Increase in childhood diabetes cases continues in second year of COVID-19 pandemic

A version of this article was first published HCP Live. This version has been lightly edited.

Pinar Hummus Balikchool, Maryland

A study from Duke University Medical Center provides further insight into real-world trends in the incidence of childhood type 1 (T1D) and type 2 diabetes (T2D) during the first and second years of the novel coronavirus disease (COVID-19) pandemic.

The latest study, which follows on from previous studies, leverages electronic medical record data from North Carolina medical centers and concludes that from 2021 to 2022, the incidence of T1D will increase by nearly 50% compared to pre-pandemic, and the incidence of T2D will more than double, with T2D accounting for 50% of all newly diagnosed pediatric diabetes cases.¹

“This has significant implications for long-term complication risk in children and impact on community health, as the impact of the pandemic on childhood diabetes trends is likely to continue,” the researchers wrote.¹

The study, led by Pinar Gumms Balikchool, M.D., a pediatric endocrinologist at Duke University Medical Center and associate professor of pediatrics at the Duke Institute of Molecular Physiology, was initiated to provide further evidence for trends in diabetes incidence during the COVID-19 pandemic and builds on previous studies she led that looked at trends in the first year of the pandemic.¹

In both studies, researchers leveraged data from a retrospective chart review of demographics, anthropometrics, and first laboratory test results for patients ages 0 to 21 who presented with new-onset diabetes to the Children’s Tertiary Care Center within the Duke University Health System. Her previous study, looking at the three-year period from April 1, 2018 to March 31, 2021, suggested that the number of T1D cases increased by 48% from 2019 to 2020, while the number of T2D cases increased by 231% from 2019 to 2020.^1,2

The current study was designed to investigate the incidence of T1D and T2D over 2021-2022. With this in mind, the researchers investigated new-onset diabetes cases over a four-year period from April 1, 2018 to March 31, 2022.¹

Analysis showed instances of T1D and T2D. The investigators emphasized that the results were consistent with the events observed in the first year of the pandemic, with investigators documenting 46 T1D and 53 T2D cases.¹

There will be a 48% increase in T1D incident cases and a 188% increase in T2D incident cases from 2021 to 2022 compared to the pre-pandemic years used for analysis. The researchers emphasized that T2D will account for 50% of all newly diagnosed childhood diabetes cases in 2021-2022. In contrast, T2D accounted for 35% of newly diagnosed childhood diabetes cases in 2018-2019 and 34% in 2019-2020.¹

The researchers also noted a clear increased likelihood of having diabetic ketoacidosis (DKA) among patients who developed T2D, although this did not reach statistical significance (P. = .08). The overall rate of DKA among new-onset T2D patients was 12% in 2018-2019, 6% in 2019-2020, 22% in 2020-2021, and 15% in 2021-2022.¹

“This raises major concerns about long-term complications and comorbidities that have a significant impact on the health of individuals and communities. Longer-term data are needed to establish whether childhood diabetes trends will return to pre-pandemic levels or whether this accelerating rate will continue for years to come,” the researchers wrote.¹

References:

1. McIntyre T, Sarah S, Benjamin R, Balikchoglu PG. In the second year of the novel coronavirus disease (COVID-19) pandemic, trends in childhood diabetes were disrupted. J Endok Society. 2023;7(8):bvad092. doi: 10.1210/jendso/bvad092
2. Modarelli R, Sarah S, Ramaker ME, Bolobiongo M, Benjamin R, Gumus Balikcioglu P. Rise in childhood diabetes: trends in diabetes incidence during the COVID-19 pandemic. J Endok Society. 2022;6(4):bvac024. doi: 10.1210/jendso/bvac024