Hospitalization rates for newly-onset type 2 diabetes in children have increased during the pandemic

Young people were more likely to receive an initial diagnosis of type 2 diabetes (T2DM) during the pandemic, while there was a significant increase in the number of new cases of pediatric T2DM during the first 9 months of the crisis. COVID-19, researchers reported. .

Most of these cases involved children and non-Hispanic black men, according to presentations at the American Diabetes Association (ADA) virtual meeting.

The rationale for researchers to conduct these studies of pediatric tertiary care centers was similar: “There is limited type 2 data on the pediatric population” during the pandemic, said Brynn Marks, MD, MSHPEd, of the Children’s National Hospital of Washington.

In the first ADA study, a retrospective chart review, among 2,729 patients admitted to Our Lady of the Lake Children’s Health in Baton Rouge between March and December 2020, 17 children were first diagnosed with T2DM (0, 62%), reported Daniel Hsia, MD, of the Pennington Biomedical Research Center at Louisiana State University in Baton Rouge.

This is an increase from the 0.27% (eight out of 2,964) who were first diagnosed between March and December 2019 (P<0.05). Of the 25 children diagnosed in total, 23 were black and 19 were male, he said.

In addition, the average age of onset of T2DM was 14.3 years in 2020 compared to 13.5 years in 2019 (P= 0.48) with the population limited to people under 19.

In addition, “Although the number of participants was limited and the labs presented were not statistically different, there was a suggestion of an increase in admission acuity in 2020 compared to 2019,” wrote Hsia and colleagues in the ADA presentation.

Patients were identified using ICD-10 codes for T2DM, hyperglycemia, and hyperosmolar hyperglycemia syndrome (HHS), while patients with type 1 diabetes (T1D) and non-hyperglycemia linked to diabetes were excluded.

The number of patients with diabetic ketoacidosis (DKA) has increased from three to eight (P= 0.31), while the number of patients with HHS fell from zero to two (P= 0.45), he reports. Both conditions usually require admission to the ICU. Mean blood sugar increased from 441 to 669 mg / dL (P= 0.14), HbA1c from 12.4% to 13.1% (P= 0.59), and a serum osmolarity of 314 to 335 mmol / kg (P= 0.19).

Orders to stay at home during the pandemic “have limited opportunities for daily physical activity, encouraged more screen time and sedentary behaviors, led to sleep disturbances, and promoted food consumption Ultra-processed Even modest weight gain over a short period of time can increase the risk of long-term consequences such as type 2 diabetes and cardiovascular disease, ”the authors wrote.

“Further studies are needed to better understand the clinical implications of these findings,” they said.

“While our study looked at hospitalizations for type 2 diabetes in children at one center, the results may be a microcosm of what is happening at other children’s hospitals across the country,” Hsia said in a report. Press release. “Unfortunately, COVID-19 has disrupted our lives in more ways than we think. Our study reinforces the importance of maintaining healthy lifestyles for children, even under such difficult circumstances.”

Hsai said his group hopes to share their data with others to see if the results reflect regional or national trends.

Marks and his colleagues conducted a cross-sectional review of their institution’s data, defining “youth” as 21 years of age and under, and defining the data as pre-pandemic from March 11, 2019 to March 10, 2020, while the pandemic data came from March 11. 2020 to March 10, 2021.

The group looked at overall diagnosis rates, demographic and clinical characteristics, and severity of presentation, Marks explained.

They found that T2D diagnoses had nearly tripled from 50 before the pandemic to 141 during the pandemic, and that the increases were significant among non-Hispanic black youth. Diagnoses of T2DM among non-Hispanic blacks as a proportion of all diagnoses increased from 58% to 76.7% (P= 0.06). The percentage of patients diagnosed with T2DM increased from 58% to 41.1% (P= 0.05).

The number of cases per month increased from 0.12 (P= 0.65) to 1.45 (P= 0.001), “and it continued to increase when data collection stopped,” Marks said. The percentage of diagnosed cases of T2DM diagnosed increased from 24% to 44% compared to cases of T1D.

In addition, the number of young people with DKA increased from two to 33 (P= 0.001), while the percentage requiring inpatient care increased from 36% to 60.3%, according to the researchers.

Last updated on June 26, 2021