Submitting/Presenting Author

Erica Wee, Children's Mercy HospitalFollow

Presenter Status

Fellow

Abstract Type

Research

Primary Mentor

Kelsee Halpin, MD, MPH

Start Date

6-5-2022 12:00 PM

End Date

6-5-2022 12:15 PM

Presentation Type

Oral Presentation

Description

Watch recording of live presentation.

Background The prevalence of type 2 diabetes mellitus (T2D) in youth has increased significantly over the past decades secondary to the increased prevalence of obesity. Epidemiologic data estimates that the incidence of youth-onset T2D increased 5% per year between 2002 and 2012. Recent studies have shown that childhood obesity increased with the COVID-19 pandemic. However, if this resulted in increased incidence of T2D has not been well-reported.

Objectives: This study seeks to evaluate new-onset T2D in youth during the COVID-19 pandemic (March 2020 to February 2021). We examined the frequency of new-onset T2D and proportion of new-onset T2D presenting in diabetic ketoacidosis (DKA) and/or hyperglycemic hyperosmolar state (HHS) during the COVID-19 pandemic compared to the prior 2 years (March 2018 to February 2019 and March 2019 to February 2020).

Study Design: A retrospective chart review of new-onset T2D in patients < 21 years was conducted between March 2018 and February 2021. Demographic and clinical data including frequency of DKA/HHS were collected. DKA defined as bicarbonate < 16 mmol/L. HHS defined as serum osmolality ≥ 330 mOsm/kg and serum glucose >600 mg/dL. Patients with any positive diabetes autoantibody were excluded.

Results: A total of 163 patients (mean [SD] 14.3 [2.3] years, 53% females, 41% Black, 27% Hispanic) were evaluated. Sixty-nine patients were diagnosed with T2D during the pandemic year which was an increase of 47% compared to the mean (n=47) diagnoses per year pre-pandemic. Two of 15 tested were COVID positive. There was no difference in BMI (p=0.440), HbA1c (p=0.584), nor initial glucose (p= 0.184) between pandemic and pre-pandemic groups. There was significantly more newly diagnosed T2D, about 1 in 4, needing inpatient admission at presentation during the pandemic vs. 1 in 20 pre-pandemic (p= 0.001). There was twice the number of patients (n=8) presenting with DKA, of which 3 had both DKA and HHS. These 3 patients with HHS all had initial serum glucose of > 1000 mg/dL. There were no patients who presented with HHS at T2D diagnosis pre-pandemic.

Conclusions: In conclusion, we noted increased incidence of T2D during the pandemic, which was more than anticipated based on epidemiologic data. We also noted a significant increase in the severity of presentation at T2D diagnosis with twice as many DKA/HHS diagnoses and more hospitalizations. Further studies are needed to determine if this increase in incidence and severity will persist over an extended period.

MeSH Keywords

type 2 diabetes; incidence; COVID-19

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May 6th, 12:00 PM May 6th, 12:15 PM

Type 2 Diabetes Mellitus During the COVID-19 Pandemic

Watch recording of live presentation.

Background The prevalence of type 2 diabetes mellitus (T2D) in youth has increased significantly over the past decades secondary to the increased prevalence of obesity. Epidemiologic data estimates that the incidence of youth-onset T2D increased 5% per year between 2002 and 2012. Recent studies have shown that childhood obesity increased with the COVID-19 pandemic. However, if this resulted in increased incidence of T2D has not been well-reported.

Objectives: This study seeks to evaluate new-onset T2D in youth during the COVID-19 pandemic (March 2020 to February 2021). We examined the frequency of new-onset T2D and proportion of new-onset T2D presenting in diabetic ketoacidosis (DKA) and/or hyperglycemic hyperosmolar state (HHS) during the COVID-19 pandemic compared to the prior 2 years (March 2018 to February 2019 and March 2019 to February 2020).

Study Design: A retrospective chart review of new-onset T2D in patients < 21 years was conducted between March 2018 and February 2021. Demographic and clinical data including frequency of DKA/HHS were collected. DKA defined as bicarbonate < 16 mmol/L. HHS defined as serum osmolality ≥ 330 mOsm/kg and serum glucose >600 mg/dL. Patients with any positive diabetes autoantibody were excluded.

Results: A total of 163 patients (mean [SD] 14.3 [2.3] years, 53% females, 41% Black, 27% Hispanic) were evaluated. Sixty-nine patients were diagnosed with T2D during the pandemic year which was an increase of 47% compared to the mean (n=47) diagnoses per year pre-pandemic. Two of 15 tested were COVID positive. There was no difference in BMI (p=0.440), HbA1c (p=0.584), nor initial glucose (p= 0.184) between pandemic and pre-pandemic groups. There was significantly more newly diagnosed T2D, about 1 in 4, needing inpatient admission at presentation during the pandemic vs. 1 in 20 pre-pandemic (p= 0.001). There was twice the number of patients (n=8) presenting with DKA, of which 3 had both DKA and HHS. These 3 patients with HHS all had initial serum glucose of > 1000 mg/dL. There were no patients who presented with HHS at T2D diagnosis pre-pandemic.

Conclusions: In conclusion, we noted increased incidence of T2D during the pandemic, which was more than anticipated based on epidemiologic data. We also noted a significant increase in the severity of presentation at T2D diagnosis with twice as many DKA/HHS diagnoses and more hospitalizations. Further studies are needed to determine if this increase in incidence and severity will persist over an extended period.