COVID-19 is linked to more diabetes diagnoses among kids, CDC study finds
A recent study from the Centers for Disease Control and Prevention shows that COVID-19 may be linked to a lifelong health problem for some children who contract the disease. The study, published on January 7, found that children and teens are more likely to be diagnosed with diabetes a month or more after their COVID infection, compared to those who did not have COVID.
Using two different health databases, IQVIA and HealthVerity, researchers evaluated data from thousands of patients younger than 18 between March 1, 2020 and February 26, 2021, comparing those who had been diagnosed with COVID-19 to those who had a pre-pandemic, non-COVID respiratory infection, and also to those who had neither.
They found that children in the IQVIA database diagnosed with COVID-19 during that time were 166% more likely than those who did not have COVID to be diagnosed later with diabetes. In the HealthVerity database, children with COVID were 31% more likely to get a new diabetes diagnosis.
Researchers said children who had COVID were also 116% more likely to develop diabetes than those who had non-COVID respiratory infections prior to the pandemic. Non-COVID respiratory infection "was not associated with diabetes," researchers said.
Dr. Mary Pat Gallagher, director of NYU Langone's Pediatric Diabetes Center, told CBS News that it's believed certain infections can create a "perfect storm" that contributes to the development of diabetes.
"If you are in the process of developing diabetes, will an infection really push you into a diagnosis more quickly than you might otherwise have experienced?" she said. "It seems like maybe we are now finding out that COVID is one of the viruses that maybe can do that a little more than other viruses."
"I think this is likely, we don't have the data, but that these kids were on their way to developing diabetes. Maybe it would have been in two years, maybe would have been in five years, but it was coming," she added. "And maybe having this infection pushed them towards an earlier diagnosis."
This increase in diabetes diagnoses throughout the pandemic is something that Dr. Sheela Natesh Magge, director of the pediatric endocrinology division at Johns Hopkins, has seen as well.
"We're seeing so many more kids come in with diabetes," she told CBS News. "And they're more sick."
The CDC's study, Magge explained, helps affirm that information. However, it does not clarify whether the diabetes is spurred by COVID itself or by other factors. The study is based on data from insurance claims, and does not include information about demographic risk factors that could have contributed to a diabetes diagnosis, including prior health status, weight and environment.
Magge specifically pointed to the fact that the pandemic has increased food insecurity, along with increasing stress and obesity over the past two years — factors that can significantly influence overall health.
"There's some evidence that COVID-19 infection could affect insulin secretion," she said. "So, you know, we just don't know what of the different effects of the pandemic are the cause. Is it actually infection, or is it just the pandemic itself and all of the societal factors related to it?"
"You could be seeing it because of all the issues with kids that are at-risk [of diabetes], like due to food insecurity, parents out of work, inactivity," she said, "all these other factors are there too."
Researchers noted this in their study, saying that the development of diabetes could be attributed to how COVID affects the body's organs, such as the "direct attack of the pancreatic cells." Researchers said it's also likely that some of the patients included in the study already had prediabetes when they contracted COVID. Prediabetes, they said, affects 20% of adolescents in the U.S.
"If you already were at risk, the pandemic probably made it worse," Magge explained. "The stress of any infection can increase blood sugars and can make you have a higher risk of any of the complications of diabetes because your blood sugars could get higher."
Researchers also said pandemic weight gain and steroid treatment patients may have received while hospitalized could have contributed to high blood sugar and diabetes. But, they added, only 1.5% to 2.2% of the patients they studied are believed to have drug- or chemical-induced diabetes.
More studies on the factors involved with the diabetes diagnosis, and the severity of the disease, need to be conducted, the CDC said.
Regardless of whether pediatric diabetes cases stem directly from the virus itself or from these broader ramifications, Magge said the study is "definitely alarming," especially when considering the long-term impact.
"I think it emphasizes that there are a lot of things we don't know about this virus," she added. "It does underscore the importance of prevention, the importance of everybody getting vaccinated and all those things, because there is a lot that we don't know, and it's definitely concerning."
Having COVID or any other viral infection while also having diabetes can also make it more difficult to manage diabetes, Dr. Gallagher added.
"COVID, in particular, really seems to be putting kids at risk for diabetic ketoacidosis much more frequently when they have type 2 diabetes than we saw with other viral infections in the past," she said. Diabetic ketoacidosis occurs when there isn't enough insulin and the liver begins to break down fat for fuel. This process produces acids called ketones, which can build up to dangerous levels, according to the CDC.
"That's a little bit frightening," Gallagher said, "because that's life-threatening."
Many reports indicate COVID-19 symptoms are generally milder for children, and the Omicron variant also appears to be somewhat less severe than earlier strains. But Magge said that there's no way to know what the long-term effects of having COVID will be, regardless of symptoms.
Dr. Gallagher encouraged people "not to panic" about the study's finding, but to use it as a reminder to work to prevent COVID infections, and for parents to be aware of diabetes symptoms. Those can include increased thirst and urination and weight loss. More severe symptoms include nausea, vomiting, and lethargy.
COVID vaccines, which are recommended for ages 5 and up, "don't necessarily absolutely prevent you from getting an infection ... and we don't have data about whether vaccination will decrease the risk of developing diabetes after COVID infection yet because it's very new. But there's good reason to believe it might," she said.