Type 2 diabetes was increasing among children even before COVID-19. Now a nationwide review of medical records shows a worsening of the problem during the pandemic, with the rate of type 2 diabetes jumping sharply, particularly among Black and Hispanic youth.

Investigators note it is unclear whether the virus infection itself was a factor in the rise, and they point to the switch to virtual learning and shutdown of sports and school activities as “environmental factors” that likely increased risk.

“During the COVID-19 lockdown, children were removed from normal day-to-day routines like going to school, playing sports and other hobbies. Not only were they less physically active, they were confined to their homes and spent a lot more time watching TV, playing video games, or with other electronic devices,” says Sheela Magge, director of the Division of Pediatric Endocrinology at Johns Hopkins Children’s Center and co-first author of the review, which appeared in The Journal of Pediatrics.

For the study, conducted in collaboration with the University of Colorado School of Medicine, the researchers compared the rates of new-onset type 2 diabetes among people age 8 to 21 in the two years prior to the pandemic to the first year of the pandemic (March 1, 2020, to Feb. 28, 2021).

The researchers identified 3,113 pediatric patients during that period, age 8 to 21 and from 24 centers across the U.S. The average number of new diagnoses per year in the two pre-pandemic years increased from 825 to 1,463 during the first year of the pandemic, an increase of 77%.

The records showed that more boys (55%) were diagnosed with type 2 diabetes than girls (45%) during the first year of the pandemic, a reversal of the percentages during the pre-pandemic years. “This was one of the more unusual findings from our study,” says Children’s Center pediatric endocrinologist Risa Wolf, co-first author of the paper. “Typically, we see more girls than boys who are newly diagnosed with type 2 diabetes, though it’s unclear why.”

Compared with rates during the previous years, the number of diagnoses among Hispanic youth almost doubled during the first year of the pandemic, and the number of diagnoses among Black youth doubled. Among white youth, the investigators noted a decrease in cases.

Type 2 diabetes is already known to disproportionately affect ethnic and racial minority populations and families with socioeconomic challenges, and the new study shows that such disparities deepened, Magge says.

The findings indicate a need for pediatricians and other primary care physicians to be vigilant in screening for type 2 diabetes. “We need to make sure we are identifying patients early so we can intervene with treatment and prevent complications,” Wolf says.

Wolf also says parents should talk to their children’s doctors about weight increases. Says Magge: “Now is the time to focus on exercising and a healthy diet for your kids.”