COVID-19 fear delays kids getting diagnosed with type 1 diabetes

Thursday, 8 October 2020

The number of children going to hospital with life-threatening complications from new onset type 1 diabetes has risen dramatically during the COVID-19 pandemic, Australian research suggests.

Diabetic Ketoacidosis (DKA), a potentially fatal condition that is caused by very high blood glucose levels and the build up of acidic substances called ketones, is developing because families have been avoiding hospitals during the pandemic, clinicians at the John Hunter Children’s Hospital in Newcastle have reported.


Symptoms of type 1 diabetes include the four Ts:

  • Tired: unexplained or excessive fatigue
  • Thirst: a thirst that can’t be quenched
  • Thin: sudden and unexplained weight loss
  • Toilet: frequent urination, especially at night

In an observational study reported in the Australian Doctor, the researchers compared rates of severe DKA presentations in children and adolescents at the John Hunter Children’s Hospital between March and May with the same period five years ago.

Severe DKA presentations jumped from around 5% of children and adolescents to 45% during this year’s COVID-19 restrictions.

The overall frequency of DKA, including mild, moderate and severe cases, was 73% of children and adolescents this year compared to 25% of paediatric presentations in the previous five years.

No significant rise in t1 diagnoses

There has been no significant difference in the number of new type 1 diabetes diagnoses in the pandemic period, with 11 cases recorded at the hospital in 2020 compared with 6-10 cases each year between 2015 and 2019.

In further evidence that people are not taking children to Emergency Departments, the John Hunter Children’s Hospital ED presentations for children and adolescents dropped from 6,550 per month before COVID-19 to 4,799 per month in 2020.

The authors suggest that presentations of new-onset type 1 diabetes were delayed because of concerns over the spread of COVID-19 and the restrictions put in place to control its spread.

“It is possible that people felt that going to their doctor or emergency department would have placed them at risk of contracting COVID-19,” they said.

Seek medical advice immediately

The authors concluded that further studies at more hospitals were needed to confirm an Australian-wide experience.

Diabetes NSW & ACT is seeking Government commitment to skilling health staff and the community in the symptoms of type 1 diabetes in a push to decrease the rates of DKA. If parents or carers notice the four T symptoms in their children, they should seek medical advice immediately.

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