Trends in the Incidence of Pediatric Type 1 Diabetes, Type 2 Diabetes, and Prediabetes Before and During the COVID-19 Pandemic.

OBJECTIVES

It is unclear how the incidence of each pediatric diabetes subtype changed during the COVID-19 pandemic. We assessed changes in the incidence of pediatric type 1 diabetes, pediatric type 2 diabetes, and prediabetes during the COVID-19 pandemic.

METHODS

We analyzed data from young people aged <19 years without prior diabetes in a large integrated US health care system from March 2017 through February 2023 using interrupted time-series analyses to compare prepandemic and pandemic rates and trends in the incidence of type 1 diabetes, type 2 diabetes, and prediabetes.

RESULTS

Of 288 574 pediatric patients, 242 were diagnosed with type 1 diabetes, 239 with type 2 diabetes, and 4438 with prediabetes. The incidence of type 1 diabetes did not change after pandemic onset in the interrupted time-series analysis. Although the incidence of type 2 diabetes and prediabetes changed with a single interruption analysis, an exploratory model of 2 interruptions revealed a better fit for each: for type 2 diabetes, the model showed a significant rise (128%; P < .001) and subsequent decrease after the early pandemic period; for prediabetes, it revealed a 142% increase (P = .005) with a rising trend (12% per month) early in the pandemic, followed by a 9% monthly downward trend.

CONCLUSION

Among this population, the COVID-19 pandemic did not affect the incidence of pediatric type 1 diabetes but was associated with significant increases in the incidence of type 2 diabetes and prediabetes, particularly early in the pandemic. Future work can build on these results to better understand how pandemic-related factors, including activity restrictions and COVID-19 disease, affected rates of pediatric type 2 diabetes and prediabetes and inform future public health practices.