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Our objective was to evaluate trends in pediatric diabetes incidence and whether COVID\u201019 was associated with increased risk across viral variant periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using National COVID\u201019 Cohort Collaborative data to evaluate incident diabetes risk among COVID\u201019\u2010positive pediatric patients compared to COVID\u201019\u2010negative patients or controls with acute respiratory illness. Cohorts were weighted on demographics, data site, and body mass index percentile. The primary outcome was the cumulative incidence ratio (CIR) of incident diabetes for each viral variant era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was no difference in the risk of incident diabetes in pediatric patients after COVID\u201019 compared to patients in COVID\u201019 negative or ARI control groups during any of the viral variant periods (e.g., ancestral period CIR 1.03, 95% CI 0.65\u20131.41). The predominant subtype of incident diabetes was T2D. Incidence rates over time followed a U\u2010shaped curve, with the highest incidence in the ancestral variant period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>COVID\u201019 was not associated with an increased risk of diabetes in pediatric patients. Incidence rates were highest early in the pandemic, and mirrored patterns of pandemic\u2010era healthcare utilization. The predominance of incident T2D subtype is concerning for the adverse effects of pandemic\u2010related lifestyle changes among pediatric patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/pedi\/3545727","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T12:49:46Z","timestamp":1764938986000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of COVID\u201019 on Incident Diabetes in Pediatric Patients: Findings From the National COVID\u201019 Cohort Collaborative 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