Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
Southern California Permanente Medical Group, Pasadena.
JAMA Netw Open. 2023 Sep 5;6(9):e2334953. doi: 10.1001/jamanetworkopen.2023.34953.
Prior research found increases in diabetes among youth during the COVID-19 pandemic, but few studies examined variation across sociodemographics.
To examine diabetes incidence rates among a diverse population of youth in the US before and during the COVID-19 pandemic.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study included data from Kaiser Permanente Southern California (KPSC) between January 1, 2016, and December 31, 2021. KPSC members aged from birth to 19 years with no history of diabetes were included. Individuals were followed up using electronic health records for diabetes incidence defined using diagnoses, laboratory values, and medications. Analyses were conducted between November 2022 and January 2023.
Age- and sex-standardized annual and quarterly incidence rates per 100 000 person-years (PYs) were calculated for type 1 diabetes and type 2 diabetes between 2016 and 2021. Rates were calculated within strata of age (<10 and 10-19 years), sex, and race and ethnicity (Asian/Pacific Islander, Hispanic, non-Hispanic Black, non-Hispanic White, and other/multiple/unknown). Using Poisson regression with robust error variances, incidence rate ratios (IRR) comparing 2020 to 2021 with 2016 to 2019 were calculated by diabetes type and within age, sex, and race and ethnicity strata and adjusting for health care utilization.
Between 2016 to 2021, there were 1200, 1100, and 63 patients with type 1 diabetes (mean [SD] age, 11.0 [4.5] years; 687 [57.3%] male), type 2 diabetes (mean [SD] age, 15.7 [2.7] years; 516 [46.9%] male), and other diabetes, respectively. Incidence of type 1 diabetes increased from 18.5 per 100 000 PYs in 2016 to 2019 to 22.4 per 100 000 PYs from 2020 to 2021 with increased IRRs among individuals aged 10 to 19 years, male individuals, and Hispanic individuals. Incidence of type 2 diabetes increased from 14.8 per 100 000 PYs from 2016 to 2019 to 24.7 per 100 000 PYs from 2020 to 2021 with increased IRRs among individuals aged 10 to 19 years, male and female individuals, and those with Black, Hispanic, and other/unknown race and ethnicity.
In this cohort study of youth in KPSC, incidence of diabetes increased during the COVID-19 pandemic and was more pronounced in specific racial and ethnic groups. Future research to understand differential impacts of physiologic and behavioral risk factors is warranted.
先前的研究发现，在 COVID-19 大流行期间，年轻人中的糖尿病发病率有所上升，但很少有研究检查社会人口统计学方面的差异。
在美国一个多元化的青年人群中，研究 COVID-19 大流行前后糖尿病的发病率。
设计、地点和参与者：这项队列研究纳入了 2016 年 1 月 1 日至 2021 年 12 月 31 日期间南加州凯撒永久（KPSC）的数据。研究对象为 KPSC 会员，年龄从出生到 19 岁，无糖尿病史。使用电子健康记录对糖尿病发病率进行随访，根据诊断、实验室值和药物定义。分析于 2022 年 11 月至 2023 年 1 月进行。
2016 年至 2021 年间，计算了<10 岁和 10-19 岁年龄组、男性和女性以及亚裔/太平洋岛民、西班牙裔、非西班牙裔黑人、非西班牙裔白人以及其他/多种/未知种族和族裔的 1 型和 2 型糖尿病每 10 万人年（PY）的年龄和性别标准化年度和季度发病率。使用泊松回归和稳健误差方差，按糖尿病类型和年龄、性别和种族和族裔分层，计算了 2020 年至 2021 年与 2016 年至 2019 年的发病率比值比（IRR），并调整了医疗保健利用率。
在 2016 年至 2021 年期间，1 型糖尿病患者分别有 1200、1100 和 63 例（平均[标准差]年龄，11.0[4.5]岁；687[57.3%]为男性）、2 型糖尿病患者（平均[标准差]年龄，15.7[2.7]岁；516[46.9%]为男性）和其他糖尿病患者。1 型糖尿病的发病率从 2016 年至 2019 年的每 10 万 PY 18.5 例增加到 2020 年至 2021 年的每 10 万 PY 22.4 例，10-19 岁、男性和西班牙裔个体的 IRR 增加。2 型糖尿病的发病率从 2016 年至 2019 年的每 10 万 PY 14.8 例增加到 2020 年至 2021 年的每 10 万 PY 24.7 例，10-19 岁、男性和女性以及黑种人、西班牙裔和其他/未知种族和族裔的 IRR 增加。
在 KPSC 的这项青年队列研究中，糖尿病的发病率在 COVID-19 大流行期间有所上升，在特定的种族和族裔群体中更为明显。需要进一步研究以了解生理和行为风险因素的差异影响。
