INTRODUCTION Cases and severity of presentation of youth-onset type 2 diabetes (Y-T2D) increased during the COVID-19 pandemic, yet the potential drivers of this rise remain unknown. During this time public health mandates paused in-person education and limited social interactions, resulting in radical lifestyle changes. We hypothesized that the incidence and severity of presentation of Y-T2D increased during virtual learning amidst the COVID-19 pandemic. MATERIALS AND METHODS We conducted a single center retrospective chart review to identify all newly diagnosed cases of Y-T2D (n=387) at a pediatric tertiary care center in Washington, DC during three pre-determined learning periods as defined by learning modality in Washington, DC Public Schools: pre-pandemic in-person learning (3/11/2018-3/13/2020), pandemic virtual learning (3/14/2020-8/29/2021), and pandemic in-person learning (8/30/2021-3/10/2022) periods. RESULTS Incident cases were stable during pre-pandemic in-person learning (3.9 cases/month, 95% CI: 2.8 - 5.4 cases/month), increased to a peak during virtual learning (18.7 cases/month, 95% CI: 15.9 - 22.1 cases/month), and declined with return to in-person learning (4.3 cases/month, 95% CI: 2.8 - 6.8 cases/month). Y-T2D incidence was 16.9 (95% CI: 9.8-29.1, p<0.001) and 5.1-fold higher (95% CI: 2.9-9.1, p<0.001) among non-Hispanic Black and Latinx youth, respectively, throughout the study period. Overall COVID-19 infection rates at diagnosis were low (2.5%) and were not associated with diabetes incidence (p=0.26). DISCUSSION/CONCLUSIONS This study provides timely insights into an important and modifiable correlate of Y-T2D incidence, its disproportionate impact on underserved communities, and the need to consider the effects on long-term health outcomes and pre-existing healthcare inequities when designing public policy.

中文翻译：

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COVID-19 大流行期间的虚拟学习和青年发病的 2 型糖尿病。

简介 在 COVID-19 大流行期间，青年发病 2 型糖尿病 (Y-T2D) 的病例数和严重程度有所增加，但这种增加的潜在驱动因素仍然未知。在此期间，公共卫生指令暂停了面对面的教育并限制了社交互动，导致生活方式发生了彻底的改变。我们假设在 COVID-19 大流行期间的虚拟学习期间，Y-T2D 的发病率和严重程度有所增加。材料和方法 我们进行了单中心回顾性图表审查，以识别华盛顿特区儿科三级护理中心在华盛顿学习方式定义的三个预先确定的学习期间内所有新诊断的 Y-T2D 病例 (n=387) ，华盛顿特区公立学校：大流行前的面对面学习（3/11/2018-3/13/2020），流行病虚拟学习（2020年3月14日-2021年8月29日）和流行病面对面学习（2021年8月30日-2022年3月10日）期间。结果 疫情前面对面学习期间事件病例稳定（3.9 例/月，95% CI：2.8 - 5.4 例/月），虚拟学习期间增加至峰值（18.7 例/月，95% CI：15.9 - 22.1 例/月），并随着返回面对面学习而​​下降（4.3 例/月，95% CI：2.8 - 6.8 例/月）。在整个研究期间，非西班牙裔黑人和拉丁裔青年的 Y-T2D 发病率分别为 16.9 倍（95% CI：9.8-29.1，p<0.001）和 5.1 倍（95% CI：2.9-9.1，p<0.001）。学习时段。诊断时的总体 COVID-19 感染率较低 (2.5%)，并且与糖尿病发病率无关 (p=0.26)。