- COVID-19 infection can become severe in children with preexisting conditions like diabetes
- Diabetes weakens the immune system, which can impair the body’s ability to heal from an infection or disease
- Frequent washing of hands, practising social-distancing, healthy eating and exercise regimen, and monitoring the child’s blood glucose levels are some tips to manage diabetes and COVID-19 risks
Michael Yafi, MD, associate professor of pediatric endocrinology at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), shared insight into the impact COVID-19 has on children with diabetes, how uncontrolled diabetes can increase health risks, and offered tips on how to manage diabetes.
"Severe impacts of COVID-19 will depend on diabetes control," said Yafi, a pediatric endocrinologist with UT Physicians. "If a child has good control of their diabetes, it does not seem as though there will be severe effects if they were to get the virus. However, children with poorly controlled diabetes are at a high risk of becoming severely ill if they were to get the virus."
Diabetes occurs as a result of impaired production or utilization of the hormone, insulin. This results in improper regulation of blood glucose levels in the body.
Type 1 diabetes is an autoimmune condition in which the body's immune system attacks the beta cells in the pancreas. This results in impaired production of insulin leading to the accumulation of glucose in the blood. Type 1 diabetes is also known as juvenile diabetes as it occurs in children.
Type 2 diabetes occurs as a result of insulin resistance.
When left untreated, both conditions can severely weaken the immune system due to high blood sugar levels. The weakened immune system makes it harder to treat viral infections like COVID-19 and thus complicates the condition.
"The exact cause of severe outcomes in patients with diabetes and COVID-19 is not yet known, but research suggests that people who have diabetes have weakened immune systems, which can impact their ability to quickly heal from an infection or disease," Yafi said.
Tips to Manage Diabetes
Uncontrolled diabetes triggers a generalized inflammatory response, which results in further damage to the immune system, making it difficult to recover from an illness.
Some tips for parents of children with diabetes are:
- Encourage kids to wash hands more frequently
- Stress the importance of not touching their faces constantly with their hands
- Avoid unnecessary gatherings and practice social distancing
- Sanitize commonly used areas around the house like door knobs, counter-tops, flush handles, and switch-boards
- Monitor and maintain a record of the child's blood sugar levels
- Ensure the child eats healthy and exercises daily
- Have extra supplies of emergency medicines in case of emergency
It is known that in the presence of co-morbid conditions like diabetes, hypertension or any cardiac problems, COVID-19 infection can become severe and may require ICU admission and mechanical ventilation.
There are arguments about whether being infected with COVID-19 can cause people to develop diabetes, though this link has not been proved and needs further research.
"We know from the history of diabetes that there is a cross-reaction of viral infections and getting diabetes," Yafi said. "We also know that the previous SARS-COV virus might have triggered an immune response in patients, like onset diabetes. However, that is still to be determined because we do not have any global epidemiological information about the association between diabetes and previous COVID-19 infection."
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