The bad rainbow of COVID-19 time: effects on glucose metabolism in children and adolescents with obesity and overweight

Background: COVID-19 restriction measurements have enhanced the obesity status in the pediatric population which might further contribute to obesity-related glucose-insulin metabolism alterations. Therefore, we retrospectively compared anthropometric and OGTT data on children with obesity during the 13 years before and during the COVID-19 pandemic. Subjects/methods: Data from 741 children with obesity and overweight were retrieved and clustered into seven groups starting from year 2008–2009 until 2020–2021. Differences in anthropometric measurements and glucose/insulin metabolism were evaluated between the different groups. Results: Children with overweight and obesity in the COVID-19 restriction group did not present increased values of SDS­Body Mass Index (BMI). Significantly higher values for Waist Circumference (WC), SDS-WC, Waist/Height ratio (WHtR), and body mass fat were detected in these children (all P < 0.01). Fasting glycaemia, glucose, and insulin excursions were significantly higher compared to pre­ pandemic children (all P < 0.01). Insulin resistance was higher while insulin secretion was lower (all P < 0.01) determining a significantly higher percentage of impaired glucose tolerance in the COVID-19 restriction group (P < 0.002). Furthermore, High-Density Lipoprotein (HDL) cholesterol was significantly lower (P < 0.01) and SDS for systolic and diastolic blood pressure values were significantly higher (P = 0.03 and P = 0.02, respectively). Conclusions: COVID-19 restriction measurements determined profound alterations in glucose and insulin metabolism in children with obesity and overweight. Urgent strategies are needed in order to reverse COVID-19 restriction measures’ effects on glucose and insulin metabolism.