Trends of Diabetes in Youth (TrenDY) during COVID-19 across the United States.

Context: The frequency and acuity at diagnosis of youth-onset type 1 diabetes (T1D) and type 2 diabetes (T2D) was reported as higher in the first year of the COVID-19 pandemic, but it is unclear if these trends persist.

Objective: To describe trends in new cases of youth-onset diabetes comparing the first 2 years of the COVID-19 pandemic with the 2 preceding years.

Design: Retrospective study.

Setting: 23 clinical centers in the US.

Patients: New-onset T1D and T2D in youth between March 1,2018 and February 28,2022.Main Outcome Measures: New diagnosis of youth-onset T1D or T2D and acuity at diagnosis.

Results: A total of 4,851 youth were diagnosed with T1D in the pre-pandemic period (Yr 1: March 1,2018 to February 28,2019, Yr 2: March 1,2019 to February 29,2020) and 5,955 individuals during pandemic (Yr 3: March 1,2020 to February 29,2021, Yr 4: March 1,2021 to February 28,2022), a 22.8% increase (ns). Proportion of DKA in T1D was higher during (43.41%) vs pre-pandemic (37.77%, p<0.01). For T2D, 1610 youth were diagnosed in the pre-pandemic period while 3443 patients were diagnosed with T2D during pandemic (a 114% increase). The increase in frequency of T2D attributable to pandemic from Yr 2 to Yr 3 was 76.8% (p<0.01), while the increase from Yr 3 to Yr 4 was not significant.

Conclusions: In youth, the frequency of both T1D and T2D increased during the COVID-19 pandemic but was significant only for T2D. When controlled for yearly trends, only frequency of T2D increased significantly in the first year of pandemic suggesting that the pandemic environment differentially impacted rates of T1D and T2D in youth.