Since the coronavirus pandemic began, doctors across Canada have noticed a significant drop in the number of cases of Type 1 diabetes presenting at hospitals — and they worry people’s lives could be at stake.
“We haven’t seen a new case of Type 1 diabetes in our population in the last month,” Dr. Elizabeth Cummings, head of endocrinology at the IWK Health Centre in Halifax, N.S., told Global News.
“We would normally see between three to six cases a month.”
Cummings says she’s spoken with fellow endocrinologists across the country and they’ve all noticed a similar drop in cases.
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Type 1 diabetes occurs when the pancreas doesn’t produce any insulin, a hormone that controls the level of sugar in your blood, according to Diabetes Canada.
People with Type 1 diabetes need to inject insulin or use an insulin pump to ensure their bodies have enough of it and their blood sugar levels are under control.
In 2013, nearly 200,000 Canadians — both children and adults — were newly diagnosed with diabetes, according to Statistics Canada. In 2017, 7.3 per cent of Canadians (roughly 2.3 million people) older than 12 reported being diagnosed with either Type 1 or Type 2.
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Roughly 10 per cent of people with diabetes have Type 1, insulin-dependent diabetes, according to Diabetes Canada.
“Our concern there is … people who are developing diabetes have symptoms that are warning signs, but if they’re not seeking medical attention for those … they can become very, very sick,” Cummings said.
The body can briefly fend off the symptoms of Type 1 diabetes, but if left untreated for a significant amount of time, a person can develop diabetic ketoacidosis (DKA).
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This is when your blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body, according to the Mayo Clinic.
“That requires hospitalization and often ICU care,” Cummings said. “If it’s not recognized, it’s very rare but it could be fatal.”
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Dr. Jeremy Gilbert, an endocrinologist at Sunnybrook Hospital in Toronto, has seen a similar drop in new cases and he’s also worried about the potential implications.
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Gilbert believes the drop is largely due to the fact that people with symptoms are not visiting their family doctor, who are typically “the first to pick it up and then send [the patient] to a specialist,” he said.
Both Cummings and Gilbert assume people are trying to avoid healthcare spaces like hospitals and clinics because they’re afraid of catching COVID-19.
In his work, Gilbert typically sees patients on an “outpatient basis,” and he often relies on regular blood work to inform his assessments.
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“The way I assess people is… I check their blood pressure, I look at their feet, I measure their weight, I review their glucose, and they often have blood work in advance,” he said.
“Now, patients are largely not doing their blood work because they’re scared to have blood work done. That … is a very real issue.”
Below, Cummings and Gilbert share what you should know about Type 1 diabetes, how to spot it and when to seek care.
There are some common symptoms of Type 1 diabetes you should know. When they present together, it’s typically a good idea to see a doctor.
“Early warning signs are an increase in thirst … drinking more than usual and frequently urinating, going to the toilet a lot [at night],” Cummings said.
If it’s your child, they may wet the bed when they’ve been previously dry at night.
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“If it goes on for a while, [you] can have weight loss that’s unexplained,” Cummings said.
Fatigue and low energy are also common.
Blurred vision, frequent or recurring infections, cuts and bruises that are slow to heal and tingling or numbness in the hands or feet are also common side effects, according to Diabetes Canada.
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“If you’re seeing [these] in your child, your teenager, a young adult [or someone else] in your circle, then those people need to seek medical attention right away,” she said.
If and when you do see a doctor, you should note that you’re worried it could be diabetes.
“This will prompt your care provider to do the right test, which is a very simple blood sugar test,” Cummings said.
Who’s at risk?
The particularly dangerous aspect of Type 1 diabetes is it can strike anyone, at any time. You don’t need a family history or particular lifestyle habits to increase your risk of developing the disease.
“It’s most common in children and teenagers, but it can happen in infants, it can happen in adults — particularly young adults,” Cummings said.
“Ninety per cent of people who are newly diagnosed with diabetes have no one in their close family with it, so it’s often quite a surprise.”
Going to the hospital
It’s crucial to see a doctor if you suspect you or a loved one may have Type 1 diabetes. You don’t want your physician to miss the “window of opportunity” to intervene, Gilbert said.
Both he and Cummings say the hospitals where they work have robust processes to keep patients safe from the spread of COVID-19.
“Things like … a minimum of two feet between each chair (if waiting rooms are open) and closed waiting rooms,” Cummings said.
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At the IWK, people are being screened upon entry and anyone with COVID-19 symptoms are sent to a different area, said Cummings.
At Sunnybrook, an “outstanding infectious disease control team” has advised physicians on how best to protect non-coronavirus patients while at the hospital.
“There’s been a lot of communication, a lot of transparency, a lot of focus on wellness and a lot of support that’s been put into place,” Gilbert said.
Questions about COVID-19? Here are some things you need to know:
Health officials caution against all international travel. Returning travellers are legally obligated to self-isolate for 14 days, beginning March 26, in case they develop symptoms and to prevent spreading the virus to others. Some provinces and territories have also implemented additional recommendations or enforcement measures to ensure those returning to the area self-isolate.
Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.
To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out.
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