Why did diabetes incidence in children increased during the corona pandemic?

A new meta-analysis showed the pediatric diabetes incidence spike during the pandemic. Despite a few theories, there are no conclusive explanations for this.

Development of paediatric diabetes during the pandemic

Diabetes diagnoses and ketoacidosis complications increased significantly in children during the pandemic years.
The exact reasons for this have not yet been conclusively clarified.
An altered microbiome, delayed diagnoses or altered environmental factors and increased calorie intake are being discussed as possible causes.

How much has the incidence of paediatric diabetes diagnoses increased?

While an annual increase in paediatric diabetes diagnoses of around 2% to 3% was recorded in pre-pandemic years, the figures for the first two years of the corona pandemic were 16% and 23% - i.e. significantly higher than before.

Why is there such a drastic increase?

The reason for this significant increase in incidence has not yet been conclusively clarified. However, there are a few theories considered:

Delayed diagnosis, particularly at the beginning of the pandemic, is conceivable.
The coronavirus itself may have a direct effect on the development of type 1 diabetes. However, it is assumed that this theory would lead to an overestimation of the incidence.
Diabetic diseases could be caused by autoimmunity, but larger studies have not been able to prove this.
The corona pandemic could have led to an increased incidence of diabetes in children due to changes in the environment.
Microbiome changes could also be responsible.
Last but not least, the weight gain of many people during the pandemic cannot be ruled out as a cause of increased metabolic disorders.

The cause remains unclear

While these possible hypotheses are exciting, it is ultimately not yet clear where the significantly higher incidence of paediatric diabetes comes from. The reason for the increased incidence of diabetes in children during the coronavirus pandemic has not yet been conclusively clarified. However, the data offer novel gaps for further research.

Source

Kamrath C, Holl RW, Rosenbauer J. Elucidating the Underlying Mechanisms of the Marked Increase in Childhood Type 1 Diabetes During the COVID-19 Pandemic-The Diabetes Pandemic. JAMA Netw Open. 2023 Jun 1;6(6):e2321231. doi: 10.1001/jamanetworkopen.2023.21231. Erratum in: JAMA Netw Open. 2023 Aug 1;6(8):e2329097. PMID: 37389881.