Spike in extreme pediatric kind 2 diabetes complication throughout COVID-19 pandemic

According to the Centers for Disease Control and Prevention (CDC), children generally appear to be less affected by COVID-19 than adults. However, a new study from Los Angeles Children’s Hospital shows that the pandemic could affect children’s health in unexpected ways. The study shows an increase in patients with diabetic ketoacidosis, a serious complication of type 2 diabetes. These data, released today in Diabetes Care, provide additional insight into the potential impact of the pandemic on the country’s children.

Diabetic ketoacidosis, or DKA, is life threatening. “DKA occurs when the level of insulin in the blood is too low for too long,” says Dr. Lily Chao, MS, Interim Medical Diabetes Director at CHLA. “Insulin helps the body use glucose. So when there isn’t enough insulin, the body begins to break down fat for energy.”

This process, she says, causes dangerously high levels of acid in the blood. If left untreated, this can lead to cerebral edema, coma, or even death. “Children come in with dehydration and DKA. But DKA is preventable and reversible if we treat it early and appropriately,” says Dr. Chao, the lead author of the paper.

Dr. As early as March 2020, Chao and her colleagues noticed that more and more patients with DKA and type 2 diabetes were coming. “We used to see a couple of DKA cases a year in type 2 diabetes,” she says, “and all of a sudden we saw an increase, so we started to keep track. Now we have the numbers that confirm that there are more children. ” with type 2 diabetes who come with this very serious complication of DKA. “

However, the question remains: what is the cause of the increased incidence of type 2 diabetes in DKA?

A year after the COVID-19 pandemic began, many children are used to wearing masks and taking online classes. But other changes have affected them as well. Fewer children may make it to the doctor’s office for their routine checkups for healthy children, possibly due to fears that families will feel exposure to SARS-CoV-2, the virus that causes COVID-19.

“Parents are afraid to leave the house,” says Dr. Chao. “Some families have to use public transport to go to the pediatrician and they are reluctant to do so during the pandemic.”

This, she says, could be one of the reasons for the shift that she and her colleagues have seen.

In addition to the lack of medical attention, other factors may play a role, such as: B. Less physical activity during lockdown or limited access to fresh, healthy food. However, there can also be a biological relationship between exposure to the virus and diabetes.

“There is definitely a link between COVID-19 and diabetes,” says Dr. Senta Georgia, researcher at the Saban Research Institute of Children’s Hospital in Los Angeles and senior author of the paper. Dr. Georgia is conducting a basic and translational research program to understand the cell biology of diabetes and develop novel therapeutics. “We don’t know if SARS-CoV-2 infects insulin-secreting cells in the pancreas,” she says. “There have been some reports of an association between COVID-19 and diabetes in adults, but no pediatric studies have been published to date.”

As a medical scientist and laboratory scientist, Dr. Chao and Dr. Georgia Unique Perspectives – but its goals are focused on getting answers to help children diagnosed with diabetes.

“Our collaboration at Los Angeles Children’s Hospital enables us to address pediatric health on multiple levels,” said Dr. Georgia. “I help Dr. Chao with the design of her clinical studies and she works with me on our basic and translational research. So we come to the problem of the increased incidence of diabetes from both a clinical and a scientific point of view.”

Future translational and clinical studies could determine whether elevated DKA in patients could be caused by infection with SARS-CoV-2. However, for now, the data clearly suggests an emerging trend towards more severe diabetes complications during the global pandemic.

The team hopes these results will increase vigilance. “It is important for pediatricians to realize that a child who has symptoms of diabetes needs immediate screening,” says Dr. Chao. “The earlier we see these children, the greater the chance we can prevent DKA.”

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Alaina P. Vidmar, MD, co-authored the paper. The study was funded by NIH / NCRR SC-CTSI Grant Number UL1 TR000130; American Diabetes Association 7-20-COVID-173; The Homer and Gloria Harvey Foundation.

About the Los Angeles Children’s Hospital

Founded in 1901, Los Angeles Children’s Hospital is the highest-ranking children’s hospital in California and the fifth on the prestigious US News & World Report Honor Roll of Best Children’s Hospitals. US News rated Los Angeles Children’s Hospital in all 10 specialist categories. Clinical care for the hospital is directed by physicians who are faculty members of USC’s Keck School of Medicine. The 1932 Hospital Membership is the largest pediatric education program for children at a detached children’s hospital in the western United States. Los Angeles Children’s Hospital Saban Research Institute houses all of the hospital’s fundamental, translational, clinical, and community research that enables proven discoveries to reach patients quickly. Our mission: create hope and create healthier future prospects. To find out more, follow us on Facebook, Instagram, LinkedIn, YouTube and Twitter and visit our blog at CHLA.org/blog.

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