IWK specialist fears rise of serious diabetes complications in children during lockdown

·3 min read
Dr. Beth Cummings said there were a few cases over the last year where children ended up in intensive care because their Type 1 diabetes wasn't caught early on. (Mario Anzuoni/Reuters - image credit)
Dr. Beth Cummings said there were a few cases over the last year where children ended up in intensive care because their Type 1 diabetes wasn't caught early on. (Mario Anzuoni/Reuters - image credit)

As Nova Scotia enters its second week of lockdown, a specialist at the IWK Health Centre in Halifax says she's concerned that parents will yet again hesitate to bring their children to the hospital if they're showing signs of diabetes, leading to the possibility of serious complications.

Dr. Beth Cummings, a pediatric endocrinologist and diabetes specialist, says in the last year, nearly 50 per cent of new diagnoses of Type 1 diabetes at the children's hospital were cases where the patient developed diabetic ketoacidosis, a serious complication that can lead to death.

She says the hospital had several cases where the children ended up in intensive care in comas and with mild brain swelling.

"It makes kids very sick, and we've seen that happen a lot more during COVID times than it was happening prior," said Dr. Cummings.

Diabetic ketoacidosis is when a person has so little insulin they cannot use glucose for energy, she said. It can make patients lethargic, and they can experience vomiting and rapid breathing.

She notes that across the country, her colleagues are seeing similar trends. "It shouldn't be something that you put off to next week or next month."

Dr. Beth Cummings, a diabetes specialist at the IWK Health Centre in Halifax, says she's alarmed by the number of kids who have developed severe complications before being diagnosed with Type 1 diabetes.
Dr. Beth Cummings, a diabetes specialist at the IWK Health Centre in Halifax, says she's alarmed by the number of kids who have developed severe complications before being diagnosed with Type 1 diabetes. (Submitted by Dr. Beth Cummings)

One year ago, Dr. Cummings raised the alarm after the IWK diagnosed just one case of Type 1 diabetes in two months, when they should have seen about eight. At the time, she feared parents were scared of COVID-19 and might be avoiding the emergency department.

Last week, Nova Scotia's health authority asked people to cancel non-urgent blood work in order to help the labs cope with an onslaught of COVID-19 tests. Cummings is concerned that parents will think that applies to diabetes diagnosis.

"It's hard to book a lab test right now. A lot of people have to wait a couple of weeks, and a child could become very sick and have diabetic ketoacidosis before that, so it's a test that needs to be done the same day basically as you notice the symptoms."

Cummings says diabetes can be diagnosed with a urine test in a family doctor's office, or parents can come straight to the emergency department at the IWK.

She says if parents or caregivers notice the common symptoms — bed wetting, frequent urination, extreme thirst or weight loss — they need to take their child for an assessment immediately.

"Parents should follow their instincts. If they feel their child is unwell, and they would have sought care before COVID, they should do so no matter what those symptoms are."

Dr. Beth Cummings shared this poster from the International Diabetes Federation to help families remember the telltale symptoms of Type 1 Diabetes.
Dr. Beth Cummings shared this poster from the International Diabetes Federation to help families remember the telltale symptoms of Type 1 Diabetes.(Submitted by Dr. Beth Cummings)

Another concern is that schools are closed. She says teachers are often key in spotting the signs and flagging cases to parents.

"A parent who is with their child all the time, every day, may not notice the changes in peeing more or losing weight."

Most people show signs of Type 1 when they're under 25, she said.

"Teenagers are probably the highest rate where we get a new diagnosis."

She encourages any parent with concerns to get their child checked, pointing out it's better to be wrong than risk serious complications.

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