Impact of SARS‐CoV2 on youth onset type 2 diabetes new diagnoses and severity

Abstract

Introduction Initial reports show an increase in youth onset type 2 diabetes during the COVID‐19 pandemic. We aim to expand on existing evidence by analyzing trends over a longer period. Objectives Our study aims to describe change in the amount, severity, and demographics of youth onset type 2 diabetes diagnoses during the COVID‐19 pandemic compared to the five years before. Methods We performed a retrospective cross‐sectional review of youth (age ≤ 21) diagnosed with type 2 diabetes during the COVID‐19 pandemic (1 May 2020–30 April 2021) and the five years before (1 May 2015–30 April 2020) at a tertiary care center. Children were identified by International Classification of Diseases codes. Charts were reviewed to confirm diagnosis. Chi‐square, t tests, and Fisher's exact tests were used for analyses. Results In the prepandemic era annual diagnoses of type 2 diabetes ranged from 41–69 (mean = 54.2), whereas during the pandemic period 159 children were diagnosed, an increase of 293%. The increase resulted in a higher incidence rate ratio during the pandemic than before, 2.77 versus 1.07 ( p = .006). New diagnoses increased most, by 490%, in Non‐Hispanic Black patients. The average HbA 1c at presentation was higher during the pandemic (9.5% ± 2.6) (79.9 mmol/mol ± 28.2) than before (8.7%±2.1) (72.1 mmol/mol ± 23.1) ( p = .003). Of those diagnosed during the pandemic, 59% were tested for COVID‐19 and three tested positive. Conclusions New diagnoses of type 2 diabetes increased during the pandemic, most notably in Non‐Hispanic Black youth. There was not a significant correlation found with clinical or biochemical COVID‐19 infection in those tested.

The COVID‐19 lockdown increased obesity disparities; will the increases in type 2 diabetes continue?

“…Rates of prediabetes were increasing in 12‐ to 19‐year‐old youth prior to the pandemic [ 11 ], and the prevalence of prediabetes was greater among 12‐ to 19‐year‐old Black and Hispanic individuals in the 2015 to 2018 NHANES cycles [ 11 ]. Several studies have demonstrated marked increases in type 2 diabetes (T2DM) among adolescents during the pandemic that ranged from 77% to 293%, with greater increases in Black and Hispanic youth compared with White youth [ 12 , 13 , 14 ]. Severe obesity was already present in many of those who developed T2DM [ 13 , 14 ].…”

“…Several studies have demonstrated marked increases in type 2 diabetes (T2DM) among adolescents during the pandemic that ranged from 77% to 293%, with greater increases in Black and Hispanic youth compared with White youth [ 12 , 13 , 14 ]. Severe obesity was already present in many of those who developed T2DM [ 13 , 14 ]. In the only study, to our knowledge, that examined weight gain immediately prior to diagnosis, weight increased by a median of 11 kg (interquartile range: 6.1‐17.7 kg) [ 14 ].…”

Multiple influences of the COVID-19 pandemic on children with diabetes: Changes in epidemiology, metabolic control and medical care

“…As an example, its incidence increased in Florida from 14.6/100000 pre-pandemic to 16.9/100000 in the first quarter of 2020[ 33 ]. There was a 293% increase in Illinois[ 34 ] and a 225% increase in Wisconsin[ 35 ] compared to the pre-pandemic mean. As expected, the increase was greater among certain racial and ethnic subgroups, particularly among the Hispanic and Black population.…”

Anti-racist strategies for clinical and translational research: Design, implementation, and lessons learned from a new course

“…Ten were published by a student with a faculty appointment [34][35][36][37][38][39][40][41][42][43]. Overall, there were 3 case reports [34,44,45], one case series [46], 2 editorials [41,43], 2 letters [37,47], 2 review articles [48,49], 7 systematic reviews [35,36,[38][39][40]42,50], 2 retrospective cohort studies [51,52], an evaluation of mobile health applications [53], and a medical education report. [54] One case report noted the subject's race, without further comment [44].…”

“…All retrospective cohort studies used race as a demographic variable, but there was variability in whether methods of collection were described and what categories were used. One found that Hispanic ethnicity was a risk factor for youth onset type 2 diabetes and discussed limitations of electronic health record data and impact of social determinants of health [51]. Other articles did not present data on race or ethnicity.…”