April 11, 2022 | Since the beginning of the pandemic, the number of cases of type 1 and type 2 diabetes in children has increased worldwide, according to several studies. Although COVID-19 does not appear to cause diabetes, it may play a role in this increase in cases. The explanations of two specialists from Quebec.
Studies in the United States and Europe show that COVID-19 and diabetes appear to be linked. “In Quebec, the situation is difficult to quantify for type 1 diabetes because, unlike Europe and the United States, we do not have a registry that lists cases of this autoimmune disease at provincial or even federal level,” stresses Laurent Legault, pediatric endocrinologist at Hôpital de Montreal for children. Furthermore, there are currently no Canadian studies on this Theme.
“However, we are beginning to see a Signal of an increase in type 1 diabetes cases in children in hospitals ” notes Rémi Rabasa-Lhoret, an endocrinologist at the Clinical Research Institute of Montreal and the University of Montreal Hospital Center. So also in the Montreal Children’s Hospital.
On the other hand, better known is the increase in cases of type 2 diabetes in Quebec. “The number of cases in children has doubled during the pandemic,” says Dr. Laurent Legault.
In the United States, the Centers for Disease Control and Prevention reports that children and adolescents infected with the coronavirus are 2.5 times more likely to be diagnosed with type 1 or type 2 diabetes than those who did not contract the virus. Another US study reports a 57% increase in the number of young people admitted with type 1 diabetes between March 2020 and March 2021.
In Europe, researchers have also noted more diagnoses of type 1 diabetes during the pandemic. In addition, they noticed an increase in the frequency and severity of diabetic ketoacidosis (severe hyperglycemia). This complication of diabetes is potentially fatal if left untreated.
COVID-19 does not cause diabetes
The coronavirus is unlikely to cause diabetes as such. However, this virus would be a trigger or accelerator in people likely to develop diabetes, because of their genetics (especially for type 1) or their lifestyle (for type 2).
What is insulin used for?
Insulin constantly adjusts blood sugar levels so that they are neither too high nor too low. Without it, the body cannot use sugar, for example, as a source of energy to perform its vital functions.
In the case of type 1 diabetes, experts believe the coronavirus signals the immune system to attack cells in the pancreas that produce insulin, as do other common respiratory infections in early childhood. “In a genetically predisposed person, the virus could preempt the onset of the disease,” thinks dr Rémi Rabasa-Lhoret.
Type 2 diabetes, in turn, usually develops as a result of a genetic predisposition in combination with unfavorable lifestyle habits. To explain the increase in type 2 diabetes cases during the pandemic, doctors point to the large sedentary lifestyle associated with health regulations.
“The children became inactive and gained weight. This makes the body less efficient at using the insulin produced by the pancreas and regulating blood sugar levels,” explains Dr. Laurent Legault.
Furthermore, The coronavirus would change the mechanisms of insulin production. “Like the flu virus, the coronavirus is thought to cause insulin resistance,” says Dr. Rémi Rabasa-Lhoret.
According to this specialist, the multisystem inflammatory syndrome associated with COVID-19 could also trigger diabetes.
Do we need to worry?
Despite the surge in cases since the pandemic began Parents should not worry that their child will develop diabetes after COVID-19. “You should know that the number of new cases of type 1 diabetes diagnosed in children each year has been increasing for a long time,” says Dr. Laurent Legault.
In addition, this would also explain part of the increase in diabetes cases, especially in type 2 Children who were hospitalized underwent several tests. These tests made it possible to detect diabetes that would probably have been diagnosed a little later.
According to the two endocrinologists The problem with diabetes is the exposure time to the disease. The earlier a person develops diabetes, the more likely they are to have long-term complications if they have poor blood sugar control. Kidney, eye and heart damage are among the potential complications.
Sources: Centers for Disease Control and Prevention and JAMA Pediatrics
Nathalie Kinnard – Born and raised