ESPEYB20 10. Type 2 Diabetes, Metabolic Syndrome and Lipid Metabolism New Data on the Epidemiology of T2D in Children (3 abstracts)
10.2. The Coronavirus Disease 2019 pandemic is associated with a substantial rise in frequency and severity of presentation of youth-onset type 2 diabetes
Magge SN , Wolf RM , Pyle L , Brown EA , Benavides VC , Bianco ME , Chao LC , Cymbaluk A , Balikcioglu PG , Halpin K , Hsia DS , Huerta-Saenz L , Kim JJ , Kumar S , Levitt–-Katz LE , Marks BE , Neyman A , O’Sullivan KL , Pillai SS , Shah AS , Shoemaker AH , Siddiqui JAW , Srinivasan S , Thomas IH , Tryggestad JB , Yousif MF , Kelsey MM & Kelsey COVID-19 and Type 2 Diabetes Consortium
J Pediatr. 2022 Dec;251:51–59.e2. doi: 10.1016/j.jpeds.2022.08.010
Brief summary: A significant increase in the incidence T2D occurred in the USA during the COVID-19 pandemic, particularly among children with obesity and males.
Comment: This is the first multicenter report on the incidence of T2D during the first year of the COVID-19 pandemic in the USA. The average number of new diagnoses per year in the two pre-pandemic years was 825, compared with 1463 during the first pandemic year. This increase of 77% is significantly higher than the 5% expected annual increase in incidence observed in the two previous years.
The authors suggest several explanations for the increase in T2D incidence. First is the increased obesity among young people during the COVID-19 pandemic. While substantial weight gain was observed across all weight and age groups during the pandemic, it was substantially greater for children who were already with overweight or obesity.1 Weight gain was accompanied by increased consumption of processed foods and decreased physical activity, both of which contribute to the risk of developing T2D. These may have been the ‘straws that broke the camel’s back’. Another suggested contributor to the pandemic-related increase in T2D is increased psychosocial stress. Finally, non-autoimmune destruction of beta cells due to SARS-CoV-2, results in reduced beta-cell function in adolescents who were predisposed to develop diabetes, was suggested
An additional interesting observation is the increase in the relative proportion of male adolescents with new-onset T2D. This corroborates a publication from Alabama, which showed increased prevalence among males.2 Data from the current study also demonstrated increased severity of the presentation of youth-onset T2D during the pandemic. HbA1c tended to be higher at presentation and a greater proportion presented with metabolic decompensation. This probably reflects delays in seeking care, due to concerns of being exposed to COVID-19.
References: 1. Vogel, M., Geserick, M., Gausche, R. et al. Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic. Int J Obes 46, 144–152 (2022). https://doi.org/10.1038/s41366-021-00968-2. 2. Schmitt JA, Ashraf AP, Becker DJ, Sen B. Changes in Type 2 Diabetes trends in children and adolescents during the COVID-19 pandemic. J Clin Endocrinol Metab. 2022 Jun 16;107(7):e2777–e2782. doi: 10.1210/clinem/dgac209.
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ESPE Yearbook of Paediatric Endocrinology
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