Poorly controlled diabetes puts children at high risk of Covid complications

Covid-19, the disease caused by SARS-CoV-2, took the world by a storm in December 2019. It took millions of lives almost in every corner of the world and affected anyone and everyone. But vaccines and practising precautionary measures helped reduce the number of coronavirus cases in India. However, the second wave of Covid is knocking doors, and the surge in cases has everyone shook in the country. It is not even sparing kids, especially those comorbidities.

Children who have Type-1 diabetes are at a higher risk of coronavirus, and poorly controlled diabetes can add to the problem. A new study found that poor diabetes can up the risk of Covid complications in kids.

Poor Diabetes Control Linked With Covid Complications In Kids

A new study presented virtually at ENDO 2021 found that children with poorly controlled Type 1 diabetes are 10 times more likely to suffer from Covid-19 complications and death compared to those with well-controlled diabetes. The study showed that children with haemoglobin (A1) higher than 9 per cent were 10 times higher at risk of Covid-19 complications than those with A1c levels under 7 per cent.

Lead author Manish Raisingani from the University of Arkansas in the US said that it is extremely important to keep children’s blood sugar under control, especially during the pandemic. For the study, the team reviewed data on about 2,000 children with Type-1 diabetes and Covid-19, along with 30,000 children with Covid-19 who did not have Type-1 diabetes.

They analysed haemoglobin A1c levels in children with diabetes. A1c is a blood test that measures a person’s average blood sugar levels over the past three months. This test also helps people manage their diabetes. People with A1c levels higher than 7 per cent are at a higher risk of diabetes. Children with Type-1 diabetes and Covid-19 are more likely to die, to require an endotracheal tube to help them breathe, to develop pneumonia, or to develop septic shock, compared with children who had Covid-19 and did not have Type-1 diabetes.

How To Properly Care For Children With Type 1-Diabetes?

Along with working closely with the doctor, parents should keep in mind the following things to manage Type-1 diabetes in children.

Regular Blood Sugar Monitoring

It is essential to record your child’s blood sugar at least four times a day, but you may need to check it more times if your child doesn’t have a continuous glucose monitor. Frequent testing will help your child’s blood sugar remain within a target range.

Eating A Healthy Diet

Diabetes patients need to follow a proper diet plan that is rich in nutrition and low in fat and calories. You should include more vegetables, fruits, lean protein, and whole grain in your child’s diet to make sure their body is getting the sufficient nutrients it requires.

Regular Exercise

It is essential for parents to encourage their child to get at 30 minutes of physical activity every day. It will help keep your child’s blood sugar within the normal range. The best way to encourage your child to indulge in some exercise is that you do it with them.

Follow-Up Medical Care

Another important aspect of good diabetes management is regular follow-up appointments with his or her doctor. It is also essential to keep their blood pressure, cholesterol levels, thyroid functions, kidney and liver function in check.

Note: Make sure you consult a medical practitioner before putting to use any of the tips mentioned in the article.

 

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Insulin and glucagon combo- Novel approach for blood sugar control in diabetes

Co-administration of insulin and glucagon provides protection against insulin-induced hypoglycemia without worsening hyperglycemia in type 1 diabetes (T1D) patients, according to a recent study published in the ADA journal Diabetes.This essentially means that this combo will control high blood sugar along with protection from sudden and severe fall in blood sugar in type 1 diabetes.

The results were also presented at the American Diabetes Association' (ADA) Virtual 80th Scientific Sessions.

Despite advances in the pharmacological and technical fields, the risk of hypoglycemia remains the major concern for the regulation of optimal blood sugar levels in type 1 diabetes. there is an increasing interest in how the opposing actions of insulin and glucagon (Gn) may be harnessed to optimize glycemic control.

For the purpose, Bruce W. Bode from Atlanta, GA, and colleagues studied 11 T1D patients (age 36±4y, gender M:F 5:6, BMI 25.0±0.7 kg/m2, disease duration 23±3y, A1C 7.0±0.3%, daily insulin dose 43±3u) on two occasions, under meal challenge conditions (liquid mixed meal, 100g carbohydrate) during a phased 6h IV regular insulin infusion with (+Gn) and without (-Gn) IV glucagon. On both occasions, subjects were treated overnight with low dose IV insulin prior to the morning meal to prevent antecedent nocturnal hypoglycemia and to attain near-normal fasting glycemia.

Insulin dosing was designed to control the early rise in plasma glucose (PG) but also to elicit hypoglycemia in the later phase.

 

Key findings of the study include:

During +Gn, glucagon was co-administered with insulin at a fixed molar ratio. At the two visits, fasting PG was similar (-Gn 121±5, +Gn 119±6 mg/dl) and the initial meal-induced PG elevation (0-3h) was indistinguishable whether glucagon was present or not (peak PG -Gn 224±18, +Gn 228±15 mg/dl; ΔPG 0-180AUC -Gn 10501±3014, +Gn 11537±1778 mg.min/dl).

 

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During +Gn, the fall in PG was attenuated in all cases with a significant difference observed in PG nadir (-Gn 51.1±4.0, +Gn100.5±11.0 mg/dl). 

Appropriate elevations in plasma insulin and glucagon were observed in keeping with study design.

"To conclude, it is feasible that insulin and glucagon can be co-administered under specific conditions allowing protection against insulin-induced hypoglycemia without impeding hyperglycemic control. This unique observation offers insight into novel approaches to glucose control in diabetes," wrote the authors.

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Celiac disease shares many genetic factors with T1Diabetes

NIDDK study continues to look at possible factors that lead to the development of the diseases in children.

 New results and information surrounding potential "triggers" of the autoimmune process leading to type 1 diabetes (T1D) and how they interact with genetic factors in children at-risk for developing the disease were highlighted in the "Update from the TEDDY Study" symposium today at the American Diabetes Association's® (ADA's) 80th Virtual Scientific Sessions. Similar evidence for celiac disease is also being accumulated through the large international study program. The data The Environmental Determinants of Diabetes in the Young (TEDDY) study has collected prospectively since 2004 will be utilized in new clinical trials to prevent these autoimmune diseases that jointly affect more than 3% of the general population.

TEDDY is an international multi-center trial researching the potential causes T1D in children. The study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). T1D occurs when the beta cells of the pancreas that normally make insulin are destroyed by the body's own immune system. When the beta cells are destroyed, the body cannot make insulin and maintain normal blood sugar levels.

Children who have T1D have certain types of genes, but not all children who have those genes develop diabetes. Something from the environment "triggers" the immune destruction of the beta cells. TEDDY is aiming to discover viruses and nutritional factors that interact with genes to "trigger" immune destruction of the beta cells, marked by the appearance of islet autoantibodies. The study enrolls infants identified as "at-risk" for developing T1D and follows them for 15 years to look for the appearance of various beta-cell autoantibodies and diabetes. TEDDY has also studied biomarkers that can predict faster or slower progression to diabetes after the autoimmune destruction has begun.

"An interesting finding from TEDDY has been how early the autoimmune destruction of insulin-producing cells begins – often in the initial two years of life," said study TEDDY co-chair Marian Rewers, MD, PhD, a professor of pediatrics and medicine and executive director of the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine. "There appear to be two subtypes of T1D that differ by genetic factors and immune phenotypes. Metabolomic biomarkers may offer clues to the subtypes and whether a child develops T1D. Interestingly, HbA1c has very different predictive characteristics for progression to clinical diabetes in children with islet autoantibodies, compared to adults with risk factors for type 1 diabetes."

 Additional key updates from the study group include:

 Persistent presence of enterovirus B species in a child's stool predicts development of islet autoimmunity, especially the earlier subtype characterized by the presence of autoantibodies to insulin. 

There are also subtle differences in the composition and function of gut microbiome in children who develop islet autoantibodies, compared to controls. Early use of probiotics may decrease the risk, while use of antibiotics was not related to islet or celiac autoimmunity. 

TEDDY has also found potentially beneficial effects of vitamin D, vitamin C, or a diet rich in polyunsaturated fatty acids, though these observations need to be confirmed in randomized clinical trials. 

Celiac disease, another autoimmune condition, shares many genetic factors with T1D, noted Dr. Rewers. TEDDY investigators follow study participants for both T1D and celiac disease in an attempt to determine why some children with high-risk genes develop T1D or celiac disease, while most remain disease-free. This information will be used to try to prevent both diabetes and celiac disease in children. Recently reported TEDDY research showed an association between gluten consumption in the early years of childhood and an increased risk of celiac disease among genetically predisposed children.

 "While T1D and celiac disease share a lot of genetic 

characteristics, there are intriguing differences in the ways these 

diseases develop and progress," added Dr. Rewers. "TEDDY is 

contributing exciting clues for design of future trials to prevent 

both T1D and celiac disease."

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
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