PMON188 Frequency of Hemoglobin A1c and Body Mass Index Increase in Youth at Risk for Developing Type 2 Diabetes Mellitus During the COVID-19 Pandemic

Abstract

Abstract BACKGROUND: Childhood obesity rates continue to increase and have progressed with the COVID-19 pandemic. Obesity is associated with comorbidities, including prediabetes and type 2 diabetes mellitus (T2D). The frequency of HbA1c progression in overweight/obese children during the COVID-19 pandemic is not well reported. OBJECTIVES: To investigate the frequency of HbA1c and BMI increase in overweight/obese youth at risk of developing T2D during the COVID-19 pandemic. METHODOLOGY: A retrospective chart review of patients followed in a pediatric endocrinology clinic with overweight/obesity and concern of developing T2D was conducted. We included patients who were seen pre-pandemic (June 2019 to May 2020) and again after the pandemic onset (June 2020 to May 2021). We chose June 2020 as the pandemic onset since our clinic resumed in-person visits at this time. Demographic and clinical data, including BMI and HbA1c, were collected in the pre-pandemic and pandemic periods for each patient. We evaluated change in HbA1c using the following categories: Category 1: <5.7%, Category 2: 5.7-6%, Category 3: 6.1-6.4%, Category 4: 6.5-8.4%, and Category 5: >8.4%. HbA1c progression defined as increase in the HbA1c category. BMI progression defined as a z-score increase of at least 0.2 and we only included patients with 6-18 months between visits for this analysis. Chi-square or Fisher's exact test and t-test were used to evaluate HbA1c and BMI progression. RESULTS: A total of 64 patients (mean age 12.6 years, 58% female, 31% Black) were evaluated and had available HbA1c data. HbA1c progression was found in 18.8% (12 of 64) of patients during the pandemic. Based on pre-pandemic age, those with HbA1c progression had a mean (SD) age of 14.1 (2.3) years while those whose HbA1c did not progress had a mean (SD) age of 12.3 (2.7) years (p=0.04). Other characteristics including birth sex (p=0.18), race (p=0.54), and insurance (public/private/self-pay) (p=0.83) were not significantly different between those with and without HbA1c progression. We found that 9.1% of patients with HbA1c progression also had BMI progression compared to 6.7% without HbA1c progression (p= 1.0). SUMMARY: We found that 18.8% of overweight/obese youth with risk of developing T2D had HbA1c progression during the COVID-19 pandemic and that older age was a risk factor for HbA1c progression. Significant BMI increase was not associated with HbA1c progression. Further studies are needed to evaluate the impact of COVID-19 pandemic on HbA1c and BMI progression in youth at risk for T2D. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.