Recent research output from the Centers for Disease Control and Prevention (CDC) suggests those children that were infected with SARS-CoV-2, the virus behind COVID-19 face higher risks for diabetes based on an analysis of half a million children under the age of 18. Put another way, the CDC team reports that those children that had COVID-19 face a higher likelihood of a diabetes diagnosis as compared to those children that were never infected with the novel coronavirus. Specifically, the CDC team estimates those kids infected face a 166% higher probability of diabetes diagnosis. Of course, there could be other factors at play here, such as the social determinants of health.

Given generally unvaccinated kids may come from lower socio-economic levels for example, which implies higher risk factors for not only a lack of COVID-19 vaccination but also co-morbidities from obesity to asthma, this can increase the risks for other issues such as a higher likelihood to end up in intensive care. Other social factors may include nutrition and eating habits, lack of exercise, and family history.

What kind of study?

Retrospective, observational study involving analysis of two American claims databases including 1) IQVIA and 2) HealthVerity

What were the databases?Subscribe to the Trialsitenews “Diabetes” ChannelNo spam – we promise

IQVIA PhaMetrics Plus is a database of adjudicated health care claims from closed U.S. health plans, including claims from primarily commercial health plans (preferred provider and health maintenance) used to provide a complete view of patient care across all care settings.

HealthVerity provides access to patient-level linked data from 70 different commercial health data sources using privacy-preserving record linkage to generate a comprehensive and longitudinal patient history.

What does this study add?

Although observational, the study reveals those children under 18 with COVID-19 had a higher probability of diabetes diagnosis >30 days post-infection than were those without COVID-19 and with pre-pandemic acute respiratory infections.   The CDC also notes that “Non-SARS-CoV-2 respiratory infection was not associated with an increased risk for diabetes.”

What are the study limitations?

The authors report four limitations include:

  • Low specificity associated with diabetes definition as it’s based on single ICD-10-CM code, lacked laboratory data at time of diagnosis and couldn’t differentiate between type 1 and type 2 diabetes
  • Possibility of misclassification as not having COVID-19 for those patients infected with SARS-CoV-2 yet no COVID-19
  • Importantly as mentioned above (SDoH: the study lacked covariates possibly affecting associations of COVID-19 and diabetes such as prediabetes, race/ethnicity, obesity status and the like
  • The study only focused on subjects with health insurance and seeking care—a whole other cohort (no insurance and not seeking care) missed.

Any real-world coverage?

Yes. For example, in El Paso local news (CBS4) reported that local health system data was backing this study’s claim. For example, Josephine Kenney, clinical coordinator or pediatric diabetes reports”

 “At El Paso Children’s we’re seeing the same trends mentioned in the study. So, an increase in children diagnosed with diabetes, both type 1 and type 2. We’re also seeing a significant number of those children who have had a previous COVID-19  infection.”     

Lead Research/Investigator (Corresponding Author)

Sharon Saydah, Ph.D., Epidemiologist

Call to ActionTrialSite reminds that child vaccination should be based on appropriate risk-benefit analyses.

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