The Rise of Pediatric Type 2 Diabetes During the COVID-19 Pandemic

The COVID-19 pandemic has affected us all in so many ways. The impact of the virus itself has left lasting effects on our health. But the pandemic also affected our health and the health of our children in other ways.

According to a new study by Johns Hopkins Medicine, there was a significant increase in the rate of type 2 diabetes among children during the COVID-19 pandemic. New cases increased in 2020 by 77% compared to 2018 through 2019. This new study looks at why there was such a vast increase in cases. As parents, you might be wondering what you need to know about your child potentially developing type 2 diabetes, and how you can prevent it. 

Does COVID-19 Cause Type 2 Diabetes?

According to the study, there is not a clear connection between the rise of pediatric type 2 diabetes and the COVID-19 virus itself. It's more a cause and effect of clear lifestyle changes brought on by quarantine and isolation.

Researchers point to the shutdown of school activities and the switch to virtual learning, which led to a decrease in physical activity and an increased risk of the onset of type 2 diabetes. While we were all quarantined in our homes, often we found ourselves snacking and eating unhealthy. Without being able to take part in our usual activities, we were all more sedentary as well.

Risa Wolf, MD a Pediatric Endocrinologist and Assistant Professor of Pediatrics at Johns Hopkins University School of Medicine says a, "more sedentary lifestyle while doing virtual education, less participation in organized sports for kids, and unhealthy eating habits that contributed to weight gain and obesity, and the development of type 2 diabetes."

What is Type 2 Diabetes?

Type 2 diabetes is a long-term condition that impairs the way the body regulates and uses glucose, which is also known as blood sugar. Insulin is a hormone made in the pancreas which lets that blood sugar into your body's cells to use as energy. With type 2 diabetes, these cells do not respond normally to insulin.

As a result, your pancreas makes more insulin to try to get the cells to respond. Your pancreas can’t keep up with that demand, and your blood sugar rises. High blood sugar is damaging to the body and can cause other serious health problems, such as heart disease, kidney disease, and vision loss.

According to Katherine Williamson, MD a pediatrician and a spokesperson for the American Academy of Pediatrics, type 2 diabetes used to only affect adults, but there has been an increase in cases of children and teens being diagnosed.

“The first signs of diabetes in a child or teen may be very subtle, and can include an increase in thirst or hunger, increased fatigue, darkening of the skin in the armpits or behind the neck, frequent infections, and blurry vision,” says Dr. Williamson. “If untreated, type 2 diabetes can damage any organ of the body, such as the heart, liver, and nerve endings. This can present as heart attacks, liver disease, and loss of sensation to the hands and feet causing recurrent and severe infections.”

How Many Children Have Type 2 Diabetes?

The study, which took place between March 20th, 2020, and Feb. 28th, 2021, looked at 3,113 pediatric patients ages 8 to 21  from 24 centers across the U.S. The average number of new diagnoses per year increased from 825 to 1,463 during the first year of the pandemic, an increase of 77%.

The study also showed more boys (55%) were diagnosed with type 2 diabetes than girls (45%), a change in the percentages during the pre-pandemic statistics. Hispanic youth and Black youth almost doubled during the first year of the pandemic, while among white youth, there was a decrease in cases. This shows the disproportion of type 2 diabetes across racial and socioeconomic populations deepened.

“Type 2 diabetes can be diagnosed as early as 10 years old, though the average age range of being diagnosed is in the early teen years." Dr. Williamson says. "The risk of diabetes continues to increase into late adolescence and adulthood.”

Treating Type 2 Diabetes in Children

Kelly Fradin, MD FAAP, a New York-based pediatrician and founder of the Instagram account @Advice I Give My Friends, says treatment can have many parts to it.

"Type 2 diabetes is often best treated by a multidisciplinary team including a pediatric endocrinologist and a dietitian," Dr. Fradin says. "Treatment plans often include medications like metformin, GLP-agonists or insulin, in addition to non-pharmacologic interventions."

"Once a child or teenager is diagnosed with type 2 diabetes, it is very difficult to reverse that diagnosis, but you can prevent long-term health issues with a significant focus on healthy eating and exercise, which may require an entire lifestyle change for the child," Dr. Williamson adds.

"In addition, children and teens with type 2 diabetes need to have their sugar levels checked regularly, along with routine labs to make sure their organs are still healthy. They may see a cardiologist if there are concerns about their heart being affected."

How to Prevent Type 2 Diabetes

According to Dr. Fradin, type 2 diabetes has strong genetic links. “Type 2 diabetes runs strongly in families with 75% of children with type 2 diabetes having an affected relative," she says. In fact, 10-15% of children who have a diabetic parent will also develop diabetes. That percentage is even higher in twins. If an identical twin has type 2 diabetes, there's a 75% chance the other will also have it.

In some children, prevention may not be possible, but Dr. Fradin says, “for parents who are looking to modify their child's risk, I recommend consultation with a pediatrician to develop a personalized plan that may include lifestyle changes like increasing physical activity, decreasing smoking or vaping, and incorporating healthy dietary choices.”

Dr. Williamson adds, “Daily exercise, 3-5 servings of fruits and vegetables, drinking lots of water, and adequate sleep are the core elements of health and diabetes prevention. You should also talk to your child's pediatrician about if your child is at a healthy weight, and if they recommend screening for type 2 diabetes if your child is overweight or has a family history of diabetes.”