In a report on the findings, published Aug. 17 in The Journal of Pediatrics, the 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.

Before the pandemic, type 2 diabetes was increasing among children around the world, and because rates of childhood diabetes are known to rise and fall over time, the investigators launched a nationwide review of medical records to assess the impact of the pandemic, according to Sheela N. Magge, M.D., M.S.C.E., director of the Division of Pediatric Endocrinology at the Children’s Center.

Magge, an associate professor of pediatrics at the Johns Hopkins University School of Medicine and co-first author of the paper, says reduced physical activity and weight gain are well-known risk factors for type 2 diabetes. “During the COVID-19 lockdown, children were removed from normal day-to-day routines like going to school, playing sports and other hobbies,” Magge says. “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.”

Type 2 diabetes is a chronic disorder that affects the body’s ability to regulate, use and process sugar. Without treatment and control, it can cause heart disease, nerve and kidney damage, impaired vision and other irreversible injury to organs.

Although generally associated with adults, an estimated one-third of American youth are considered at risk because of being overweight and obese. Magge adds that previous research from other institutions has shown that children diagnosed with diabetes appear to get complications faster than adults.

For the new 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 (March 1, 2018, to Feb. 29, 2020) 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%.

During the first year of the pandemic, the records showed that more boys (55%) were diagnosed with type 2 diabetes than girls (45%), a reversal of the percentages during the pre-pandemic years. “This was one of the more unusual findings from our study,” says pediatric endocrinologist Risa Wolf, M.D., assistant professor of pediatrics at the Johns Hopkins University School of Medicine and 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 new analysis documented the rise in cases with measures of increased body mass index (body fat based on height and weight) and higher blood glucose and hemoglobin A1c test results (standard diagnostic measures of diabetes).

In addition, during the pre-pandemic years, more patients were diagnosed while outpatients (57%) than during the pandemic year, when more were diagnosed and treated as inpatients (57%), suggesting greater severity.

Overall, the researchers found that 21% of the young people diagnosed presented with “metabolic decompensation,” of which the most serious symptoms include vomiting, lethargy, confusion and rapid breathing. Pre-pandemic, such symptoms occurred in only 9% of children with new-onset type 2 diabetes. Because the study involved a retrospective (look back) review of medical records, the investigators say there is a potential for inconsistencies in reporting or missing information.

However, they say 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.”

Along with Magge and Wolf, authors of the study from the Johns Hopkins University School of Medicine are biostatistician Elizabeth Brown, and pediatric endocrinology fellow Sonum Bharill. Other authors are Megan Kelsey and Laura Pyle from the University of Colorado, Valeria Benavides from the University of Illinois College of Medicine at Peoria/Children’s Hospital of Illinois, Monica Bianco from Northwestern University/Ann & Robert H. Lurie Children’s Hospital of Chicago, Lily Chao from Children’s Hospital Los Angeles, Anna Cymbaluk from Texas Children’s Hospital/Baylor College of Medicine, Pinar Gumus Balikcioglu from Duke University Medical Center/Duke Molecular Physiology Institute, Kelsee Halpin from the University of Missouri-Kansas City School of Medicine/Children’s Mercy Kansas City, Daniel Hsia from Our Lady of the Lake Children’s Hospital/Pennington Biomedical Research Center, Lina Huerta-Saenz from Penn State Health Children’s Hospital/Penn State College of Medicine, Jane Kim from the University of California San Diego/Rady Children’s Hospital-San Diego, Seema Kumar from the Mayo Clinic, Lorraine Levitt Katz from the Children’s Hospital of Philadelphia, Brynn Marks from Children’s National Hospital, Anna Neyman from the Indiana University School of Medicine/Riley Hospital for Children, Katie O’Sullivan from University of Chicago Medicine, Sabitha Sasidharan Pillai from the Warren Alpert Medical School of Brown University/Hasbro Children’s Hospital, Amy Shah from the Cincinnati Children’s Hospital Medical Center/University of Cincinnati, Ashley Shoemaker from the Vanderbilt University Medical Center, Juwairriyyah Siddiqui from the Columbia University Irving Medical Center/Harlem Hospital, Shylaja Srinivasan from the University of California San Francisco, Inas Thomas from the University of Michigan, Jeanie Tryggestad from the University of Oklahoma Health Sciences Center and Maha Yousif from the University of Texas Southwestern.

The study was funded by the institutions.

No authors declared conflicts of interest under Johns Hopkins University School of Medicine policies.

The researchers will present their results today at the fall meeting of the American Chemical Society (ACS).

“The beauty of our resin system is that at the end of its use cycle, we can dissolve it, and that releases it from whatever matrix it’s in so that it can be used over and over again in an infinite loop,” says John Dorgan, Ph.D., who is presenting the work at the meeting. “That’s the goal of the circular economy.”

Made of fiberglass, wind turbine blades can be half a football field in length. Although some companies have found ways to recycle fiberglass into lower-value materials, most discarded blades end up in landfills. And the disposal problem is likely to get worse. “Larger wind turbine blades are more efficient, so companies keep making bigger and bigger ones,” Dorgan says. “Often, wind farms will actually replace the turbine blades before the end of service life because the farms can generate more electricity with bigger blades.”

Dorgan and colleagues at Michigan State University made a new turbine material by combining glass fibers with a plant-derived polymer and a synthetic one. Panels made of this thermoplastic resin were strong and durable enough to be used in turbines or automobiles. The researchers dissolved the panels in fresh monomer and physically removed the glass fibers, allowing them to recast the material into new products of the same type. Importantly, the recast panels had the same physical properties as their predecessors.

In addition to new wind turbine blades, the novel resin could be used for a variety of other applications. By mixing the resin with different minerals, the team produced cultured stone that could be transformed into household objects, such as countertops and sinks. “We’ve recently made a bathroom sink with the cultured stone, so we know it works,” says Dorgan. The researchers could also crush the recovered material and mix it with other plastic resins for injection molding, which is used to make items like laptop covers and power tools.

The material could even be upcycled into higher-value products. Digesting the thermoplastic resin in an alkaline solution released poly(methyl methacrylate) (PMMA), a common acrylic material for windows, car taillights and many other items. Raising the temperature of the digestion converted PMMA into poly(methacrylic acid), a super-absorbent polymer that is used in diapers. The alkaline digestion also produced potassium lactate, which can be purified and made into candy and sports drinks. “We recovered food-grade potassium lactate and used it to make gummy bear candies, which I ate,” Dorgan says.

Now that the researchers have demonstrated that the resin has suitable physical properties for wind turbines, they hope to make some moderately sized blades for field testing. “The current limitation is that there’s not enough of the bioplastic that we’re using to satisfy this market, so there needs to be considerable production volume brought online if we’re going to actually start making wind turbines out of these materials,” Dorgan notes.

And is there a “yuck factor” involved in eating candy that was once part of a wind turbine? Dorgan doesn’t think so. “A carbon atom derived from a plant, like corn or grass, is no different from a carbon atom that came from a fossil fuel,” he says. “It’s all part of the global carbon cycle, and we’ve shown that we can go from biomass in the field to durable plastic materials and back to foodstuffs.”

The researchers acknowledge funding from the David L. and Denise M. Lamp Endowment.

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The researchers will present their results today at the fall meeting of the American Chemical Society (ACS).

“Nanoplastics are a major concern if they’re in the air that you breathe, getting into your lungs and potentially causing health problems,” says Raz Jelinek, Ph.D., the project’s principal investigator. “A simple, inexpensive detector like ours could have huge implications, and someday alert people to the presence of nanoplastics in the air, allowing them to take action.”

Millions of tons of plastic are produced and thrown away each year. Some plastic materials slowly erode while they’re being used or after being disposed of, polluting the surrounding environment with micro- and nanosized particles. Nanoplastics are so small — generally less than 1-µm wide — and light that they can even float in the air, where people can then unknowingly breathe them in. Animal studies suggest that ingesting and inhaling these nanoparticles may have damaging effects. Therefore, it could be helpful to know the levels of airborne nanoplastic pollution in the environment.

Previously, Jelinek’s research team at Ben-Gurion University of the Negev developed an electronic nose or “e-nose” for monitoring the presence of bacteria by adsorbing and sensing the unique combination of gas vapor molecules that they release. The researchers wanted to see if this same carbon-dot-based technology could be adapted to create a sensitive nanoplastic sensor for continuous environmental monitoring.

Carbon dots are formed when a starting material that contains lots of carbon, such as sugar or other organic matter, is heated at a moderate temperature for several hours, says Jelinek. This process can even be done using a conventional microwave. During heating, the carbon-containing material develops into colorful, and often fluorescent, nanometer-size particles called “carbon dots.” And by changing the starting material, the carbon dots can have different surface properties that can attract various molecules.

To create the bacterial e-nose, the team spread thin layers of different carbon dots onto tiny electrodes, each the size of a fingernail. They used interdigitated electrodes, which have two sides with interspersed comb-like structures. Between the two sides, an electric field develops, and the stored charge is called capacitance. “When something happens to the carbon dots — either they adsorb gas molecules or nanoplastic pieces — then there is a change of capacitance, which we can easily measure,” says Jelinek.

Then the researchers tested a proof-of-concept sensor for nanoplastics in the air, choosing carbon dots that would adsorb common types of plastic — polystyrene, polypropylene and poly(methyl methacrylate). In experiments, nanoscale plastic particles were aerosolized, making them float in the air. And when electrodes coated with carbon-dot films were exposed to the airborne nanoplastics, the team observed signals that were different for each type of material, says Jelinek. Because the number of nanoplastics in the air affects the intensity of the signal generated, Jelinek adds that currently, the sensor can report the amount of particles from a certain plastic type either above or below a predetermined concentration threshold. Additionally, when polystyrene particles in three sizes — 100-nm wide, 200-nm wide and 300-nm wide — were aerosolized, the sensor’s signal intensity was directly related to the particles’ size.

The team’s next step is to see if their system can distinguish the types of plastic in mixtures of nanoparticles. Just as the combination of carbon dot films in the bacterial e-nose distinguished between gases with differing polarities, Jelinek says it’s likely that they could tweak the nanoplastic sensor to differentiate between additional types and sizes of nanoplastics. The capability to detect different plastics based on their surface properties would make nanoplastic sensors useful for tracking these particles in schools, office buildings, homes and outdoors, he says.

The researchers acknowledge support from the Israel Innovation Authority.

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