[Reading Science] The COVID-19 Pandemic Also Damaged Children's Pancreas

Children and Adolescents Type 1 Diabetes Increase Rate 10 Times
"Exact Cause Still Unknown"
Learning and Socialization Disruption, COVID Generation 'Emergency'

The COVID-19 pandemic has had many adverse effects, especially on children. Prolonged school closures led to decreased learning efficiency, causing an educational emergency. Due to staying at home, health management such as weight control, interpersonal relationships, and socialization were also affected. The term "Corona Generation" even emerged. However, it has been confirmed that diabetes among children and adolescents surged during the COVID-19 period. The increase rate was as high as about tenfold. The specific causes have not yet been identified, indicating the need for further research.

A blood sugar test at a daycare center for diagnosing juvenile diabetes. Stock photo. Not related to the article.

A research team from the SickKids Research Institute in Toronto, Canada, published a study with these findings on the 30th of last month on 'Network Open,' a journal site operated by the American Medical Association (JAMA). The team analyzed the incidence of diabetes in approximately 38,000 children and adolescents under 19 years old, based on 17 existing related studies.

Type 1 diabetes is a disease in which genetic and environmental factors cause the autoimmune system to attack cells in the pancreas, preventing the production of insulin, a hormone responsible for blood sugar regulation. It mainly affects children and adolescents. Elevated blood sugar levels can cause long-term damage to blood vessels, potentially leading to blindness, kidney failure, heart attacks, nerve damage, and in severe cases, limb amputation. Type 2 diabetes primarily occurs in adults over 40 years old. It involves increased insulin resistance in the body, resulting in impaired insulin function, high blood sugar, and relative insulin secretion disorders.

The research team found that the number of type 1 diabetes patients increased by 14% in 2020, the first year of the pandemic, compared to the previous year. In 2021, the second year, the increase accelerated, surging by 27% compared to 2019. Raizel Schulman, a researcher at the SickKids Research Institute, expressed surprise on the 21st (local time) in the international journal Nature, saying, "The incidence was much higher than we expected." Clemens Kamrath, a professor at Justus Liebig University in Germany who did not participate in the study, said, "Considering that the annual increase rate of type 1 diabetes in children was steadily 2-4% before COVID-19, the increase rate jumped more than tenfold," adding, "It exceeds the speed and scale we thought possible."

Earlier studies also reported cases of increased type 1 diabetes in many countries during the early pandemic, raising concerns that COVID-19 might have triggered this. Other research reported a surge in new diabetes cases several months after the peak of COVID-19. However, it remains unclear whether the COVID-19 virus directly caused diabetes by attacking pancreatic cells or if it was an indirect cause.

The research team analyzed only studies conducted for at least 12 months before and during the COVID-19 pandemic. They calculated statistics considering population size, not just the number of cases. Through this, they confirmed that the number of children with type 1 diabetes actually increased during the first two years of the pandemic. They also found that the seasonal pattern of incidence disappeared. Previously, type 1 diabetes occurred more frequently in winter than in summer, but this seasonality vanished after the pandemic.

They also confirmed that type 1 diabetes showed more severe symptoms during the pandemic. The incidence of diabetic ketoacidosis, a potentially life-threatening complication of type 1 diabetes, surged by about 26% from 2019 to 2020. Researcher Schulman said, "This is probably because patients hesitated or were unable to receive emergency treatment when initial symptoms appeared," adding, "Diabetic ketoacidosis can be prevented early, but once it develops, symptoms persist. This is one of the most important findings of this study."

Scientists still do not know the cause of this phenomenon or how long it will last. However, the research team believes that the COVID-19 virus likely did not directly attack pancreatic cells. Studies from Finland, Scotland, and Denmark showed no direct correlation between coronavirus infection trends and the incidence of type 1 diabetes. Some suggest that viruses like enterovirus or hepatitis B virus might have caused autoimmune abnormalities that led to pancreatic cell attacks.

On the other hand, some argue that this might be a temporary phenomenon. Lars Stene, a researcher at the Norwegian Institute of Public Health, told Nature, "A 14% increase in one year is an unbelievable result," and argued, "Incidence rates fluctuate significantly year to year, and the number of cases can differ by about tenfold between individual countries."