Abstract
PURPOSE
To examine whether trends in new-onset pediatric type 2 diabetes (T2D) -- inclusive of patients requiring hospitalization and patients managed outpatient -- were impacted during the COVID-19 pandemic, and to compare patient characteristics prior to and during COVID-19.
METHODS
A retrospective single-center medical-record review was conducted in a hospital which cares for 90% of Alabama’s pediatric T2D patients. Patients with new-onset T2D referred from March 2017-March 2021 were included. Counts of patients presenting per month (“monthly rates”) were computed. Linear regression models were estimated for the full sample and stratified by Medicaid and non-Medicaid insurance status. Patient characteristics prior to versus during COVID-19 were compared.
RESULTS
642 patients presented with new-onset T2D over this period. Monthly rates were 11.1 ± 3.8 prior to COVID-19,19.3 ± 7.8 during COVID-19 (p=0.004). Monthly rates for Medicaid patients differed prior to and during COVID-19 (7.9 ± 3.4 vs 15.3 ± 6.6, p = 0.003) but not for non-Medicaid patients (3.3 ± 1.7 vs 4.0 ± 2.4, p=0.33). Regression results showed significant increases in monthly rates during COVID-19 for the full sample (β=, p<0.05) and for Medicaid enrollees (β=, p<0.05) Hospitalization-rate, severity of obesity, and hemoglobin A1c remained similar prior to and during COVID-19, though the proportion of male patients increased from 36.8% to 46.1% (p=0.021).
CONCLUSIONS
A rise in new-onset T2D was observed among Alabama’s youth during the COVID-19 pandemic, a burden that disproportionately affected Medicaid enrollees and males. Future research should explore the pathways through which the pandemic impacted pediatric T2D.
Keywords: COVID-19, type 2 diabetes, pediatric diabetes, Medicaid