I work in a very small pediatrics office. In the last 8 days we have had 3 patients diagnosed with onset of type 1 diabetes. In the 7 years that i have worked there i can only count one or two other cases.
This is crazy!!
I have heard a theory that a virus may damage the pancreas in people who are genetically prone to developing diabetes. Is there any basis to this theory?
Do you think this should be reported? Its not an infectious disease, but I really think the public should know that for some reason there has been this influx. Am i overreacting? I guess it could just be coincidence....but i just cant stop thinking about it.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Type I and high fructose sugar infection? What? Obesity? What? Type I is a malfunction of the pancrease and the production of (or the lack thereof insulin) The children are usually very thin with huge appetites, unquenchable thirst with frequent urination. There are theories that it is auto-immune related and can follow a viral infection of the child. Some of us need to brush up on our A&P.
To the OP. That you have seen so many in a short peroid of time bears watching. I have found in nursing things come in three's. If you have one code there wiil be 2 more. Overall there is an increase in the diagnosis of auto-immune disorders in adults and children and the is alot of speculation as two why. WHeter it is enviormental or not remains to be seen. I would discuss it with your MD's and get their opinion or theories as to why.........but don't go crazy. Diabeties is not reportable to anyone and a cluster is much larger tha 3 children in one practice but I like your enthusiasm!
Viruses DO NOT attack the pancreas causing Type 1.
It is autoimmune. This means the body's own immune system attacks the beta cells (not the whole organ) of the pancreas which produce insulin
There is a THEORY that a virus may set off or accelerate the immune process in those ALREADY GENETICALLY pre-disposed. This would happen because the antibodies look, to the immune system, similar to the pancreatic beta cells.
Tell those parents to stop feeding their kids junk food
We are talking about Type I diabetes.
Edit: Well, I got so aggravated by this judgmental response that I skipped to the end to reply. Now that I see that I am the last of many to have this same response.......well, I stand by it. And that post is more than a little scary. I can only hope that the author is not quite a nurse yet. And hopefully, not very far along in nursing school.
If this is a smallish town or city it may be a case of parents talking...... Ex: Little Susie is thirsty all the time......My friend at work said her nephew was thirsty all the time and he just got diagnosed with diabetes...... maybe I should take Susie to the Dr...... So a lot of kids get diagnosed at once instead of being spread out over months.
It MAY be just a coincidence, but it's probably not. If your practice TRULY just had this "wave" of type 1 diagnoses, there is probably a reason for it. The explanation above seems possible. Or maybe there was recently a class on diabetes in school or for parents. Or the school has a new, more astute, nurse. There could definitely be a SOCIAL reason that prompted these parents to bring their kids in for evaluation. MAYBE (if you live in a REALLY small town) you have discovered a pocket of people who (unbeknownst to them) share a little more of their gene-pool with their neighbors than they would have expected (that's one way to find a cousin!), though that would be a tough one to prove since T1DM isn't specifically a genetic variant. Whatever it is, 3 new diagnoses after a period of none in a small town with a stable population seems very non-coincidental. In and of itself, it's not a cause for alarm--but if you were able to find a connection between these patients, it could be satisfying (if not useful). BUT, of course, if you were to go investigating you would have to follow a research protocol which might be more than you bargained for.
Anyway, a trusty list of T1DM risk factors and what you already know about the patients may at least get you thinking about how something like this MIGHT happen.
And for any nay-sayers, let me clarify that I would be WAY less likely to assume there was some underlying reason that brought 3 new hyperlipidemia, or T2DM, or CAD diagnoses into a clinic even if there HAD recently been a draught of such cases (unless it was a pediatric clinic--but I digress). But T1DM is just not THAT common in a clinic that serves a random sample of the population. Put it this way--if there were 3 brain cancer patients that presented in one week, you would be irresponsible to NOT do some investigating.
It's the time of year. Kids back to school. Share their germs. Kids might get a little sick with something or other, but most importantly, their immune systems kick into gear and in effect, go nutso on their pancreas.
They compensate for a while, but then the symptoms get to the point that parents can't help but notice something strange going on. Those are the lucky ones. Then you get the kids, that while we all (hopefully) know it's not a matter of high fructose corn sugar infection, eat some of the Halloween candy around the house, and the extra sugar sends them over the edge into DKA, and they get admitted to the hospital passed out with blood sugars in the 400+. The Halloween candy of course didn't cause it, but a kid that has a pancreas still working a bit can put out just enough insulin to remain asymptomatic for the most part, but that extra bit of HFCS infection (which is my new favorite phrase) isn't something their body can still compensate for.
Everything peds has a time of year. Even Type 1 DM.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
You don't recall an influx like that from your first 6 years working there? Has your overall patient load increased over the past year?
If you were to check back far enough, it would probably even out statistically and show a time of year trend. I noticed that when I worked in dermatology - I counted all our biopsy reports for a 7 year period of time (I'm just a nerd like that) because of a bunch of melanoma dx close together but over all the years it remained the same ie 200 basal cell carcinomas and 3 melanomas (not sure of exact ratios but close). The cluster effect tends to be in the beginning of beach season when people notice abnormalities on their skin.
If you were going to report that to anyone, who would you report it to?
Specializes in NICU, PICU, PCVICU and peds oncology.
Over the years of my career, I've seen a bunch of different things present as clusters. When I worked neonatal stepdown we'd see a cluster of babies with Down Syndrome, then a cluster with cleft lip and palate... then a cluster of gastroschisis. When I moved to PICU I noticed a similar phenomenon. One summer we saw 4 teenaged boys from our oncology unit come down with typhlitis. This year we had 11 children present with brain tumors in the space of 2 months, and all but one of them were boys. As for Type 1 diabetes, we see clusters of DKA around Easter and Halloween. But the odd thing is that they usually present BEFORE the big day. It's all a big coincidence.
I know others have said this already, but I agree that three cases, even in a small practice, is a coincidental blip rather than anything statistically significant. I work in acute care and we get runs of all kinds of bizarre things - at the moment it's PICA infarcts. Like nurse 156 and janfrn wrote, the hiccups happen from time to time.
But I really think Obamacare did it! 
Esme12, ASN, BSN, RN
20,908 Posts
Type I and high fructose sugar infection? What? Obesity? What? Type I is a malfunction of the pancrease and the production of (or the lack thereof insulin) The children are usually very thin with huge appetites, unquenchable thirst with frequent urination. There are theories that it is auto-immune related and can follow a viral infection of the child. Some of us need to brush up on our A&P.
To the OP. That you have seen so many in a short peroid of time bears watching. I have found in nursing things come in three's. If you have one code there wiil be 2 more. Overall there is an increase in the diagnosis of auto-immune disorders in adults and children and the is alot of speculation as two why. WHeter it is enviormental or not remains to be seen. I would discuss it with your MD's and get their opinion or theories as to why.........but don't go crazy. Diabeties is not reportable to anyone and a cluster is much larger tha 3 children in one practice but I like your enthusiasm!