Type 1 Diabetes Mellitus in the COVID-19 Era: A Descriptive Cross-Sectional Study from Al-Jabal Al-Akhdar, Libya

Abstract

Type 1 diabetes mellitus (T1DM) requires lifelong insulin therapy. The coronavirus disease 2019 (COVID-19) pandemic may have affected diabetes presentation and care directly through infection and indirectly through disrupted access to health services. This study described selected clinical characteristics of people with T1DM followed at a government diabetes center in eastern Libya and examined the temporal context of COVID-19 in the available records. We conducted a retrospective, descriptive cross-sectional review of 126 records from the Educational Diabetes Center in Al-Jabal Al-Akhdar, Libya, covering November 2017 through March 2022. The source data did not indicate whether the 126 records represented unique individuals or included repeat visits; therefore, all denominators are record-based. The analysis summarized counts and percentages, and calendar-period counts were also expressed as averages per observed month to account for the partial coverage of 2017 and 2022. No inferential tests were performed. Of 126 records, 51 (40.5%) were dated 2021, equivalent to 4.25 records per observed month. Renal impairment was recorded in 6 records (4.8%), myopia in 17 (13.5%), a previous viral infection in 2 (1.6%), an associated condition in 2 (1.6%), injection-site lipodystrophy in 1 (0.8%), and hyperlipidemia in 2 (1.6%). A family history of confirmed COVID-19 before diabetes onset was recorded in 3 records (2.4%); all described female patients who reportedly presented with diabetic ketoacidosis approximately three months after the family infection. The dataset documents a small number of T1DM presentations after reported household COVID-19 exposure. Because exposure was based on family history, patient infection was not established, record uniqueness could not be verified, and the design lacked a population denominator or non-T1DM control group, the findings do not demonstrate that COVID-19 caused or increased the risk of T1DM. Larger controlled studies with verified exposure and standardized outcome definitions are required.