Local experts study COVID-diabetes link

By Madeline Ackley
Twitter: @Mkayackley

When Arizona began experiencing its first big wave of COVID-19 cases in 2020, Phoenix Children’s endocrinologist Dr. Melissa Chambers started noticing something strange in her young patients.

Little by little, Chambers and her colleagues began seeing abnormally high rates of diabetes in children who had recently recovered from COVID-19.

At the time, the novel coronavirus was just that, and less was known about the impacts this new virus might have on patients post-recovery.

At first, the increase in both Type 1 and Type 2 diabetes in kids “was just something we noticed,” Chambers said in an interview with Independent Newsmedia. “We just kind of filed that away and said, ‘We’ll watch that. That’s interesting.’”

Without studies or data, there wasn’t much more Chambers and her colleagues at Phoenix Children’s Hospital could do–until they began comparing experiences with other endocrinologists around the world.

“And sure enough, when we looked at the actual numbers, we really are seeing a sign here,” Chambers said.

Now, Chambers has joined a consortium of experts from around the nation studying the potential link between COVID-19 and diabetes. Barring any holdups, she anticipates that data will be available in close to six months.

But the study Chamber’s is contributing to won’t be the first published on the troubling ties between COVID and diabetes.

Experts have been publically warning of a “tsunami” of diabetes cases in kids early on in the pandemic. An Italian study published in September 2020 showed half of COVID-19 patients admitted to the hospital at the beginning of the pandemic experienced hyperglycemia–high blood sugar–for the first time.

“These people were not diabetic before,” lead author Dr. Paolo Fiorina stated in a Boston Children’s blog post. “But during admission, about 46 percent of the patients were found to have new hyperglycemia,” he said.

On Jan. 7, 2022, the Centers for Disease Control published a study supporting what many experts have felt all along: an analysis of insurance claim databases show a significant uptick in diabetes in children in the month following a COVID diagnosis.

Link between viruses and Type 1 diabetes isn’t new

There is already an established link between viruses, like the common cold, and the onset of Type 1 diabetes, which is typically diagnosed during childhood.

Type 1 diabetes, previously known as juvenile diabetes, is an autoimmune disease, meaning the body attacks its own immune system. Unlike Type 2, there is a strong genetic component to Type 1 that predisposes certain people to the disease. But experts say an environmental catalyst, like a virus, is needed to trigger it.

Other coronaviruses, like Middle East Respiratory Syndrome (MERS) attack the cells of the pancreas, the organ that produces insulin the body needs to function, and some viruses can even cause the body’s immune system to go haywire.

“There are certain viruses that do specifically seem to trigger the immune system to react in...a more spastic way, or dysregulated way,” Chambers explained. “We weren’t sure that COVID would be one of those viruses, but it does appear to be.”

“If you have the genetic predisposition to develop type one diabetes…then having that dysregulated immune response can then turn your own immune system against your pancreatic cells,” she said.

But is COVID uniquely damaging to the body’s immune function, or is it just better at infecting large numbers of people? More research is needed, but Chambers suspects the latter.

“I think the difference here is the sheer number” of COVID cases, she said. “Viruses in the past…just haven’t hit this number of children all at once.”

While it’s too early to tell if COVID-19 is more dangerous to those predisposed to Type 1 than the common cold, the pandemic response may have an even more tangible link to Type 2 diabetes in children.

Pandemic shutdowns, inactivity may be linked to rising Type 2 diagnosis

Type 2 cases in children are also on the rise but probably for different reasons than Type 1.

Unlike Type 1, Type 2 diabetes is linked to a poor diet and obesity, which can lead to insulin resistance.

While Type 2 diabetes has been on the rise in children for years, experts posit that pandemic restrictions such as lockdowns and school closures was the push that drove many pre-diabetic kids over the edge in the last couple years.

Dr. Chambers gives some credence to this idea.

“The thought there is…we’ve taken kids out of school. Now they don’t have P.E., they don’t have recess. Now they’re very sedentary,” Chambers said.

“We saw a lot of weight gain in children and teens,” she added.

COVID mitigation the only way to prevent long-term conditions

Learning that a child’s permanent condition may have been caused by a virus can be alarming and painful for parents, Chambers said.

“It’s hard for families,” she said, especially those who were on the fence about vaccinating their young children.

“Some of those families feel guilty, you know, that I should have done that maybe this wouldn’t have happened.”

“Of course, we never can say one way or the other what would have happened,” Chambers said.

Her best advice to those concerned about developing diabetes after COVID? Do your best not to catch COVID in the first place, by masking in crowded places, teaching proper handwashing techniques and vaccinating kids who are eligible.

The CDC has approved the vaccine for children as young as five, which has some parents on the fence, concerned about potential side effects.

Chambers tries her best to answer questions parents have, helping them make sense of jargony studies so they can come to an informed decision.

“This whole time feels very unsure to parents, and every decision feels wrong…when I approach a decision like that…I just have to compare the risks and the benefits, and we have to pick the most right,” Chambers said.

“As a scientist…as someone who’s worked in our COVID units and seeing kids with this, I chose vaccination for my children the second it was available.”

Madeline Ackley can be reached at mackley@iniusa.org or found on Twitter @Mkayackley.