The increase in diagnoses of diabetes with ketoacidosis increased by more than 9% during the months of lockdown: this is shown by a study conducted by the Italian Society of Pediatric Endochronology and Diabetology, Siedp.
The study, which will be presented at the next National Congress, analyzed the clinical data of 3230 children under 15 from 40 Italian pediatric diabetes centers in the period 2017-2020. The results indicate that the increase in the diagnosis of type 1 diabetes with ketoacidosis increased by more than 9% during the lockdown months and remained above 5% throughout the remainder of 2020.
“From this worrying data we can deduce – intervenes Valentino Cherubini, director Sod, Departmental Organizational Structure, of Pediatric Diabetology Ospedali Riuniti di Ancona – that many children have received the diagnosis of type 1 diabetes late and indicates the need to devote more energy to prevention “.
Alarm bells: what to watch out for
There are, experts say, some important alarm bells that a parent must always keep under control, especially in the summer season. By doing more movement, children turn out to be more tired, more thirsty and more pee. These are the very first suspicious signs for a diagnosis of diabetes 1 but at the same time they are also the effects of heat and physical activity. If you do not intervene immediately, the ketoacidosis which is a complication due to delayed diagnosis.
To avoid false alarms, there is therefore the need to activate due checks if other symptoms occur.
“These are small tricks, easy to put into practice but absolutely predictive. In the summer it is normal for a child to drink more, to pee more, and to be more tired than usual, so it is unthinkable that this is already the case. diabetes suspected alarm 1. I suggest instead to keep an eye on whether among the changes of the child – continues Cherubini – there are other symptoms including very strong bad breath, stomach ache, difficult breathing, sudden weight loss and hunger . They do not necessarily have to be all at the same time, because 2 or 3 of these will be enough to better investigate. Early diagnosis of type 1 diabetes in children also protects against a series of adult complications. Just think that a single episode of ketoacidosis diabetic (which occurs when the pH of the blood falls below 7.30 and becomes severe when it is below 7.1) can cause permanent damage, particularly in the cognitive sphere “.
The checks to be done
To confirm or remove the suspected type 1 diabetes in children, the first response, immediate and painless, comes from simple sticks available in pharmacies. “It is clear and normal that children drink more in the summer and sometimes the increase in water demand is underestimated. It is even more important that parents know how to intervene immediately to confirm or cancel the suspicion of diabetes 1. In addition – Cherubini points out – the heat and dehydration require a quicker intervention to restore the hydroelectrolytic balance. If there is a suspicion of diabetes, the prescription of blood and urine tests can delay the diagnosis. If in doubt, the first precaution is that of going to the pharmacy for a blood glucose measurement with a stick or making a stick on the urine to check if there is glucose “.
Nearly one in 10 type 1 diabetic is under the age of 15
Of the 150 thousand Italians with type 1 diabetes, about 11 thousand are under 15 forced to manage a pathology that will accompany them in life. This is a number to be multiplied by the number of non-stop parents who have to take charge of the disease, especially concerned about what happens and will happen outside the home (at school, in sports activities, at parties with friends). The technological evolution of very small devices, without external and waterproof tubes, is proving to be a valid support for better management since the age of 2.
The help of technology
The certainty of the data and the safety of precise therapeutic interventions have made both the continuous blood glucose meter and the insulin infuser two fundamental technological tools for improving the lifestyle of the patient and of the whole family. “The blood glucose pattern of a child with type 1 diabetes is very difficult to predict, but thanks to the latest CGM technology (continuous glucose monitoring, i.e. continuous monitoring of blood glucose in real time) it is possible to have a very high, precise and safe level of predictivity. This generates a reassuring effect on patients who have become more aware and ready to intervene in the face of a real need generated by the sound of the alarm. In the case of the youngest – concludes Cherubini – the success of a measurement that is always correct also impacts the health of the parent, relieved of the fear of having to rush to give instructions or intervene directly when it is not necessary. All patients, including the youngest, will also be able to make therapeutic decisions without comparing the data with what they obtained by pricking their fingertip. This is an important step, unique up to now and recognized by the FDA “.
Tips for summer
Experts advise, for the summer, to keep an eye on what can be considered alarm bells. A routine that changes with the summer is that of millions of children who, abandoning their school books, devote themselves to play or sports activities. Thanks to the heat and increased sweating, many parents may miss a sequence of alarm bells that instead help to understand if there is diabetic decompensation (ketoacidosis). As easy to deny this concern as it is simple to face a possible confirmation of type 1 diabetes thanks to the levels of technology that help maintain a lifestyle for all ages.
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