Alberta’s diabetes worsens as the pandemic drags on, clinics say

At Siksika Health Services, Jacey Solway is closely monitoring her diabetic patients, who have begun to show up in greater numbers since the province began lifting COVID-19 public health measures earlier this year.

“The last two years have been very hard for one person, especially with the amount of stress that the pandemic brought, with people losing their jobs. Their normal day-to-day life was rejected,” Solway said. , a chronic disease. management nurse.

“We see more customers that we haven’t been able to attract in the last two years.”

Diabetics require close and ongoing medical attention, and Solway discovers that some are emerging with the need for more medication and others are simply trying to regain control of their disease.

The clinic, he said, is closely monitoring their needs and monitoring any potential increase in new diagnoses.

“That’s something that’s on our radar here.”

New diagnosis after COVID infection

Dr. Doreen Rabi, a diabetes specialist, is seeing some clear trends at her Calgary clinic more than two years after the pandemic.

“We’re seeing more referrals for new-onset diabetes. And I’m certainly seeing the need to increase therapy for people living with diabetes. And then [we’re] also seeing the impacts we are seeing on any other health condition, only worsening diabetes, ”said Rabbi, a professor at Cumming School of Medicine at the University of Calgary.

Dr. Doreen Rabi, a diabetologist at Cumming School of Medicine at the University of Calgary, says doctors are seeing a higher risk of new and worsening diabetes a year after a diagnosis of COVID. (Jennifer Lee / CBC)

“What we are seeing is quite consistent [in the research] is that in the year following the diagnosis of COVID, we are seeing an increased risk of new diabetes and also a higher risk of worsening diabetes. “

It is another puzzling pandemic phenomenon.

According to Rabi, a recent U.S. study of medical records of veterans found that people diagnosed with COVID were 40% more likely to develop new diabetes compared to those who had not had a diabetes. diagnosis of COVID-19 or in relation to a historical control group.

But this area of ​​research is relatively new and there are still many unknowns.

While the reasons are not entirely clear, Rabbi believes there are probably a number of factors that contribute to the trends he is seeing.

“While COVID may alter someone’s ability to produce insulin, this is probably not the main driver of new diabetes,” he said.

A prolonged inflammatory response, after a COVID infection, could lead to insulin resistance, he said.

Factors known to increase the risk of diabetes have also been more acute during the pandemic, such as unemployment, poverty, food insecurity and isolation.

And pandemic-related delays in access to health care are also likely to play a key role, according to Rabi, who heads the medical school’s endocrinology and metabolism division.

“There was a period of time when people accessing resources and the care they needed were severely affected. So whether the increase in referrals we’re seeing now is related exclusively to previous COVID infections or with just a few important system backups related to managing COVID is really hard to say, “he said.

Dr. Neeja Bakshi, an Edmonton-based internal medicine physician, is also seeing an increase in patients at her clinic with metabolic conditions such as new or worsening diabetes along with high blood pressure and high cholesterol.

Neeja Bakshi, an internal medicine specialist in Edmonton, says health care providers are trying to resolve the relationship between COVID-19 and diabetes. The doctor is observing an increase in new and worsening diabetes referrals, along with other metabolic disorders. (CBC)

It is difficult to find out the cause, he said, noting that people often experience significant changes in their lives when they are diagnosed with COVID, including decreased physical activity and changes in diet.

“In the last two and a half years, a lot of things have happened that have affected people’s lifestyle, their ability to access medication. [and] ability to access care, ”he said.

In an effort to better understand the relationship between the virus and chronic conditions such as diabetes, Bakshi now includes questions about COVID infections as part of his routine screening process.

“We’re starting to take notes and stories about where diabetes comes from, especially in those who may not have been at high risk to begin with,” he said.

“In medicine, we always look at the risk factors of“ how is your family history, ”“ what is your lifestyle, ”“ how is your genetic disposition. ”And now I think we need to add: “Did you have COVID?”

It’s another way that health care providers are trying to adapt, as the pandemic gets longer, and slowly putting together the long-term implications of COVID-19.

“It shows that we have a long way to go to understand how COVID works,” Bakshi said.

“This virus is pretty devastating. It’s pretty inflammatory. It’s pretty systemic. It involves a lot of organ systems. And I don’t know if we really understand the full depth of that yet.”

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