The COVID-19 pandemic is associated with a substantial rise in frequency and severity of presentation of youth-onset type 2 diabetes.

Abstract

Objectives

To evaluate the frequency and severity of new cases of youth-onset type 2 diabetes in the United States during the first year of the pandemic compared with the mean of the prior two years.

Study design

Multicenter (n=24 centers), hospital-based, retrospective chart review. Youth aged ≤ 21 years with newly-diagnosed TYPE 2 DIABETES between March 2018 and February 2021, body mass index ≥ 85th%ile, and negative pancreatic autoantibodies were included. Demographic and clinical data, including case numbers and frequency of metabolic decompensation, were compared between groups.

Results

A total of 3113 youth (mean [SD] 14.4 [2.4] years, 50.5% female, 40.4% Hispanic, 32.7% Black, 14.5% non-Hispanic White) were assessed. New cases of TYPE 2 DIABETES increased by 77.2% in the year during the pandemic (n=1463) compared with the mean of the previous 2 years, 2019 (n=886) and 2018 (n=765). Likelihood of presenting with metabolic decompensation and severe diabetic ketoacidosis also increased significantly during the pandemic.

Conclusions

The burden of newly diagnosed youth-onset type 2 diabetes increased significantly during the COVID-19 pandemic, resulting in enormous strain on pediatric diabetes health care providers, patients, and families. Whether the increase was caused by COVID-19 infection, or just associated with environmental changes and stressors during the pandemic is unclear. Further studies are needed to determine whether this rise is limited to the United States and whether it will persist over time.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1016/j.jpeds.2022.08.010

Publication Info

Magge, Sheela N, Risa M Wolf, Laura Pyle, Elizabeth A Brown, Valeria C Benavides, Monica E Bianco, Lily C Chao, Anna Cymbaluk, et al. (2022). The COVID-19 pandemic is associated with a substantial rise in frequency and severity of presentation of youth-onset type 2 diabetes. The Journal of pediatrics. p. S0022-3476(22)00719-3. 10.1016/j.jpeds.2022.08.010 Retrieved from https://hdl.handle.net/10161/25633.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Gumus Balikcioglu

Pinar Gumus Balikcioglu

Associate Professor of Pediatrics

I have a research interest in the pathogenesis and predictors of progression to Type 2 diabetes in children and adolescents. I examined the relationship between insulin secretion and GAD65 antibody levels at diagnosis on glycemic control in Type 2 Diabetes. I then explored the relationship between body mass index and GAD65 antibody status on β-cell secretion at diabetes onset in African-American children. I subsequently demonstrated that type 2 diabetes in children is associated with abnormalities in cortisol metabolism.

Type 2 diabetes is disproportionately high among African Americans and Hispanic populations and is more common in adolescent females than males despite comparable BMI-z scores. My colleagues and I have explored these differences in a recent analysis of obese adolescents. Using metabolomic profiling, principal components analysis, and regression analysis, we found associations between insulin resistance and a branched chain amino acid-related metabolic signature as well as striking sex dependent differences in metabolic profiles. Our findings are the first to underscore the role of sex differences in metabolic function and outcomes in pediatric obesity. Collectively, my studies have identified strong associations between insulin resistance, cortisol metabolism, and sex steroid action.

I would like to explore if changes in cortisol metabolism and the sex differences in metabolic function is a cause or a consequence of obesity; and if these metabolic findings can predict the development of insulin resistance and type 2 diabetes.

 

 


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