ACDC Position Statement on COVID-19

20th MAY 2020

The period of lockdown has been a difficult time, with many children missing their normal time at school and with friends.  The government is now setting out plans for easing lockdown restrictions, and the potential return to school.  Many will be looking forward to some sort of normality returning.  Many will also find it daunting and will worry about catching the virus. COVID-19 is a new illness which means we do not understand everything about it yet. In general, most children with COVID-19 get mild symptoms, and some may have no symptoms at all. Recently, around 100 children across the UK have been diagnosed with a more serious condition called COVID-19 paediatric multisystem inflammatory syndrome. There is no evidence to suggest that children with diabetes are more prone to this compared to other children without diabetes.  There is also no evidence that children with diabetes are more likely to be infected with COVID-19 compared to children without diabetes, any more than they are with gastroenteritis or any other infections that circulate during the school year. We should continue to be vigilant, especially around handwashing and social distancing.

The *recent published national diabetes data on COVID-19 mortality from NHS England and Public Health England show that until 11th May 2020, there has been no deaths of anyone with diabetes under the age of 20 due to COVID-19. This aligns with the global reports of children with diabetes. There is some evidence that higher HbA1c levels and obesity are linked to higher risk in both Type 1 and Type 2 diabetes. Other forms of diabetes such as MODY have been reported in the study but numbers are very low.

We would advise all children and young people with diabetes to use this as an opportunity to try to maintain a healthy lifestyle and optimise their diabetes care with the aim of achieving good diabetes management. For children with Type 1 diabetes you may see a rise in blood glucose levels as with any viral illness. Please follow your Sick Days Management and check blood glucose and ketones regularly. If blood glucose or ketone levels are not improving with sick days management, please contact your diabetes team as usual or, if very unwell, please attend hospital.

In principle, children with diabetes can return to school as long as protective measures in the education setting are in place in accordance to national guidance. You may wish to consider how well your child will be able to maintain social distancing, and the support your child needs from school.  You will be considering whether anyone else at home may be at higher risk of catching the virus. You will be considering how well you are able to educate your child at home, and the risks of them falling behind in their education from staying at home.  You will also be thinking about the enjoyment and beneficial social interaction your child will have seeing friends again.

There will be further national guidance on return to schools and we await any further advice from the Chief Medical Officer.

         May Ng, ACDC Chair

Honorary Associate Professor and Consultant Paediatric Endocrinologist

      On behalf of ACDC

Twitter   @ACDC_UK   @mayng888

 

   *https://www.england.nhs.uk/publication/type-1-and-type-2-diabetes-and-covid-19-related-mortality-in-england/ (published 20th May 2020)

COVID-19 and children with diabetes: emerging knowledge

      See Sick Days management in http://www.a-c-d-c.org/endorsed-guidelines/

ACDC Position Statement on COVID-19 | Association of Children’s Diabetes Clinicians

ACDC Position Statement on COVID-19

20th MAY 2020

The period of lockdown has been a difficult time, with many children missing their normal time at school and with friends.  The government is now setting out plans for easing lockdown restrictions, and the potential return to school.  Many will be looking forward to some sort of normality returning.  Many will also find it daunting and will worry about catching the virus. COVID-19 is a new illness which means we do not understand everything about it yet. In general, most children with COVID-19 get mild symptoms, and some may have no symptoms at all. Recently, around 100 children across the UK have been diagnosed with a more serious condition called COVID-19 paediatric multisystem inflammatory syndrome. There is no evidence to suggest that children with diabetes are more prone to this compared to other children without diabetes.  There is also no evidence that children with diabetes are more likely to be infected with COVID-19 compared to children without diabetes, any more than they are with gastroenteritis or any other infections that circulate during the school year. We should continue to be vigilant, especially around handwashing and social distancing.

The *recent published national diabetes data on COVID-19 mortality from NHS England and Public Health England show that until 11th May 2020, there has been no deaths of anyone with diabetes under the age of 20 due to COVID-19. This aligns with the global reports of children with diabetes. There is some evidence that higher HbA1c levels and obesity are linked to higher risk in both Type 1 and Type 2 diabetes. Other forms of diabetes such as MODY have been reported in the study but numbers are very low.

We would advise all children and young people with diabetes to use this as an opportunity to try to maintain a healthy lifestyle and optimise their diabetes care with the aim of achieving good diabetes management. For children with Type 1 diabetes you may see a rise in blood glucose levels as with any viral illness. Please follow your Sick Days Management and check blood glucose and ketones regularly. If blood glucose or ketone levels are not improving with sick days management, please contact your diabetes team as usual or, if very unwell, please attend hospital.

In principle, children with diabetes can return to school as long as protective measures in the education setting are in place in accordance to national guidance. You may wish to consider how well your child will be able to maintain social distancing, and the support your child needs from school.  You will be considering whether anyone else at home may be at higher risk of catching the virus. You will be considering how well you are able to educate your child at home, and the risks of them falling behind in their education from staying at home.  You will also be thinking about the enjoyment and beneficial social interaction your child will have seeing friends again.

There will be further national guidance on return to schools and we await any further advice from the Chief Medical Officer.

         May Ng, ACDC Chair

Honorary Associate Professor and Consultant Paediatric Endocrinologist

      On behalf of ACDC

Twitter   @ACDC_UK   @mayng888

 

   *https://www.england.nhs.uk/publication/type-1-and-type-2-diabetes-and-covid-19-related-mortality-in-england/ (published 20th May 2020)

COVID-19 and children with diabetes: emerging knowledge

      See Sick Days management in http://www.a-c-d-c.org/endorsed-guidelines/