate resources to supporting an acute increased need for paediatric and ultimately young adult diabetes care and strategies to prevent DKA in patients with new-onset diabetes," the researchers said.