April 11, 2022 | Since the start of the pandemic, the number of cases of type 1 and 2 diabetes in children has increased, according to several studies around the world. Although COVID-19 does not appear to cause diabetes, it may have a role to play in this increase in cases. The explanations of two specialists from Quebec.
In the United States and Europe, studies show that COVID-19 and diabetes appear to be related. “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 the cases of this autoimmune disease at the provincial or even federal level,” says Laurent Legault, pediatric endocrinologist at the Montreal Hospital for Children. Additionally, there are currently no Canadian studies available on the subject.
“However, we are beginning to see a Sign of increasing cases of type 1 diabetes in children in hospitals “, points out Rémi Rabasa-Lhoret, an endocrinologist at the Montreal Clinical Research Institute and the Hospital Center of the University of Montreal. This is also the case at Montreal Children’s Hospital.
Instead, the increase in cases of type 2 diabetes in Quebec is better known. “The number of cases has doubled in children during the pandemic,” says Dr. Laurent Legault.
In the United States, the Centers for Disease Control and Prevention report 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 have not contracted 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 type 1 diabetes diagnoses during the pandemic. In addition, they noted an increase in the frequency and severity of diabetic ketoacidosis (severe hyperglycemia). This complication of diabetes is life-threatening if left untreated.
COVID-19 does not cause diabetes
The coronavirus probably does not cause diabetes as such. However, this virus would be a trigger or an accelerator in people susceptible to developing diabetes, by your genetics (especially for type 1) or your lifestyle (for type 2).
What is insulin used for?
Insulin constantly adjusts the blood sugar level so that it is neither too high nor too low. Without it, the body cannot, for example, use sugar as a source of energy to carry out its vital functions.
In the case of type 1 diabetes, experts believe the coronavirus signals the immune system to attack the cells in the pancreas that produce insulin, much like other common respiratory infections in early childhood. “In a genetically predisposed person, the virus could anticipate the onset of the disease,” thinks Dr. Rémi Rabasa-Lhoret.
For its part, type 2 diabetes usually develops due to a genetic predisposition combined with poor lifestyle habits. To explain the increase in cases of type 2 diabetes during the pandemic, doctors point to the great sedentary lifestyle related to health standards.
“The children became inactive and gained weight. This makes the body less efficient in using the insulin produced by the pancreas and in regulating blood sugar levels”, explains Dr. Laurent Legault.
On the other hand, the coronavirus would modify 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, multisystem inflammatory syndrome, which is associated with COVID-19, could also trigger diabetes.
Should we be worried?
Despite the increase in cases since the start of the pandemic, parents do not need to worry that their child will develop diabetes after having COVID-19. “You should know that the number of new cases of type 1 diabetes diagnosed each year in children has been on the rise for a long time,” says Dr. Laurent Legault.
In addition, part of the increase in cases of diabetes, especially type 2, would also be explained by the fact that children admitted to the hospital underwent various tests. These tests allowed to detect a diabetes that probably would have been diagnosed a little later.
According to the two endocrinologists, the problem with diabetes is the time of exposure 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 possible complications.
Sources: Centers for Disease Control and Prevention and JAMA Pediatrics
Nathalie Kinnard – Born and raised