Is Covid-19 behind 2-fold rise in type 1 diabetes cases in kids?

How can my child have diabetes at such a tender agerdquo was the spontaneous reaction of Ashwini Gadekar 36 mother of 10yearold Komal who was rushed to the emergency room of civicrun Shatabdi Hospital Govandi last week in a comatose state Fortunately timely medical aid was provided and she regained her senses 48 hours after her admissionThreeyearold Radhika name changed was also admitted during the same period in a similar comatose state with multiorgan failure She had to be put on ventilator support at Jaslok Hospital Brave Radhika fought all odds and is now on the path of recovery and will be returning home by this weekendBoth Komal and Radhika were diagnosed with Diabetic Ketoacidosis DKA and were in a very critical condition Both have been tagged for Type 1 diabetes and will be on insulin support for the rest of their livesDr Mahesh Mohite senior consulting paediatrician and intensivist at Wadia Children Hospital Parel right Dr Fazal Nabi Director Paediatrics at Jaslok HospitalInterestingly their parents had no clue about them Komal and Radhika being diabetic The paediatricians caution that DKA is a highrisk stage and earlier detection can prevent the child from suddenly slipping into a comatose state which gradually leads to multiorgan failure if emergency treatment is not given within the rule of golden hoursWith BMCrsquos initiative to start Diplomate of National Board DNB courses in six peripheral hospitals some of the civicrun peripheral hospitals including Shatabdi have started performing many supra major surgeries and are also treating highrisk complicated paediatricmedical casesHer ugar level was 650Speaking to midday Dr Chetan Shetty Head of the Department Paediatrics hired as a fulltime consultant for teaching DNB students said ldquoKomal was brought to us in a very critical condition she was breathing heavily and was in a severely dehydrated state For the past one week Komal was very sick Her sugar was 650 normal values lt200 and other blood tests revealed that the acids in her blood had increased to lifethreatening levels due to complications of diabetes diabetic ketoacidosis She was immediately admitted to the Paediatric Intensive Care Unit PICU treated with fluids and insulin infusions It took over 48 hours for her to regain and come back to normalcy She was subsequently shifted to the paediatric ward and was finally discharged on Saturday March 5rdquoStarted two weeks agoKomalrsquos mother Ashwini works as a housemaid and is the sole breadwinner earning R6000 monthly her husband stays away at their native place Ashwini said ldquoKomal never had any health issues The problem started around two weeks ago when Komal had almost stopped eating food We took her to a local physician who diagnosed her with typhoid The initial few days she took medicine but her condition only deterioratedrdquoAshwini recalled ldquoKomal was at home and suddenly she fell unconscious Luckily I was home and I rushed her to Shatabdi Hospital where treating doctors informed that her condition was critical and that they would do their best I feared for the worst but as the doctors were very good they could save my daughters life Komal is back home and doctors have advised her to take insulin four times which they only helped us to getCan Komal lead normal lifeDr Shetty said ldquoWe have given her a short dose of insulin at present so that her sugar levels can be monitored Gradually we will shift her to a single dose of insulin which will last for a longer duration She will have to depend on insulin for the rest of her life but she can do everything that a child of her age would dordquoSigns to look forDr Shetty said ldquoThe clinical signs of DKA include severe dehydration deep breathing nausea andor vomiting abdominal pain blurry vision confusion drowsiness progressive decrease in the level of consciousness and eventually loss of consciousness coma etc The primary risk factors for DKA are especially more in poorer countries due to delayed diagnosis lower prevalence poor compliance and limited access to medical servicesTwofold rise in DKADr Fazal Nabi Director Paediatrics at Jaslok Hospital said ldquoCOVID19 has impacted our lives making all of us more indoor which greatly introduces many health problems such as obesity leading to Diabetes Mellitus and Hypertension Normally the incidence of DKA is one case a year in a private set up but during during this pandemic period it has increased to threefour cases a year showing a twofold rise in DKA This is also supported by European data The DKA symptoms are polyuria polydipsia weight loss abdominal pain vomiting etc but due to COVID impact the patients are admitted in emergency rooms with complications such as comatose confusion renal failure etcrdquoRadhika was savedDr Nabi said ldquoA threeyearold girl Radhika was brought to Jaslok Hospital with breathlessness and altered sensorium for two days With our efforts we revived the patient I have at present three paediatric cases who are type 1 diabetic and will require insulin support for the rest of their livesrdquoHe added that parents can easily monitor bedside glucose level urine ketones which will help in diagnosing DKA By keeping a check parents can handle the child from slipping into a complicated situation of DKACorrelation needs more dataDr Mahesh Mohite senior consulting paediatrician and intensivist at Wadia Children Hospital Parel and runs a private clinic in Panvel said ldquoUsually I would earlier get ten cases of type 1 paediatric diabetes in the age group of 5 to 15 years yearly And after the second wave of COVID19 we had almost 12 cases of type 1 paediatric Diabetic Ketoacidosis in span of three months These children have to spend the rest of their lives taking insulinrdquoHowever Dr Mohite further said ldquoWe do not have any confirmatory reply or scientific data to correlate COVID and sudden spur in type 1 diabetic casesrdquo Dr Nabi and Dr Shetty agreed and said ldquoMore analytical data would be required for getting clarity on the samerdquo