Four Messages Regarding COVID-19 & Pediatric Endocrinology

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We remain available 24/7: Please know that we are here for our patients. We and other centers have noticed that patients are often sicker than in the past when they come for medical care, presumably because they have delayed seeking care out of fear of contracting COVID-19. Importantly, please know that our medical center remains one of the safest places. All visitors are screened, including by temperature scanning cameras, and all staff maintain strict precautions. If you have questions or concerns about managing your endocrine condition, please contact us by phone/email/fax. If you are ill and might benefit from endocrine advice, we will work hard with you over the phone to help keep you from needing to come to the hospital. As of May 4, we have carefully re-opened our outpatient clinic for routine visits, in accordance with policies set by the State of Iowa. Additionally, we can conduct selected routine visits not requiring physical examination via video-chat. Contact us and we will help you arrange a clinic visit. Further information can be found at our official clinical website.

A reassuring note: The healthcare community is learning more about the effects of COVID-19 on specific patients. You may have read that diabetes is a risk factor for severe COVID-19. Please know however that this data regards adults, mainly older adults. On March 25th, our European colleagues reported their impression that pediatric-aged patients with diabetes are not at increased risk of severe COVID-19. Likewise, initial data reports from the US have not mentioned diabetes as a pediatric-aged risk factor. On May 29, a peer-reviewed French scientific article reported similar findings. See this blog post for more details. It would be reasonable to assume the same is likely true for pediatric-aged patients with various endocrine disease, though we have yet to see any data. In any case, it remains important to be careful with your diabetes and endocrine medications. For youth with diabetes, aim to control your blood sugars as best possible, make sure to take your long-acting insulin / keep your insulin pump in good working order. The reason to keep your blood sugars in range as best possible is that persons with diabetes have a higher risk of needing to be hospitalized with COVID if their blood sugar have been running higher (see our review of this data). For youth with adrenal insufficiency, make sure to take your prescribed hydrocortisone or other steroids, and give stress dose steroids if ill etc as instructed. Keep your prescriptions up. Be sure to minimize exposures, practice social distancing, frequent hand washing, etc. See our hospital COVID-19 website for additional information.

COVID-19 increases risk of DKA: Data has now been published showing that many persons with type 1 diabetes who develop COVID-19 will develop diabetic ketoacidosis (DKA). Our summary of the study can be found here (link). If you or your loved one has type 1 diabetes, and develops symptoms of COVID-19, be sure to contact your diabetes doctor to help provide advice on how to prevent DKA. Fluids, carbohydrates, ketone checks, and extra insulin are very important in this regard. We remain on call 24×7 to assist.

Adrenal insufficiency may increase COVID-19 risk: Several endocrine sources have published opinions suggesting that adrenal insufficiency may predispose persons to severe COVID-19. Our summary of these opinions can be found here (link). If you or your loved one has adrenal insufficiency, it might be important to minimize COVID-19 exposures, wear protective masks, practice social distancing and frequent hand washing, etc. If you have questions or concerns, we are happy to discuss. If you think you have developed COVID-19, please know that we remain on call 24×7 to assist.

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