Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Health Policy & Organization, University of Alabama at Birmingham, Birmingham, AL, USA.
J Clin Endocrinol Metab. 2022 Jun 16;107(7):e2777-e2782. doi: 10.1210/clinem/dgac209.
There is concern that the growing incidence of pediatric type 2 diabetes (T2D) may have been further exacerbated by the COVID-19 pandemic.
To examine whether trends in new-onset pediatric T2D-inclusive of patients requiring hospitalization and patients managed as outpatients-were impacted during the COVID-19 pandemic, and to compare patient characteristics prior to and during COVID-19.
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 to 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 vs during COVID-19 were compared.
A total of 642 patients presented with new-onset T2D over this period. Monthly rates were 11.1 ± 3.8 prior to COVID-19 and 19.3 ± 7.8 during COVID-19 (P = .004). Monthly rates for Medicaid patients differed prior to and during COVID-19 (7.9 ± 3.4 vs 15.3 ± 6.6, P = .003) but not for non-Medicaid patients (3.3 ± 1.7 vs 4.0 ± 2.4, P = .33). Regression results showed significant increases in monthly rates during COVID-19 for the full sample (β= 5.93, P < .05) and for Medicaid enrollees (β= 5.42, P < .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 = .021).
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.
人们担心，儿童 2 型糖尿病（T2D）的发病率不断上升，可能因 COVID-19 大流行而进一步加剧。
研究 COVID-19 大流行期间新发儿童 T2D（包括需要住院治疗和门诊管理的患者）的趋势是否受到影响，并比较 COVID-19 前后患者的特征。
对一家医院进行回顾性单中心病历回顾，该医院为阿拉巴马州 90%的儿童 T2D 患者提供服务。纳入 2017 年 3 月至 2021 年 3 月期间新诊断为 T2D 的患者。计算每月就诊的患者人数（“月就诊率”）。对全样本和按医疗补助和非医疗补助保险状况分层的样本进行线性回归模型估计。比较 COVID-19 前后患者的特征。
在此期间，共有 642 例患者新诊断为 T2D。COVID-19 前的月就诊率为 11.1±3.8，COVID-19 期间为 19.3±7.8（P=0.004）。COVID-19 前后医疗补助患者的月就诊率不同（7.9±3.4 vs 15.3±6.6，P=0.003），而非医疗补助患者的月就诊率无差异（3.3±1.7 vs 4.0±2.4，P=0.33）。回归结果显示，全样本（β=5.93，P<0.05）和医疗补助患者（β=5.42，P<0.05）在 COVID-19 期间的月就诊率显著增加。COVID-19 前后，住院率、肥胖严重程度和糖化血红蛋白（HbA1c）仍相似，但男性患者比例从 36.8%增加到 46.1%（P=0.021）。
在 COVID-19 大流行期间，阿拉巴马州的青少年中出现了新发 T2D 的增加，这一负担不成比例地影响了医疗补助患者和男性。未来的研究应探讨大流行影响儿童 T2D 的途径。
