ESPE Abstracts

Background: The alarming increase in the prevalence of obesity in children and adolescents following COVID-19 pandemic has given rise to an upward trend in Type 2 Diabetes.

Aims/Objectives: To determine the prevalence of newly diagnosed Type 2 Diabetes in children and adolescents from the year 2018 to 2022.

Methods: A hospital based retrospective study was conducted in the Paediatric Endocrinology Clinic at a tertiary care Centre in Kerala, South India, to determine the prevalence of new onset Type 2 Diabetes among children attending Paediatric Endocrinology Clinic during a 4-year period from 1^st January 2018 through 1^st August 2022. Demographic, anthropometrics, clinical data and laboratory, and outcomes were obtained. All the data was interpreted using descriptive and inferential statistics on R software and SPSS version 21.0.

Results: The prevalence of Type 2 Diabetes has increased by 66.66% after the COVID-19 pandemic onset. The mean age of 1^st presentation has decreased from 14.5 years to 11.9±2 years following COVID-19, with males being affected more than females. Increased screen time and reduced physical activity were present in 90 % of the children. All of them had a positive family history of Type 2 Diabetes. Children diagnosed to have Type 2 Diabetes following COVID-19 had an average BMI of 24.82±3, with abdominal circumference above 90^th percentile for all. All the diagnosed cases were started on Metformin. However, 30% of children presented with mild to moderate DKA requiring insulin in addition to OHA for glycaemic control.

Discussion: COVID-19 lockdown disrupted the everyday routine of children and adolescents in a significant way. Increase in the screen time and lack of adequate physical activity has led to an increase in childhood obesity and thereby Type 2 Diabetes presenting at a much younger age than before COVID-19. The number of children with Type 2 Diabetes presenting with cardiometabolic complications like dyslipidaemia and hypertension at a younger age was also high. Around 40% of children above 10 years presented as metabolic syndrome. Children admitted with new onset Type 2 Diabetes after the COVID-19 pandemic were significantly more likely to present with DKA.

Conclusion: Following COVID-19 pandemic, the sedentary lifestyle and associated childhood obesity has led to a significant increase in Type 2 Diabetes cases with a greater risk of DKA. This shows a change in Paediatric diabetic trend. Further multicentric studies must be done to unveil the extend of COVID-19 pandemic impact on Paediatric Type 2 Diabetes.