Rise in new-onset Type 2 diabetes among Alabama youth during COVID-19 pandemic

By: Hannah Echols

BIRMINGHAM, Ala. – Alabama, a state with many counties in the U.S. Diabetes Belt, saw an increase in new-onset Type 2 diabetes among youth during the COVID-19 pandemic. Results published in the Journal of Clinical Endocrinology & Metabolism showed the significant increase and indicated that Medicaid enrollees and males were disproportionately affected by the disease.

Using data from Children’s of Alabama, researchers at the University of Alabama at Birmingham conducted a retrospective study to look at new Type 2 diabetes cases from March 2017 to March 2021. Prior to the start of the pandemic, the average monthly rate of new pediatric diagnoses was 11.1. After April 2020, the monthly rate increased to 19.3.

“Existing studies already showed a worrisome increase in pediatric Type 2 diabetes, specifically among low-income and ethnic minorities,” said Ambika Ashraf, M.D., associate director of the Comprehensive Diabetes Center at Children’s of Alabama and director of the Division of Pediatric Endocrinology and Diabetes at UAB. “Our results suggest the COVID-19 pandemic further exacerbated the concerning trend.”

Pediatric Type 2 diabetes occurs when one’s body does not produce enough insulin to properly regulate blood sugar levels. The long-term condition can lead to an increased risk of disorders in the nervous, immune and circulatory systems. Other risk factors for Type 2 diabetes include weight, inactivity, family history, age, prediabetes, race and ethnicity.

“Approximately 53% of all children in Alabama are enrolled in Medicaid, which is often an indicator of lower family income,” said Jessica Schmitt, M.D., first author and assistant professor in the Division of Pediatric Endocrinology and Diabetes at Children’s and UAB. “In addition to medications, maintain a healthy diet and activity level are important in management of Type 2 diabetes. This can be difficult for children living in lower socioeconomic conditions.”

While the UAB team discovered the increase in new-onset Type 2 diabetes pediatric cases, both in Medicaid and non-Medicaid enrolled youth, Ashraf says further studies are needed to determine the exact cause of the increase.

“There was a drastic change in activity and sedentary lifestyles in youth during spring of 2020 and other studies show that adolescent males experienced greater weight gain and were more sedentary than female counterparts,” Ashraf said. “However, we do not know if these short-term changes are directly linked to the increase in diagnoses. We also did not have information on prior COVID-19 infections among patients studied.”

Other study authors include UAB School of Public Health faculty David Becker, Ph.D., associate professor in Department of Health Policy and Organization and Bisakha Sen, Ph.D. professor in the Department of Health Policy and Organization, vice chairperson of research, and BCBS Endowed Chair in Economics.

About Children’s of Alabama
Since 1911, Children’s of Alabama has provided specialized medical care for ill and injured children, offering inpatient, outpatient and primary care throughout central Alabama. Ranked among the best children’s hospitals in the nation by U.S. News & World Report, Children’s serves patients from every county in Alabama and nearly every state. Children’s is a private, not-for-profit medical center that serves as the teaching hospital for the University of Alabama at Birmingham (UAB) pediatric medicine, surgery, psychiatry, research and residency programs. The medical staff consists of UAB faculty and Children’s full-time physicians as well as private practicing community physicians.

About UAB

Known for its innovative and interdisciplinary approach to education at both the graduate and undergraduate levels, the University of Alabama at Birmingham, a part of the University of Alabama System, is an internationally renowned research university and academic medical center with over $600 million in research awards annually, as well as Alabama’s largest single employer, with some 26,000 employees, and has an annual economic impact exceeding $7.15 billion on the state. The pillars of UAB’s mission include education, research, innovation and economic development, community engagement, and patient care. Learn more at www.uab.edu.