Pandemic associated with spike of diabetes among children

October 5, 2023

Diabetes in Those Under Age 20

Source: Mefford, et al JAMA Network Open, September 21, 2023 LINK

Researchers for Kaiser Permanente of Southern California recently published data in JAMA Network Open showing impressive increases in both Type 1 and Type 2 diabetes among those below age 20. They used the data warehouse from their electronic health record, which has data on 4.8 million health plan members. Electronic health records are often clinically more accurate than health plan claims, although the data is more difficult to analyze as it is often unstructured. Age standardized risk for diabetes over this period went up from 19.55 to 24.27 per 100,000 children - a 20% increase.

It’s not a surprise that the pandemic led to an increase in cases of diabetes among children. Type 1 diabetes, an autoimmune phenomenon, often follows a viral illness. Type 2 diabetes, often associated with obesity, is likely to increase as weight crept up during the pandemic, too.

Diabetes is one of many inflammatory illnesses which are seen at a higher rate following a COVID-19 infection. Data also shows an increased risk of autoimmune diseases including rheumatoid arthritis, lupus and inflammatory bowel disease, and an increased risk of cardiovascular disease, including both heart attacks and strokes. These are all associations and causality has not been proven. In some instances, people might have had an underlying disease which was only diagnosed because they sought medical attention for their COVID-19.

It’s reassuring to see the rate of new cases of diabetes declining in the later years of this study. But although incidence rates (new cases of diabetes) went down in 2021, this spike of newly diagnosed people with diabetes in 2020 will mean that the prevalence of diabetes will continue to be higher in this generation.

Implications for employers:

-        Higher rates of diseases including diabetes in those who have had COVID-19 could lead to higher medical costs in the future.

-        Employers can continue to encourage COVID-19 vaccinations as a method to decrease overall health care risk. The Advisory Committee on Immunization Practices found that the medical advantages outweigh any disadvantages in every age group.

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