Shulman and her colleagues restricted their analysis to studies that had at least 12 months of data before and during the pandemic. They also included only those that reported the size of the population studied, not just case numbers — “so we could truly know if there was an increase in the incidence”, she says.
In addition to confirming that the incidence of type 1 diabetes in children rose during the first two years of the pandemic, they also found that the pandemic disrupted the seasonality of childhood type 1 diabetes. The illness usually follows clear seasonal patterns, with higher rates of new cases in winter than in summer months.
By contrast, the team was not able to analyse rates of type 2 diabetes in children, because there weren’t many studies with enough data. Type 2 diabetes develops when the pancreas doesn’t produce enough insulin and when the body stops responding to it. Inactivity and obesity are risk factors. The meta-analysis did reaffirm that children diagnosed with type 1 diabetes tended to present with more severe forms of disease during the pandemic than before. The incidence of diabetic ketoacidosis, a potentially life-threatening complication of new-onset type 1 diabetes, rose by 26% from 2019 to 2020, probably because people were hesitant or unable to seek emergency care when early symptoms appeared.
But other researchers are not fully convinced by the findings. Lars Stene, an epidemiologist studying risk factors for type 1 diabetes at the Norwegian Institute of Public Health in Oslo, says a 14% jump in incidence in just one year “sounds implausible to me”. He says the incidence of the condition fluctuates a lot year-to-year anyway, and tenfold differences in incidence exist between the countries studied.
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