The corona pandemic has doubled the number of children with life-threatening metabolic imbalances due to undetected diabetes. An interview with Professor Andreas Neu from Tübingen University Hospital, Vice President of the German Diabetes Society.
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How can this sudden increase in diabetes-related metabolic disorders be explained?
A so-called ketoacidosis – that is a severe hypoglycemia with excess acidity of the body due to a lack of insulin – is indeed something dangerous and possibly life-threatening. The increase during the first corona lockdown in spring 2020 has several causes:
1. During this phase, attention was paid to other symptoms. They looked for signs of infection, checked fever and things like that.
2. For fear of infection, visits to the doctor were avoided as much as possible.
3. Many routine appointments and checkups have been postponed. Often, diabetes is discovered as part of a routine appointment.
4. Was the number of consultation hours in many practices or medical institutions reduced?
The sum of these factors has led to the fact that in many cases the diabetes manifestation was recognized far too late.
So the number of children with diabetes has not increased?
The number has not changed in the last year. It has risen as much as in the previous 20 years. In other words, there was no episode here due to the corona.
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A recent study shows that during the spring lockdown in Germany, the number of children with a life-threatening metabolic imbalance due to undetected diabetes doubled.
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IMAGO / MASKOT
How many children are we talking about in Germany?
In Germany around 32,000 children and adolescents under the age of 20 suffer from type 1 diabetes.
What is type 1 diabetes and what are the consequences?
In type 1 diabetes, the vital insulin is no longer produced. As a result, glucose utilization is disturbed. This means that the cells can no longer absorb the sugar and use it for their energy production. So we have an oversupply of carbohydrates in the body. That is, too much glucose. However, this cannot be used and the organism starves internally.
How can I tell if my child is developing diabetes?
The symptoms are relatively easy to spot:
- Frequent drinking,
- frequent urination,
- Weight loss and
- Slump in performance.
These are the classic symptoms of diabetes. Once identified, these symptoms are easy to identify. On the other hand, they are not dramatic either – nobody is in pain, nobody is bleeding. It is therefore important to be very aware of symptoms.
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Type 1 diabetes: the body can no longer produce the hormone insulin or cannot produce enough to lower the blood sugar level.
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IMAGO / agefotostock
Should paediatricians give parents these symptoms even more intensively during preventive examinations?
We believe that everyone who deals with children and young people, parents, educators, teachers, sports supervisors, should know these warning signs of diabetes. Because the number of serious metabolic disorders in Germany has not decreased for 20 years. We are talking about 20 percent of all new diabetes cases associated with this complication. This is a situation that we think of: it is unsustainable. We have to do something. The first thing we can do is raise awareness. We have it – the professional associations together with the Professional association for paediatricians – tackled for this year.
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In dealing with diabetes, for example in diagnosis, in technology (injections, blood sugar measurement) and in innovations for the everyday life of those affected, there has been significant progress in recent years.
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IMAGO / YAY Images
What has improved significantly in the development and treatment of diabetes in recent years?
Thanks to technical innovations, therapies have become completely different than they were just a few years ago. Almost all children have what is known as continuous glucose monitoring. That means a small catheter in the subcutaneous fatty tissue and a reader that permanently displays the glucose level in the organism. Many children today no longer use the syringe or a similar variant of the PEN for insulin injection, but an insulin pump. It administers the insulin continuously, partly automatically, and thus simulates the function of the natural pancreas. These technical innovations are practically standard in child diabetology today and have made life much easier for those affected.
However, it still remains a challenge to deal with these technical aids. Because type 1 diabetes is still a chronic disease that makes itself felt in many everyday situations and that we can treat, but not cure.
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