T1D presentations delayed by COVID-19 cause spike in ICU

Type 1 diabetes

By Mardi Chapman

1 Jul 2020

The John Hunter Children’s Hospital in Newcastle has experienced a concerning spike in the number of children presenting ill with new onset diabetes during the COVID-19 pandemic.

Endocrinologist Dr Prudence Lopez told the limbic they had seen seven children requiring intensive care in a three-month period compared to only one child with new diabetes going to PICU in 12-months in 2019.

She said they had to assume that families were delaying presentation to hospital due to anxiety around COVID-19.

“That’s the feeling that we are getting. When we started seeing an increase we started asking and the people that we asked indicated that they did wait until later because they were worried about having been told to stay home, and seeing all the pictures of people lining up at hospital getting tested.”

However she said their spike seemed to be something of an outlier compared to other hospitals.

“I am on the APEG diabetes subcommittee and we seem to have had more unwell presentations than other areas in the country. We don’t know why that is.”

She said the general experience during COVID-19, both here and overseas, was either a lack of presentations altogether or more sick people presenting.

“We seem to be seeing more unwell people presenting late.”

“Our theory at the start was that kids weren’t going to school so teachers weren’t telling parents they are leaving the class to wee every ten minutes or they are going through bottles of water. They are not seeing grandparents who are saying how skinny they are,” she said.

“That may play into it as well the fear of coming up to the hospital and catching COVID off somebody else.”

She said Hunter New England Health had attempted to increase community awareness through advice on social media and in local news.

“We thought we should put a message out there so nothing terrible happens. I think that’s all we can do at the moment and hope that now kids are back at school and seeing grandparents, at least that aspect of things will go away.”

She said the number of ED presentations was significantly down overall.

“In our hospital in paediatrics, neurologists haven’t seen as many kids coming in with seizures. There weren’t any increases in cancer cases or people coming in sick with CF but we did have this spike in unwell diabetes.”

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