New type 2 diabetes more likely in youth after COVID-19 vs. other respiratory diseases
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Key takeaways:
- Youths had a higher risk for developing type 2 diabetes following COVID-19 than other respiratory illnesses.
- The increased risk for type 2 diabetes in overweight or obesity was twice as high with COVID-19.
Children and adolescents diagnosed with COVID-19 were more likely to develop new-onset type 2 diabetes than those who had other respiratory infections, according to data published in JAMA Network Open.
In an analysis of data from health records in the TriNetX database, children and adolescents aged 10 to 19 years diagnosed with COVID-19 from 2020 to 2022 had a higher risk for new-onset type 2 diabetes than those who contracted other respiratory illnesses at 1 month (RR = 1.55; 95% CI, 1.28-1.89), 3 months (RR = 1.48; 95% CI, 1.24-1.76) and 6 months (RR = 1.58; 95% CI, 1.35-1.85) post-infection. The findings confirm data observed in previously published studies and highlight a crucial risk children face when they contract COVID-19, according to Pauline Terebuh, MD, MPH, assistant professor in the center for artificial intelligence in drug discovery at Case Western Reserve University School of Medicine.
“Type 2 diabetes has been increasing among adolescents for decades, which is a worrisome trend,” Terebuh told Healio. “COVID-19 may further increase the risk among adolescents.”
Terebuh and colleagues identified youths who did not have preexisting diabetes and were diagnosed with a respiratory illness from ICD-10 codes. Other respiratory illnesses included influenza, pneumonia and other acute upper respiratory or lower respiratory infections. Children and adolescents in the other respiratory infection group had no record of a positive SARS-CoV-2 test, SARS-CoV-2 antibodies or COVID-19 diagnosis during the study period. New-onset type 2 diabetes diagnoses were also identified through ICD-10 codes.
The database included 306,864 youths who had COVID-19 and 611,008 children and adolescents with other respiratory illnesses. Propensity-score matching was performed to form a group of 306,801 children and adolescents with COVID-19 (52.8% girls; mean age, 14.9 years) and 306,801 youths with other respiratory illnesses (52.6% girls; mean age 14.9 years).
The COVID-19 group had a higher risk for new-onset type 2 diabetes than the other respiratory illnesses group at all three follow-up timepoints. In a subanalysis of youths with at least one BMI measure indicating overweight or obesity, those who previously had COVID-19 were twofold more likely to develop type 2 diabetes than those with other respiratory illnesses at 1 month (RR = 2.07; 95% CI, 1.12-3.83), at 3 months (RR = 2; 95% CI, 1.15-3.47) and at 6 months (RR = 2.27; 95% CI, 1.38-3.75).
In another subanalysis only including children and adolescents who had an inpatient visit within 1 month of infection, those who had COVID-19 were more likely to develop type 2 diabetes at 1 month (RR = 3.1; 95% CI, 2.04-4.71), 3 months (RR = 2.74; 95% CI, 1.9-3.96) and 6 months (RR = 2.62; 95% CI, 1.87-3.66) than those who had another respiratory disease.
“People with diabetes have increased medical costs and are at risk for complications down the road,” Terebuh told Healio. “If diabetes starts earlier in life, our youth will be carrying that burden for many years. All potential contributors to that trend are deserving of our attention, including COVID-19 and increasing prevalence of obesity.”
Future studies should examine whether GLP-1 receptor agonists and other new diabetes and obesity medications could have a role in treating youths who develop type 2 diabetes following COVID-19, Terebuh said in an interview.
For more information:
Pauline Terebuh, MD, MPH, can be reached at pdt@case.edu.
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