COVID-19 School Closures: Implications for Pediatric Diabetes Management - A Commentary

Objective: The United States COVID-19 outbreak shuttered public and private schools, confining more than 55.1 million students to their homes. In this paper, we discuss the unique vulnerabilities faced by families affected by pediatric diabetes as well as structural issues exposed by the COVID-19 pandemic. Methods: Drawing on clinical and anthropological expertise, we review the unintended consequences of remote schooling for management of pediatric diabetes and other chronic health conditions. Results: We identify multiple barriers to pediatric diabetes care imposed by conditions during the COVID-19 pandemic. We propose a 4-tiered policy solution that aims to improve crisis response and to protect the health of children with chronic conditions, like diabetes, long-term. Conclusions: The COVID-19 pandemic has precipitated wide disruptions to schooling, employment, finances, and transportation, placing enormous burdens on families that care for a child with diabetes. Comprehensive policies supporting integrated diabetes care, student accommodations in remote learning conditions, extended medication supplies, and increased healthcare access would not only prevent adverse outcomes for children with diabetes in crisis settings, but also lay a durable foundation needed to increase health equity of all children living with chronic conditions.