Parents urged to screen for diabetes symptoms after link found to COVID infections in kids

"This is just one more reason for kids to be vaccinated."

Joanne Laucius 4 minute read January 12, 2022

Researchers and physicians are urging parents to be aware of the symptoms of diabetes in children who have been infected with COVID-19.

Children were more likely to get a new diabetes diagnosis 30 or more days after being infected with COVID than those who had not been infected, according to new research published Friday by the U.S. Centers for Disease Control and Prevention.

COVID-19 doesn’t cause diabetes. But, for children who are predisposed, a virus can trigger an autoimmune process that damages the pancreas, said Dr. Sarah Lawrence, a pediatric endocrinologist at CHEO and an associate professor of pediatrics at the University of Ottawa.

“A virus — it could be just a cold — puts stress on the body. We see this all the time,” she said. “They have pre-diabetes for a period of months or years, then they tip out.”

Lawrence had suspected there might be a spike in diabetes diagnoses at CHEO during the pandemic. But, when CHEO’s new type 1 diabetes diagnoses for 2021 were tallied up, it was 127 patients — only a few more than recent numbers, which stood at a little more than 120 new diagnoses annually.

“It’s going to take us a few years to see if we have had a bump in the rate of diabetes. COVID-19 may have triggered that first bump,” Lawrence said.

“This is just one more reason for kids to be vaccinated.”

The authors of the CDC study urged health-care providers to screen for diabetes symptoms in children and youth with a history of COVID infection. Symptoms include frequent urination, increased thirst, increased hunger, weight loss, tiredness or fatigue, stomach pain and nausea or vomiting.

Lawrence and her colleagues across Canada have formed a working group to look at ways to enlist parents and the general public in increasing awareness of the symptoms in children.

“I want to reassure people. I’m not anticipating a huge spike,” Lawrence said. “But we want parents to be aware of the symptoms and to bring their kids in (to see doctors) if they notice any of these. It needs to be monitored.”

The CDC study looked at children and youth who had been diagnosed with COVID-19 in two U.S. medical claims databases, IQVIA and HealthVerity, between March 1, 2020, and Feb. 26, 2021.

The study reviewed claims of 80,893 young patients at IQVIA and 439,439 at HealthVerity. New diabetes diagnoses were 166 per cent more likely to occur at IQVIA and 31 per cent more likely to occur at HealthVerity among those who had been infected with COVID-19 than the uninfected.

Patients under 18 with COVID-19 were also more likely to get new diabetes diagnoses than those who had pre-pandemic acute respiratory infections, the researchers found.

Studies of European children and youth during the pandemic have already found increases in type 1 diabetes diagnoses and increased frequency and severity of diabetic ketoacidosis at the time of diagnosis, the CDC study noted. In adults, diabetes might be a long-term consequence of COVID-19 infection.

The pandemic may also have indirectly increased diabetes risk through increases in body mass index, which is a risk factor for both serious COVID-19 illness and diabetes.

There’s need for more research. The underlying causes, whether it’s the COVID-19 infection or treatment for an infection, need to be better understood, the CDC study said. Researchers also want to know whether diabetes associated with COVID-19 is transient or chronic.

The majority of people with type 1 diabetes, once known as “juvenile diabetes” or insulin-dependent diabetes, are diagnosed before age 18.

Diabetes Canada estimates that about 28,000 young people between the ages of 1 and 19 are living with type 1 diabetes and about 2,000 have type 2. Diabetes prevalence has increased. A decade ago, there were about 26,000 people between 1 and 19 living with type 1 and type 2, Diabetes Canada says.

Lawrence said that, when she first started practising endocrinology at CHEO in 1995, about 50 patients were diagnosed every year with type 1. It’s now a little over 120 cases.

Definitive evidence has yet to emerge, said Dr. Seema Nagpal, vice-president of science and policy at Diabetes Canada.

“At this early point in time, the research shows an association between contracting COVID-19 and then being diagnosed with diabetes — but there’s no definitive evidence that shows new onset diabetes is caused by COVID-19,” she said in a statement.

“This is very concerning and we must undertake high-quality research to determine exactly what is happening with these youth and why.”


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