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COVID-19 a Risk Factor for New Pediatric Diabetes

— Vaccination is key for prevention, researchers say

MedpageToday
A little girl listens to her female doctor explaining an insulin injector pen.

Kids who test positive for COVID-19 may have an increased risk for diabetes, according to new CDC data.

Looking at two different data sources, the risk of being newly diagnosed with diabetes -- including type 1, type 2, and other types of diabetes -- was significantly higher for those with COVID-19 compared with those who never tested positive for the virus, reported Sharon Saydah, PhD, of the CDC COVID-19 Emergency Response Team, and colleagues in the .

Incidence of diabetes was significantly higher among kids with COVID-19 versus those without the infection in both the HealthVerity (HR 1.31, 95% CI 1.20-1.44) and IQVIA healthcare (HR 2.66, 95% CI 1.98-3.56) claims databases.

This link to diabetes appeared to be specific to COVID-19. To confirm, the researchers compared the IQVIA cohort with cases of non-COVID-related acute respiratory infections (ARI) prior to the pandemic. Those with COVID-19 had more than a twofold higher risk for developing new-onset diabetes compared to those with other respiratory infections (HR 2.16, 95% CI 1.64-2.86).

"New diabetes diagnoses were 166% (IQVIA) and 31% (HealthVerity) more likely to occur among patients with COVID-19 than among those without COVID-19 during the pandemic and 116% more likely to occur among those with COVID-19 than among those with ARI during the pre-pandemic period," Saydah's group concluded.

This didn't come as a surprise, since a slew of other studies have demonstrated the association between SARS-CoV-2 infection and diabetes in adults.

While the exact mechanism of this link isn't yet known, Saydah and colleagues suggested it might involve pancreatic cells. "COVID-19 might lead to diabetes through direct attack of pancreatic cells expressing angiotensin converting enzyme 2 receptors, through stress hyperglycemia resulting from the cytokine storm and alterations in glucose metabolism caused by infection, or through precipitation of prediabetes to diabetes," they wrote.

They also suggested that the use of steroid treatment during hospitalization for COVID-19 may also contribute -- at least in part -- to "transient hyperglycemia," though this is likely not the root cause, as only about 2% of codes included were for drug-induced or chemical-induced diabetes.

The IQVIA database included 80,893 patients who tested positive for COVID-19 from March 1, 2020, through Feb. 26, 2021. About half of patients were female, with an average age of 12, and only 0.7% were hospitalized for COVID-19. The HealthVerity database included nearly 440,000 patients diagnosed with COVID-19, who tested positive from March 1, 2020 through June 28, 2021. Average age was 13, half were female, and about 0.9% were hospitalized.

In both patient groups, 94% of new diabetes cases were either type 1 or type 2. Diabetic ketoacidosis was common, seen in 49% of the IQVIA group and 40% of the HealthVerity group.

These findings ultimately show how important prevention is, Saydah and colleagues explained, noting that vaccination is key for all eligible children and adolescents. They also underscored how healthcare providers should monitor their pediatric patients for diabetes in the months following a COVID-19 infection.

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    Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.

Disclosures

Saydah and co-authors reported no disclosures.

Primary Source

Morbidity and Mortality Weekly Report

Barrett CE, et al "Risk for newly diagnosed diabetes >30 days after SARS-CoV-2 infection among persons aged <18 years -- United States, March 1, 2020-June 28, 2021" MMWR 2022; DOI: 10.15585/mmwr.mm7102e2.