15-OR: The COVID-19 Pandemic and New-Onset Pediatric Type 2 Diabetes
| Autor: | Maureen Monaghan, Jiaxiang Gai, Aneka Khilnani, Randi Streisand, Brynn E. Marks, Abby G. Meyers, Jennifer Boughton, Doris E. Estrada |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty endocrine system diseases Coronavirus disease 2019 (COVID-19) business.industry Endocrinology Diabetes and Metabolism Ethnic group nutritional and metabolic diseases Type 2 diabetes medicine.disease Tertiary care Health equity New onset Chart review Pandemic Internal Medicine medicine business |
| Zdroj: | Diabetes. 70 |
| ISSN: | 1939-327X 0012-1797 |
| Popis: | Introduction: Reports are emerging about the impact of the COVID-19 pandemic on pediatric T1D, however few studies have explored pediatric T2D. We aimed to investigate changes in T2D initial clinical presentation and patient demographic characteristics during COVID-19. Methods: A retrospective cross-sectional review of youth diagnosed with T2D during the COVID-19 pandemic (3/11/2020-11/30/2020) and in the time matched period in 2019 was conducted at a pediatric tertiary care center. BMI Z-score (>1.64), age (>8) and the absence of DKA and autoantibodies at diabetes diagnosis (A1c >6.5%) were used to screen for T2D, with confirmation by chart review. Chi-square, Fisher’s exact, and independent samples t-tests were used for analyses. Results: During the pandemic, cases of T2D increased 233% from 2019 (n=36, Mage=14.1±2.6 years, 56% F) to 2020 (n=84, Mage=14.6±2.2 years, 42% F). Rates of new onset T2D increased as the pandemic continued, from 4-8 per month in April-June to 20 and 16 cases, respectively, in October and November. Only 3 youth were actively infected with COVID-19 at T2D diagnosis. Rates of DKA at diagnosis increased from 6% in 2019 to 21% in 2020 (p=0.03), with 6 cases of hyperosmolar DKA during the pandemic as compared to none in 2019. Before the pandemic, 53% of youth diagnosed with T2D were Black, compared to 77% during the pandemic (p=0.03). Similar increases were seen among those with public insurance, rising from 67% to 86% (p=0.02). Conclusions: Cases of T2D and severity of initial presentation increased during the first 9 months of the COVID-19 pandemic, particularly among Black and publicly insured youth. These findings align with prior reports highlighting the disproportionate impact of the COVID-19 pandemic on racial/ethnic and socioeconomically disadvantaged communities. As few youth were infected with COVID-19 at T2D diagnosis, pandemic-related social distancing measures may also have disproportionate impacts on these communities and serve to worsen pre-existing health disparities. Disclosure B. E. Marks: None. A. Khilnani: None. A. Meyers: None. D. E. Estrada: None. J. Boughton: None. J. Gai: None. R. Streisand: None. M. Monaghan: None. |
| Databáze: | OpenAIRE |
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