Is COVID-19 to blame? Trends of Incidence and Sex Ratio in Youth-onset Type 2 Diabetes in Germany

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posted on 2023-05-04, 14:57 authored by Christian Denzer, Joachim Rosenbauer, Daniela Klose, Antje Körner, Thomas Reinehr, Christina Baechle, Carmen Schröder, Susanna Wiegand, Reinhard W. Holl, Nicole Prinz, the DPV Initiative

Objective:

We investigated the incidence of pediatric type 2 diabetes (T2D) in Germany during two years of the COVID-19 pandemic (2020-2021), compared with the control period 2011-2019.

Study design and methods:

Data on T2D in children (6 to <18 years) were obtained from the DPV registry. Poisson regression was used to estimate incidences for 2020 and 2021 based on data from 2011 to 2019, and these were compared with observed incidences in 2020/2021 by estimating incidence rate ratios (IRRs) with 95% CIs.

Results:

The incidence of youth-onset T2D increased from 0.75 per 100,000 patient-years [PY] in 2011 (95% CI 0.58; 0.93) to 1.25 per 100,000 PY in 2019 (95% CI 1.02; 1.48), an annual increase of 6.8% (95% CI 4.1; 9.6). In 2020, T2D incidence increased to 1.49 per 100,000 PY (95% CI 1.23; 1.81), which was not significantly higher than predicted (IRR 1.15, 95% CI 0.90; 1.48). In 2021, the observed incidence was significantly higher than expected (1.95 [95% CI 1.65; 2.31] vs. 1.38 [1.13; 1.69] per 100,000 PY; IRR 1.41 [1.12; 1.77]). While there was no significant increase in incidence in girls in 2021, the observed incidence in boys (2.16 [1.73; 2.70] per 100,000 PY) significantly exceeded the predicted rate (IRR 1.55 [1.14; 2.12]), leading to a reversal of the sex ratio of pediatric T2D incidence.

Conclusions:

In Germany, incidence of pediatric type 2 diabetes increased significantly in 2021. Adolescent males were more affected by this increase, resulting in a reversal of the sex ratio of youth-onset T2D.