THU134 Proportion Of Type 2 Diabetes Amongst New Diabetes Diagnosis In Youth Continues To Increase 12 Months After Pandemic Start
Authors: Bell-Sambataro Esther Eunice , Hoffman Robert Paul , Lahoti Amit 
Published: October 2023

Abstract
Disclosure: E.E. Bell-Sambataro: None. R.P. Hoffman: None. A. Lahoti: None.
Background: Recent studies have shown significant increase in incidence of type 2 diabetes (T2D) in youth in the first 12 months of COVID-19 pandemic likely related to lockdowns, decreased physical activity and increased food consumption, leading to increased weight gain and worsening insulin resistance in at risk adolescents. However, it is unclear if these patterns have persisted beyond the first year of pandemic. We hypothesized that the proportion of T2D amongst youth with new onset diabetes (DM) would decrease to pre pandemic levels after 3/1/2021. Methodology: In this single institution study, youth with new onset DM were identified from the electronic medical record (EMR) database using ICD-10 diagnoses codes. Patients meeting ADA criteria of DM diagnosis were included while patients with diagnosis before 3/1/2018 or after 2/28/2022, age &gt;18 years at diagnosis or DM types other than type 1 diabetes (T1D) or T2D were excluded. Patient characteristics and anthropometric data at DM diagnosis were collected. Frequency of T1D and T2D per year were calculated (Year 1: 3/1/2018-2/28/2019, Year 2: 3/1/2019-2/29/2020, Year 3: 3/1/2020-2/28/2021, Year 4: 3/1/2021-2/28/2022). Descriptive categorical data is reported as frequency and proportion. Chi square, independent sample t tests, and ANOVA were used as appropriate to evaluate differences between years. Results: Frequency of new onset T1D and T2D per year (proportion of T2D among new onset DM), respectively for year 1 was 191 and 63 (24.8%); year 2 was 193 and 45 (18.9%); year 3 was 231 and 109 (32.1%); year 4 was 262 and 130 (33.2%). The increase in proportion of T2D from year 1 to 4 was statistically significant (p &lt;0.001). From year 1 to 4, age at diagnosis and percentage females for both groups and race for T1D patients were not statistically significant. Percentage Blacks amongst all new onset T2D youth increased significantly from 31% in year 1 to 51.3% in year 4 (p&lt; 0.01). BMI z-scores increased significantly in T1D patients from year 1 to 4 (p= 0.008). BMI z-scores in T2D patients decreased significantly between year 2 & 3 (p= 0.002) and rose back between year 3 & 4 (p= 0.005). Conclusions: Our study shows the increase in proportion of T2D patients amongst youth with new onset DM has persisted beyond the first year of COVID-19 pandemic suggesting the increase may not be only due to pandemic era restrictions and lifestyle changes. While prior studies showed higher BMI z-scores at T2D diagnosis compared to pre pandemic period, in our study BMI z-scores for new onset T2D youth decreased significantly in the 1st year of pandemic. This could have been due to swift implementation of telehealth in our community and institution that allowed continued access to healthcare, DM screening and earlier T2D diagnosis. The rapid change in the landscape of pediatric diabetes with growing proportion of T2D is an alarming trend that requires additional studies.
Presentation: Thursday, June 15, 2023