In pandemic, early indicators of childhood diabetes could also be missed, professional warns | Native Information


Melissa Mucha’s son hadn’t felt right.

The symptoms would drain and drain – one day 11-year-old Connor would feel fine and the next he would be sick. But since it was cold and flu season, she thought it was just a mistake. His COVID-19 test was negative, so Mucha and her husband Matt “didn’t really think about it much”.

Soon after that, Connor had gotten worse and worse. He couldn’t suppress anything and quickly lost weight.

“He looked like a skeleton,” said Mucha of Keene. “He’s a little kid to start with, so if you lose 12 pounds so quickly it is a marked one Difference in appearance. … It was like dying. “

He was taken to the emergency room, where it was quickly discovered that his blood sugar levels had caused him to be in diabetic shock. Connor was diagnosed with type 1 diabetes within minutes.

“There’s nothing you can do to prevent or cure it. So it’s a lifelong, manageable condition,” said Mucha. “And when you’re 11, it’s hard.”

Dartmouth-Hitchcock Children’s Hospital reports that more severe cases of pediatric type 1 diabetes are emerging during the COVID-19 pandemic.

And while the viral disease itself isn’t causing this surge, some of the effects of the pandemic – like increased use of telemedicine services – can leave doctors missing early warning Ann Christiano, a pediatric nurse and coordinator of the pediatric diabetes program at Dartmouth-Hitchcock Children’s Hospital, Lebanon.

“What we’ve seen since COVID is that children present themselves more sick than they used to be,” she said.

“A worrying trend”

There are two types of diabetes that occur when blood sugar, also called blood sugar, is too high.

Type 2 is most common in the United States and accounts for around 90 to 95 percent of cases, according to John Hopkins University.

It’s usually diagnosed in adults who are overweight or inactive, Christiano said. These people can still produce insulin at first. However, the body becomes resistant to its effects and over time the pancreas stops producing insulin.

Insulin enables cells in muscle, fat, and liver to take up glucose in the blood. The glucose serves as energy for these cells or can be converted to fat if necessary. Insulin also influences other metabolic processes such as the breakdown of fat or protein.

This is a different process for Type 1, which is usually diagnosed in people under the age of 20 with no familial diabetes. Christiano said it was an autoimmune disease in which the body fights itself and ultimately destroys the cells that produce insulin.

“When you can’t use your glucose for energy, your body actually turns to burning fat for energy. The byproduct of that acid can build up quickly in the system if you don’t have insulin and it can make you very sick,” she said .

Because it’s an autoimmune disease, it takes about nine months to a year for children to develop type 1, so, according to Christiano, they don’t show symptoms until they’ve lost about 85 percent of their function.

And while people with type 2 diabetes can try to control their blood sugar by losing weight or changing their diet, type 1 is a lifelong illness and people diagnosed must take insulin.

Every fall, Christiano said, there is usually an increase in pediatric type 1 cases at the same time more people get cold or flu.

“The process isn’t directly caused by a virus … but in the end, hormones go up and our sugars go up because our bodies need more energy to fight this disease,” she said. “And if you are about to develop type 1 diabetes, you are now producing more sugar to fight that disease. This is why children are more likely to occur when they have another disease.”

That continued during the COVID-19 pandemic, but Christiano said more children were needed hospitalized for diabetes.

At Dartmouth-Hitchcock Children’s Hospital, around 50 percent of new diagnoses typically have to be hospitalized and the rest able to start outpatient care. Now she said, “it’s a much higher percentage” who are hospitalized.

“It was a worrying trend,” she said.

According to Christiano, there are several reasons for this. This includes pediatricians examining some patients over the phone to limit the number of face-to-face visits and children out of school so school nurses don’t spot them early.

The early signs of type 1 diabetes are excessive thirst and urination, said Christiano. More serious symptoms smell funny Breath or urine, nausea, vomiting, and tiredness.

Growing awareness

Tanner Thompson, 13, who lives in Keene, was diagnosed with Type 1 on Jan. 30, according to his mother, Briana.

Like Connor, Tanner was very dehydrated and said he didn’t feel right.

“I’m a nurse and I saw some signs that I was peeing a lot and I got him to go to the walk-in clinic,” she said. “He didn’t want to leave. He kicked and screamed and said he was fine … then they sent us to the emergency room, where they did more tests with Tanner and said he was in the DKA.”

Diabetic ketoacidosis, or DKA, is a serious condition that can lead to a diabetic coma or even death. It happens when the The body begins to burn fat cells for energy.

Tanner is new to his diagnosis and his mother said he was working on adjusting.

“I think he is [reacting] like a typical 13 year old … a “why me?” something like that, “said Thompson.” He has come to terms with the whole process of grieving. “

10-year-old Henry Germana began to have symptoms in early December.

His mother, Leslie, said he was extremely tired for about three weeks, despite sleeping more than 12 hours a night. Like the others, he urinated excessively and was always either sick or hungry.

“The day before his diagnosis he was sick and tired and had started to squirm as he walked from room to room,” said Germana von Keene in an email. “Then at midnight he woke up vomiting and couldn’t really tell us what was bothering him.”

She took him to the emergency room after Googling his symptoms and realizing it could be diabetes. He was also taken to Dartmouth-Hitchcock and stayed there for four days to restore his insulin levels.

“We were all very scared and concerned about what type 1 diabetes would mean for its future,” said Germana, “but we have all adjusted to this new normal and are confident.”

Like the rest of the parents, Mucha, Connor’s mother, hopes telling his story will alert more people to the early signs of the disease.

“It was extremely traumatic to see his stomach and how it went downhill So quickly and realizing that it’s not the stomach fault, “said Mucha.” And the responsibility that is required to successfully face this is difficult. It’s hard to see that your child needs to have this type of awareness. “