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Background

In a retrospective cohort study of nearly 614,00 individuals aged 10 to 19 years, an increased risk of a new diagnosis of type 2 diabetes (T2D) within 6 months of a COVID-19 diagnosis was observed compared to other respiratory infections.

According to the study "SARS-CoV-2 Infection and New-Onset Type 2 Diabetes Among Pediatric Patients, 2020 to 2022," published in JAMA Network Open in October 2024, understanding the increase of risk related to new diagnosis of T2D, "will add an important component to consideration of the risks and benefits of preventing SARS-CoV-2 infection in children," wrote the study authors.

The study conducted by a team of investigators from the Case Western Reserve University School of Medicine in Cleveland, Ohio, and led by Margaret G. Miller, of the School of Medicine's Center for Artificial Intelligence in Drug Discovery.

The authors noted rates of T2D among children were rising before the COVID-19 pandemic, referencing that between 2001 to 2017, prevalence of T2D in children and adolescents aged 10 to 19 years increased from 0.34 to 0.67 per 1000 youths, a 95% relative increase.

Study details and results

To determine the relationship between COVID-19 and risk of T2D development, the investigators used electronic health records from the TriNetX analytics platforms from January 1, 2020, to December 31, 2022 for children without preexisting diabetes.

The primary outcome was a new diagnosis of T2D compared by risk ratios (RRs) and using 95% CI at 1, 3, and 6 months after index infection.

"Given the possibility of several factors contributing to effect modification, comparisons were also made for subpopulations of children based on body mass index (BMI)," wrote the study authors, along with disease severity, and sex.

Of the 613,602 patients in the main study population, 306,801 had COVID-19, with a mean age at index of 14.9 years and of which 52.8% were female. Other respiratory infections were present in 306,801 individuals in the main study population, but no documented COVID-19 infection. This group had a mean age of 14.9 years and 52.6% were female.

According to results, the risk of a new T2D diagnosis was significantly increased from day of infection to 1, 3, and 6 months following COVID-19 diagnosis compared with the matched cohort with other respiratory infections, with RRs as follows:

• 1 month: 1.55 (95% CI, 1.28-1.89)
• 3 months: 1.48 (95% CI, 1.24-1.76)
• 6 months: 1.58 (95% CI, 1.35-1.85)

Similar results were revealed in the subpopulation classified as having overweight or obesity, with RRs as follows:

• 1 month: 2.07 (95% CI, 1.12-3.83)
• 3 months: 2.00 (95% CI, 2.04-4.71)
• 6 months: 2.27 (95% CI, 1.38-3.75)

"When comparison was restricted to a subpopulation of pediatric patients who had an inpatient encounter within 1 month of documented COVID-19 infection or ORI, a similarly increased risk of developing T2D was seen at all points (RR at 1 month: 3.10 (95% CI, 2.04-4.71); RR at 3 months: 2.74 (95% CI, 1.90-3.96); RR at 6 months: 2.62 (95% CI, 1.87-3.66)," wrote the authors.

Reference:

Miller MG, Terebuh P, Kaelber DC, Xu R, Davis PB. SARS-CoV-2 Infection and New-Onset Type 2 Diabetes Among Pediatric Patients, 2020 to 2022. JAMA Netw Open. 2024;7(10):e2439444. doi:10.1001/jamanetworkopen.2024.39444