Reassuring lessons from Italy for children with diabetes in the COVID-19 pandemic

Paediatric endocrinologists in Italy and China have a reassuring message that children with diabetes are not  at any increased risk of illness compared to their peers.

In an update published by the International Society for Paediatric and Adolescent Diabetes (ISPAD), endocrinologists from China and Italy say children with diabetes are not showing a different disease pattern and there have been no cases of COVID-19 in youth with diabetes requiring hospitalisation.

For example, Professor Andrea Scaramuzza from Cremona, Italy, said he was not aware of a severe case of COVID-19 in youth with diabetes under 25 years.

However Dr Scaramuzza urged families to continue to take their child to a paediatrician or emergency services when they have symptoms of new onset diabetes or DKA. He said there had been multiple cases of patients presenting to emergency services with severe DKA.

Dr Scaramuzza also emphasised the importance of following public health measures in addition to standard diabetes care and, when needed, sick day management guidelines.

Similarly, Professor Luo Xiaoping of Tongji Hospital, Wuhan, China, reports no hospitalised or severe cases of COVID-19 reported in youth  under 25 years of age with diabetes.

He said the closure of services meant there were several cases of delayed admission of children with newly diagnosed type 1 diabetes (T1D) or DKA.

“We find these reports from paediatric endocrinology experts in COVID-19 hotspots globally, though anecdotal, to be reassuring,” the IPSAD report stated.

However it stressed that this does not diminish the need to follow public health guidance—the same precautious apply to youth with diabetes. Any illness makes diabetes more difficult to manage and can increase the risk of diabetic ketoacidosis (DKA).

ISPAD also emphasized the importance of continued attentiveness to standard diabetes care to avoid the need for hospitalisation and emergency or urgent care visits during the COVID-19 pandemic. Tele-health should be used more as a way to continue to care for youth with diabetes and avoid visits to clinics or hospitals, it said.

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