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2019 年冠状病毒病大流行与青年 2 型糖尿病发病频率和严重程度的显著升高有关。

The Coronavirus Disease 2019 Pandemic is Associated with a Substantial Rise in Frequency and Severity of Presentation of Youth-Onset Type 2 Diabetes.

机构信息

Division of Pediatric Endocrinology and Diabetes, Johns Hopkins Hospital/Johns Hopkins University School of Medicine, Baltimore, MD.

Department of Pediatrics, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, CO.

出版信息

J Pediatr. 2022 Dec;251:51-59.e2. doi: 10.1016/j.jpeds.2022.08.010. Epub 2022 Aug 17.

Abstract

OBJECTIVES

To evaluate the frequency and severity of new cases of youth-onset type 2 diabetes in the US during the first year of the pandemic compared with the mean of the previous 2 years.

STUDY DESIGN

Multicenter (n = 24 centers), hospital-based, retrospective chart review. Youth aged ≤21 years with newly diagnosed type 2 diabetes between March 2018 and February 2021, body mass index ≥85th percentile, and negative pancreatic autoantibodies were included. Demographic and clinical data, including case numbers and frequency of metabolic decompensation, were compared between groups.

RESULTS

A total of 3113 youth (mean [SD] 14.4 [2.4] years, 50.5% female, 40.4% Hispanic, 32.7% Black, 14.5% non-Hispanic White) were assessed. New cases of type 2 diabetes increased by 77.2% in the year during the pandemic (n = 1463) compared with the mean of the previous 2 years, 2019 (n = 886) and 2018 (n = 765). The likelihood of presenting with metabolic decompensation and severe diabetic ketoacidosis also increased significantly during the pandemic.

CONCLUSIONS

The burden of newly diagnosed youth-onset type 2 diabetes increased significantly during the coronavirus disease 2019 pandemic, resulting in enormous strain on pediatric diabetes health care providers, patients, and families. Whether the increase was caused by coronavirus disease 2019 infection, or just associated with environmental changes and stressors during the pandemic is unclear. Further studies are needed to determine whether this rise is limited to the US and whether it will persist over time.

摘要

目的

评估美国在大流行期间第一年新出现的青年 2 型糖尿病病例的频率和严重程度与前 2 年的平均值相比。

研究设计

多中心(n=24 个中心)、基于医院的回顾性病历审查。纳入年龄≤21 岁、新诊断为 2 型糖尿病、体重指数≥第 85 百分位数且阴性胰腺自身抗体的患者。比较两组之间的人口统计学和临床数据,包括病例数和代谢失代偿的频率。

结果

共评估了 3113 名青少年(平均[SD]14.4[2.4]岁,50.5%为女性,40.4%为西班牙裔,32.7%为黑人,14.5%为非西班牙裔白人)。与前 2 年(2019 年,n=886;2018 年,n=765)相比,大流行期间(n=1463)新诊断的 2 型糖尿病病例增加了 77.2%。代谢失代偿和严重糖尿病酮症酸中毒的发生几率也显著增加。

结论

在 2019 冠状病毒病大流行期间,新诊断的青年 2 型糖尿病患者的负担显著增加,这给儿科糖尿病医疗保健提供者、患者和家庭带来了巨大压力。增加是否是由 2019 冠状病毒病感染引起的,还是仅仅与大流行期间的环境变化和压力因素有关尚不清楚。需要进一步研究以确定这种上升是否仅限于美国,以及它是否会随着时间的推移而持续。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f1a/9383958/ee20f11caa14/gr1_lrg.jpg

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