BMI Changes in Youth with Type 2 Diabetes during COVID-Shelter-in-Place: The Role of Neighborhood Risk Factors

ABSTRACT

The California government imposed a shelter-in-place (SIP) order on 3/15/2020 to slow the spread of COVID-19. For many children and adolescents, particularly youth with type 2 diabetes (T2D) , school closures led to major changes in daily routines, affecting physical activity levels and dietary choices. We performed a retrospective descriptive study on youth ages 7 to 21 years with T2D who were seen at our health care system at least one time in the year preceding SIP and again in the year after, allowing us to calculate change in BMI over time during SIP. Utilizing databases from the United States government, we examined the effects of living in an area with at least one risk factor ("food deserts" with a paucity of healthy food, "food swamps" with an abundance of unhealthy food, or rural regions) on BMI change compared to low-risk neighborhoods. We included 78 youth with T2D and 46% lived in at-risk areas. Overall, youth had a slight increase in BMI during SIP (0.± 0.2 kg/m2/month) . Youth living in at-risk areas had a rise in BMI during this time period (0.02 ± 0.2 kg/m2/month) , whereas youth in low-risk areas had a small drop in BMI (-0.± 0.2 kg/m2/month) . As this study was not powered to detect group differences, further investigation of neighborhood risk factors is needed to aid in tailoring community-level interventions to combat obesity in youth with T2D.