Jesse Solway, a graduate nurse who specializes in caring for people with diabetes, says she and her colleagues are monitoring their diabetic patients to see how their needs have changed because of COVID-19. (Submitted by Jesse Solway – Image Credit)
At Siksika Health Services, Jesse Solway has been closely monitoring his diabetic patients, who have begun to appear in greater numbers since the province began repealing COVID-19 public health measures earlier this year.
“The last two years have been really difficult for a person, especially with the amount of stress that came with the pandemic – people have lost their jobs. Their normal daily lives have been discarded, “said Solway, a chronic illness management nurse.
“We see more customers we haven’t been able to catch in the last two years.”
Diabetics need constant medical care, and Solway finds that some need more medication, while others are simply trying to regain control of their disease.
The clinic, she said, is closely monitoring their needs and monitoring for a possible increase in new diagnoses.
“It’s something that’s on our radar here.”
New diagnosis after COVID infection
Dr. Doreen Rabi, a diabetes specialist, sees some clear trends at his clinic in Calgary, more than two years after the pandemic.
“We see more recommendations for new diabetes. And I certainly see the need to increase therapy for people living with diabetes. And then [we’re] we also see the effects we see with any other health condition – just a worsening of diabetes, “said Rabi, a professor at Cumming School of Medicine at the University of Calgary.
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“What we see is quite consistent [in the research] is that in the year after the diagnosis of COVID, we see an increased risk of new diabetes, as well as an increased risk of worsening diabetes. “
This is another puzzling pandemic phenomenon.
According to Rabi, a recent study in the United States – a review of veterans’ medical records – found that people diagnosed with COVID had a 40% increased risk of developing new diabetes compared to those who were not diagnosed with COVID-19 or historical control group.
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But this area of research is relatively new and there are still many unknowns.
Although the reasons are not entirely clear, Rabbi believes there are probably a number of factors contributing to the trends she sees.
“While COVID may change someone’s ability to produce insulin, it is probably not the main driver of new diabetes,” she said.
Prolonged inflammatory response after COVID infection can lead to insulin resistance, she said.
Factors known to increase the risk of diabetes were also more acute during the pandemic, including unemployment, poverty, food insecurity and isolation.
And delays in accessing health care related to the pandemic are also likely to play a key role, according to Rabi, who heads the medical school’s department of endocrinology and metabolism.
“There was a time when people who had access to the resources and care they needed were really having a hard time. So whether the leap in recommendations we see now is purely related to previous COVID infections or something like big backups of the COVID management system, it’s actually pretty hard to say, “she said.
Dr. Nija Bakshi, an internal medicine physician from Edmonton, also observed an increase in patients at her clinic with metabolic conditions, including new or worsening diabetes, along with hypertension and high cholesterol.
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It is difficult to pinpoint the cause, she said, noting that people often experience significant changes in their lives when they are diagnosed with COVID, including a decline in physical activity and changes in diet.
“So much has happened in the last two and a half years that has affected people’s lifestyles, their ability to access medicines. [and] access to care, “she said.
In an effort to better understand the link between the virus and chronic conditions such as diabetes, Bakshi is already including questions about COVID infections as part of his routine screening process.
“We’re starting to keep notes and stories about where diabetes comes from – especially for those who may not have been at high risk in the beginning,” she said.
“In medicine, we always look at risk factors, ‘what is your family history,’ ‘what is your lifestyle,’ ‘what is your genetic predisposition?’ And now I think we should add, “Did you have COVID?”
This is another way in which healthcare providers are trying to adapt as the pandemic drags on and slowly come together for the long-term effects of COVID-19.
“This shows that we have a long way to go to understand how COVID works,” Bakshi said.
“This virus is quite devastating. It’s quite inflammatory. It’s quite 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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