IWK specialist fears rise of significant diabetes issues in kids throughout lockdown

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As Nova Scotia enters the second week of lockdown, a specialist at the IWK Health Center in Halifax is concerned that parents will again be reluctant to hospitalize their children if they show signs of diabetes, which can lead to a serious illness Complications.

Dr. Beth Cummings, a pediatric endocrinologist and diabetes specialist, says nearly 50 percent of new diagnoses of type 1 diabetes in the children’s hospital last year were cases where the patient developed diabetic ketoacidosis, a serious complication that results in death can lead .

She says the hospital had several cases where the children in the intensive care unit ended up in a coma and with mild brain swelling.

“It makes children very sick, and we’ve seen this happen much more frequently in COVID times than before,” said Dr. Cummings.

Diabetic ketoacidosis is when a person is so low on insulin that they cannot use glucose for energy, she said. It can make patients sluggish, and they can experience vomiting and rapid breathing.

She notes that her colleagues across the country are seeing similar trends. “It shouldn’t be something you put off next week or next month.”

Dr. Beth Cummings, a diabetes specialist at the IWK Health Center in Halifax, says she is alarmed at the number of children who have had severe complications prior to being diagnosed with type 1 diabetes. (Submitted by Dr. Beth Cummings)

A year ago, Dr. Cummings sounded the alarm after the IWK diagnosed only one case of type 1 diabetes in two months, which they should have seen about eight. At the time, she feared parents were afraid of COVID-19 and might avoid the emergency room.

Last week the Nova Scotia Health Department urged people to stop non-urgent blood tests to help laboratories cope with a rush of COVID-19 tests. Cummings is concerned that parents think this is true for diagnosing diabetes.

“It is currently difficult to book a laboratory test. Many people have to wait a few weeks and a child could get very sick and have diabetic ketoacidosis beforehand. Therefore, this test must generally be done on the same day as you notice the symptoms.”

According to Cummings, diabetes can be diagnosed with a urine test in a family doctor’s office, or parents can come straight to the IWK’s emergency room.

She says if parents or caregivers notice the most common symptoms – bed-wetting, frequent urination, extreme thirst, or weight loss – they need to take their child for an assessment right away.

“Parents should follow their instincts. If they feel that their child is not doing well and they sought help prior to COVID, regardless of these symptoms, they should do so.”

Dr. Beth Cummings shared this International Diabetes Federation poster to help families remember the tell-tale symptoms of type 1 diabetes. (Submitted by Dr. Beth Cummings)

Another problem is that schools are closed. She says teachers are often key to spotting the signs and reporting cases to parents.

“A parent who is with their child all day each day may not notice how their peeing or weight loss changes.”

Most people show signs of Type 1 when they’re under 25, she said.

“Teenagers are probably the highest rate at which we get a new diagnosis.”

She is concerned about encouraging all parents to have their child screened and advising that it is better to be wrong than risk serious complications.