Incidence of Diabetes in Children and Adolescents During the COVID-19 Pandemic
A Systematic Review and Meta-Analysis. 30th June 2023, Toronto
jamanetwork.com/journals/jama...
Key Points
Analysis of 42 studies
N = 102,984 youths (19 years and under)
Incidence of type 1 diabetes was higher during the COVID-19 pandemic compared with before the pandemic.
The findings suggest the need to elucidate possible underlying mechanisms to explain temporal changes
Synthesize estimates of changes in incidence rates
Minimum observation period of 12 months during and 12 months before the pandemic
(Also looked at incidence of DKA in new-onset diabetes during the pandemic.)
Results, Type 1 diabetes incidence rates
N = 38,149 youths
First year of the pandemic, incidence rate ratio = 1.14
During months 13 to 24, incidence rate ratio = 1.27
(Expected 3% to 4% annual increase trends in Europe)
Results, Type 2 diabetes incidence rates
Ten studies reported incident in both periods.
Eight studies, an increase incident of type 2 diabetes
Results, DKA incidence rates
Fifteen studies
Incidence rate ratio = 1.26
Conclusions
Future studies are needed to assess whether this trend persists,
and may help elucidate possible underlying mechanisms to explain temporal changes.
More from the study
Some studies reported an association between SARS-CoV-2 infection and new-onset diabetes.
However, (challenges in SARS-CoV-2 diagnosis), concerns about the validity of these studies.
Data sets used in other studies did not capture asymptomatic SARS-CoV-2
There is no clear mechanism by which COVID-19 could directly or indirectly lead to new-onset type 1 or 2 diabetes.
Purported direct mechanisms
SARS-CoV-2 entry receptor ACE2 is expressed on insulin-producing β cells
There is no clear underlying mechanism explaining the association between SARS-CoV-2 infection and subsequent increased risk of diabetes.
Population-based studies suggest…. that the increase in incidence may be due to an immune-mediated mechanism.
Proposed indirect effects of the COVID-19 pandemic and containment measures that may be associated with diabetes
(contrary to what would be expected based on the decrease in viral infections among children)
‘Catch-up’ could only influence the first year of the pandemic
Reflection on yesterday’s lab leak video and biological war
As someone who has spent a number of years studying biological warfare (BW) and ways to defend against it,
I'm not convinced that the Wuhan virus was not meant to be a BW agent.
High lethality isn't necessarily required to be an effective weapon;
it just needs to be able to incapacitate a significant number of people.
The incapacitated people are no longer able to do their jobs,
and the added benefit to the employer of the weapon is that those incapacitated people now take up more resources and more people to treat them than if they died.
Also, the genetic techniques that they used,
techniques that made it difficult to identify any man-made changes,
is in line with one of the main attractions of BW - plausible deniability.
Thank you for your thorough, objective and thoughtful reports!