Rise in Pediatric Diabetes Cases Continued Through Year 2 of COVID-19 Pandemic

Pinar Gumus Balikcioglu, MD
Credit: Duke University School of Medicine

A study from the Duke University Medical Center is providing further insight into real-world trends in the incidence of pediatric type 1 and type 2 diabetes during the first and second years of the COVID-19 pandemic.

A follow-up to an earlier study, the latest research leveraged EHR data from medical centers in North Carolina and concluded incident cases of type 1 diabetes increased nearly 50% and incident cases of type 2 diabetes more than doubled in 2021-2022 relative to prepandemic years, with type 2 diabetes now accounting for 50% of all newly diagnosed cases of pediatric diabetes.¹

“This has profound implications for long-term complication risks in children and for community health consequences as we may continue to see effects of the pandemic on pediatric diabetes trends,” wrote investigators.¹

Led by Pinar Gumus Balikcioglu, MD, a pediatric endocrinologist at Duke University Medical Center and associate professor of Pediatrics Member of Duke Molecular Physiology Institute, the current study was launched to provide further evidence of trends in incident diabetes during the COVID-19 pandemic, building on a previous study she led examining trends during the first year of the pandemic.¹

In both studies, investigators leveraged data obtained from a retrospective chart review of demographics, anthropometrics, and initial laboratory results from patients ages 0-21 years who presented with new-onset diabetes to a pediatric tertiary care center within the Duke University Health system. In her previous study, which examined a 3-year period from April 1, 2018, through March 31, 2021, results suggested incident cases of type 1 diabetes increased by 48% from 2019 to 2020 while incident cases of type 2 diabetes increased by 231% from 2019 to 2020.^1,2

The current study was designed to examine incident cases of type 1 diabetes and type 2 diabetes in 2021-2022. With this in mind, investigators examined cases of new-onset diabetes during a 4-year period from April 1, 2018, through March 31, 2022.¹

Upon analysis, results indicated incident cases of type 1 diabetes and type 2 diabetes. Investigators underlined this result was consistent with incident cases observed in the first year of the pandemic, where investigators recorded 46 incident cases of type 1 diabetes and 53 incident cases of type 2 diabetes.¹

Relative to the prepandemic years used in the analysis, incident cases of type 1 diabetes increased by 48% and incident cases of type 2 diabetes increased by 188% in 2021-2022. Investigators highlighted type 2 diabetes represented 50% of all newly diagnosed pediatric diabetes cases in 2021-2022. In comparison, type 2 diabetes account for 35% of the newly diagnosed pediatric diabetes cases in 2018-2019 and 34% of these cases in 2019-2020.¹

Investigators also called attention to an apparent increase in likelihood of presenting with diabetic ketoacidosis among those with incident type 2 diabetes, but this failed to reach statistical significance (P = .08). The overall rate of DKA in those with new-onset type 2 diabetes were 12% in 2018-2019, 6% in 2019-2020, 22% in 2020-2021, and 15% in 2021-2022.¹

“This raises great concern for long-term complications and comorbidities leading to profound individual and community health consequences. More longitudinal data are needed to establish if pediatric diabetes trends will return to prepandemic rates, or if this rate of acceleration will persist for years to come,” investigators wrote.¹

References:

1. McIntyre T, Sarah S, Benjamin R, Balikcioglu PG. Disrupted Pediatric Diabetes Trends in the Second Year of the COVID-19 Pandemic. J Endocr Soc. 2023;7(8):bvad092. Published 2023 Jul 1. doi:10.1210/jendso/bvad092
2. Modarelli R, Sarah S, Ramaker ME, Bolobiongo M, Benjamin R, Gumus Balikcioglu P. Pediatric Diabetes on the Rise: Trends in Incident Diabetes During the COVID-19 Pandemic. J Endocr Soc. 2022;6(4):bvac024. Published 2022 Feb 16. doi:10.1210/jendso/bvac024