Objective: Overweight and obesity are more prevalent in children and adolescents with type 1 diabetes than in youth without type 1 diabetes. COVID-19 related lockdowns in Australia and New Zealand in 2020 and 2021 meant significant restrictions on activity and face to face school attendance. We compared changes in BMI SDS in children and adolescents < 18 years between the pre-pandemic years 2018-19 and pandemic years 2020-21.
Methods: Clinical and demographic data for children and adolescents < 18 years of age and type 1 diabetes diagnosed after 6 months of age, registered with the Australasian Diabetes Data Network (ADDN) were extracted for 2018-2021. Generalised estimating equations (GEE) were used to analyse trends in BMI SDS over time and account for repeated measures from the same individuals. Multivariable GEE regression models were used to adjust for potential confounding variables.
Results: 67419 visits over 2018-2021 for 24383 individuals aged < 18 years, from 33 sites were included. There was a positive association with BMI SDS over time. All jurisdictions, in comparison with Western Australia, had a positive association with BMI SDS. Total daily dose, CSII use, and female sex were also positively associated with a higher BMI SDS. Age, HbA1c and in an Australia only model, higher socioeconomic status, were negatively associated with BMI SDS in 2018-2020 The same analysis with 2021 data is pending.
Conclusions: Lockdowns have been associated with higher BMI SDS in children and adolescents with type 1 diabetes in Australia and New Zealand. This has implications for public health and social policy in future lockdowns.