A recent study by the Centers for Disease Control and Prevention shows that COVID-19 may be associated with a lifelong health problem for some children who get the disease. The study, published on January 7, showed that children and teens are more likely to be diagnosed with diabetes a month or more after their COVID infection compared to those who did not have COVID.
Using two different health databases, IQVIA and HealthVerity, researchers evaluated data from thousands of patients under the age of 18 between March 1, 2020 and February 26, 2021, comparing those who had been diagnosed with COVID-19 with those who had had a pre-pandemic, non-COVID respiratory infection, and also to those who had none of them.
They found that children in the IQVIA database diagnosed with COVID-19 at that time were 166% more likely to be diagnosed with diabetes later than those who did not have COVID. In the HealthVerity database, children with COVID were 31% more likely to be diagnosed with diabetes.
Researchers said children who had COVID were also 116% more likely to develop diabetes than those who had non-COVID respiratory infections before the pandemic. Non-COVID respiratory tract infection “was not associated with diabetes,” researchers said.
Dr. Mary Pat Gallagher, director of NYU Langone’s Pediatric Diabetes Center, told CBS News that it is believed that certain infections can create a “perfect storm” that contributes to the development of diabetes.
“If you’re developing diabetes, will an infection really push you to a diagnosis faster than you would otherwise have experienced?” she said. “It seems that we may now be finding out that COVID is one of those viruses that might do it a little more than other viruses.”
“I think it’s likely we do not have the data, but that these children were on their way to developing diabetes. Maybe it would have been in two years, maybe it would have been in five years, but it came.” she added. “And perhaps this infection has pushed them in the direction of an earlier diagnosis.”
This increase in diabetes diagnoses throughout the pandemic is something that Dr. Sheela Natesh Magge, director of the pediatric endocrinology department at Johns Hopkins, has also seen.
“We see so many more children coming in with diabetes,” she told CBS News. “And they’re sicker.”
The CDC’s investigation, Magge explained, helps confirm this information. However, it does not clarify whether diabetes is spurred by COVID itself or by other factors. The study is based on data from insurance claims and does not include information on demographic risk factors that could have contributed to a diabetes diagnosis, including previous health status, weight and environment.
Magge specifically pointed out that the pandemic has increased food insecurity, along with increasing stress and obesity over the last two years – factors that can significantly affect overall health.
“There is some evidence that COVID-19 infection may affect insulin secretion,” she said. “So you know, we just do not know what of the different effects of the pandemic is the cause. Is it actually infection, or is it just the pandemic itself and all the societal factors related to it?”
“You can see it because of all the problems with children who are at risk [of diabetes], just like because of food insecurity, parents without work, inactivity, “she said,” all these other factors are there too. “
Researchers noted this in their study, saying that the development of diabetes could be attributed to how COVID affects the body’s organs, such as the “direct attack of the pancreatic cells.” Researchers said it is also likely that some of the patients included in the study already had prediabetes when they got COVID. Pre-diabetes, they said, affects 20% of young people in the United States
“If you were already in danger, the pandemic has probably made it worse,” Magge explained. “The stress of any infection can increase your blood sugar and can put you at a higher risk for any of the complications of diabetes because your blood sugar can get higher.”
Researchers also said pandemic weight gain and steroid treatment that patients may have received while hospitalized could have contributed to high blood sugar and diabetes. However, they added that only 1.5% to 2.2% of the patients they studied are thought to have drug- or chemical-induced diabetes.
Several studies of the factors involved in the diagnosis of diabetes and the severity of the disease need to be performed, the CDC said.
Whether pediatric diabetes cases stem directly from the virus itself or from these broader consequences, Magge said the study is “certainly alarming,” especially when considering the long-term effect.
“I think it underscores that there are a lot of things we do not know about this virus,” she added. “It emphasizes the importance of prevention, the importance of all be vaccinated and all those things, for there is much we do not know, and it is certainly worrying. ”
Having COVID or any other viral infection while having diabetes can also make it harder to manage diabetes, added Dr. Gallagher.
“COVID in particular really seems to put children at risk for diabetic ketoacidosis much more frequently when they have type 2 diabetes than we saw with other viral infections in the past,” she said. Diabetic ketoacidosis occurs when there is not enough insulin and the liver begins to break down fat into fuel. This process produces acids called ketones, which can build up to dangerous levels, according to the CDC.
“It’s a little bit scary,” Gallagher said, “because it’s life threatening.”
Many reports indicate that COVID-19 symptoms are generally milder in children, and that Omicron variant also appears to be somewhat less severe than previous strains. But Magge said there is no way to know what is long-term effects of having COVID will be, regardless of symptoms.
Dr. Gallagher urged people to “not panic” over the study’s finding, but to use it as a reminder to work to prevent COVID infections and for parents to be aware of diabetes symptoms. These may include increased thirst and urination and weight loss. More severe symptoms include nausea, vomiting and lethargy.
COVID vaccines recommended for at age 5 and up, “does not necessarily absolutely prevent you from getting an infection … and we do not have data on whether vaccination will reduce the risk of developing diabetes after COVID infection yet, because it is very new. But there is good reason to think that maybe, “she said.
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