New-onset diabetes diagnoses increased for youths during COVID-19 pandemic
Click Here to Manage Email Alerts
Key takeaways:
- More children and adolescents were diagnosed with diabetes annually in 2020 and 2021 compared with 2016 to 2019.
- Incidence rates for type 2 diabetes climbed for teens, Black youths and Hispanic youths.
Incidence rates for both type 1 and type 2 diabetes diagnoses increased among children and adolescents during the COVID-19 pandemic compared with 2016 to 2019, according to study findings published in JAMA Network Open.
“In this cohort study of youth less than 20 years of age in Kaiser Permanente Southern California, rates of new-onset diabetes increased during the COVID-19 pandemic and were more pronounced in specific racial-ethnic groups,” Matthew T. Mefford, PhD, research scientist in the department of research and evaluation at Kaiser Permanente Southern California, told Healio. “These findings highlight the importance for clinicians and care providers to screen thoughtfully for youth-onset diabetes and for providers and families to emphasize healthy lifestyles and activity for children across the age spectrum.”
Mefford and colleagues conducted a retrospective cohort study of children and adolescents aged 19 years and younger who were members of Kaiser Permanente from 2016 to 2021. Diabetes incidence rates for determined for each year. Children were considered to have diabetes if they had two or more diagnoses on separate days, one diabetes diagnosis and one outpatient prescription for a diabetes medication, one diagnosis and two or more abnormal laboratory results indicative of diabetes, or one inpatient primary discharge diagnosis of diabetes plus one outpatient indicator of diabetes. Diabetes type was determined through diagnosis codes. Demographics, BMI, laboratory results and health care utilization were collected.
During the full study period, 1,200 youths were diagnosed with type 1 diabetes, 1,100 were diagnosed with type 2 diabetes and 63 had a diabetes diagnosis with no specified type.
The incidence rate for type 1 diabetes was higher from 2020 to 2021 compared with 2016 to 2019 (incidence rate ratio [IRR] = 1.17; 95% CI, 1.04-1.31). Incidence rates for type 1 diabetes increased among those aged 10 to 19 years (IRR = 1.17; 95% CI, 1.01-1.36), boys (IRR = 1.18; 95% CI, 1-1.39) and Hispanic youths (IRR = 1.21; 95% CI, 1.01-1.44).
Incidence rates for type 2 diabetes were also higher in 2020 to 2021 compared with 2016 to 2019 (IRR = 1.62; 95% CI, 1.43-1.82). Type 2 diabetes rates increased in 2020 to 2021 compared with the 4 prior years for children aged 10 to 19 years (IRR = 1.63; 95% CI, 1.44-1.84), girls (IRR = 1.44; 95% CI, 1.22-1.69), boys (IRR = 1.83; 95% CI, 1.54-2.17), Black youths (IRR = 1.95; 95% CI, 1.41-2.68) and Hispanic children (IRR = 1.61; 95% CI, 1.39-1.86).
When incidence rates were analyzed quarterly, the rate of type 1 diabetes diagnoses declined from 26.2 per 100,000 person-years in the first quarter of 2016 to 18.3 per 1,000 person-years in the fourth quarter of 2021, though rates climbed for children aged 0 to 9 years and for Asian and Pacific Islander youths during that same period. The rate of type 2 diabetes diagnoses increased from 18.4 per 100,000 person-years in the first quarter of 2016 to 20.3 per 100,000 person-years in the fourth quarter of 2021. Type 2 diabetes rate increases were observed in all age groups, boys, Asian and Pacific Islanders youths, Black children and white youths. Between the second quarter of 2020 and the fourth quarter of 2020, Black and Hispanic youths had a large increase in incident type 2 diabetes diagnoses.
“We did not examine specific reasons for the increase in new-onset diabetes during the pandemic in the current study,” Mefford said. “However, prior research has suggested, among other reasons, biologic effects of COVID-19 infection and increases in sedentary lifestyle behaviors, sleep disturbances and poorer eating habits which may have occurred during the pandemic.”
Mefford said more studies are needed to analyze physiologic and behavioral risk factors for children and adolescents who were diagnosed with new-onset diabetes during 2020 and 2021.
For more information:
Matthew T. Mefford, PhD, can be reached at matthew.t.mefford@kp.org.
Perspective
Back to Top
Increasing rates of both type 1 and type 2 diabetes have been observed for many years. In the present study, type 1 diabetes incidence increased from 19.55 to 24.27 per 100,000 between 2016 and 2021, which is in line with the previously reported 3% to 5% increase per year and other recently published reports. Therefore, it is unclear how much of the change may be attributed to the pandemic. However, the incidence of type 2 diabetes increased from 15.66 to 29.44 per 100,000 in the same period. Not only did the rate double, but there were more incident cases of type 2 than type 1 in 2021 with a greater portion of the increase occurring in Black and Hispanic children. This means there are almost certainly pandemic-related factors that need to be understood and addressed, and doing so will push back against growing health outcomes inequalities in U.S. youth.
Collapse
Read more about
Click Here to Manage Email Alerts