What the research tells us about diabetes and COVID-19

The first wave of the COVID-19 pandemic is easing in South Africa. This means that we can finally catch our breath enough to look at some of the research that’s coming in from all over the world. The diabetes and COVID-19 research is fascinating because it highlights what we saw in South Africa at the height of the pandemic, but also because it gives us an idea of what could lie in the future. Because South Africa was hit a few months after Europe and the USA, we can learn from their experience.

Risk of COVID-19 infection:

In Italy, people with diabetes have a four times higher risk of being infected with COVID-19.
Here’s the full article: COVID-19 infection in Italian people with diabetes: Lessons learned for our future (an experience to be used)

In the US, people with diabetes are twice as likely to be in the COVID-19 population. They tested this by age group and based on the total prevalence, including undiagnosed.

Here’s the full article: Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020

Hospitalisation and ICU admission:

People with diabetes are two times more likely to be hospitalized and three times more likely to be admitted to ICU if they have COVID-19.

Here’s the US study: Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019

Case fatality rate:

‘Case fatality rate’ essentially means how many people die from a certain condition. People with diabetes have a three times higher case fatality rate when infected with COVID-19.

Read the full article here: Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China

The results of this nationwide analysis in England show that Type 1 and Type 2 diabetes were both independently associated with significantly increased odds of in-hospital death with COVID-19.

Read the whole article here: Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study

The good news? Better control is associated with lower mortality. That means that keeping your blood sugar in good control has a direct link to better recovery from COVID-19. 

• In Type 1 diabetes, the mortality rate was 3 times better from the optimal to the worst control.
• In Type 2 diabetes, the mortality rate was 1.6 times better from the optimal to the worst control.
• SEMDSA (the Society for Endocrinology, Metabolism and Diabetes of South Africa) has recently published resources for diabetes and COVID-19 that support these findings.

Diabetes and COVID-19 research

So what does this diabetes and COVID-19 research show us? 

In Diabetes and COVID-19: Risks, Management, and Learnings From Other National Disasters, the authors say: 

“As well as posing direct immediate risks to PWD (People With Diabetes), COVID-19 also risks contributing to worse diabetes outcomes. This is due to disruptions caused by the pandemic, including stress and changes to routine care, diet, and physical activity.”

One of the biggest concerns for people with diabetes seems to be the interruption in care. With more tools available for virtual healthcare, there’s no reason we can’t consult with our doctors using telemedicine (telephone or video call instead of in-person appointments).

“Depending on the global region, 20–50% of patients in the coronavirus disease 2019 (COVID-19) pandemic had diabetes.”

The 20 doctors who wrote this article give some highly technical information about why people with diabetes could be at greater risk. But they also affirm that the most important thing to do is keep monitoring your blood sugar as frequently as possible. Ideally every 2 to 4 hours or using a CGM (Continuous Glucose Monitor).

Read the full article here: Practical recommendations for the management of diabetes in patients with COVID-19

Mental health and diabetes

“Evidence from other national emergencies shows that such disruptions can lead to worse diabetes outcomes during and after these events… The current pandemic and social isolation are likely to increase rates of anxiety and depression, which may also lead to poor adherence to medications and worsening of risk factor control.”

The mental health aspect of COVID-19 is something that is only now beginning to emerge… It may turn into one of the biggest problems of the pandemic – particularly for people with diabetes.

Extra support for people with diabetes 

The same article outlines the response in France. There, a group of health care professionals and researchers launched a web app called CoviDIAB to offer diabetes-specific, scientifically based information and to provide support. 

“This free service includes access to a frequently updated media library and to live webinars with nurses, physicians, and experts. Twice a week, registrants also receive short questionnaires about COVID-19 symptoms and tests for anxiety/depression. If indicated, registrants automatically receive a notice suggesting medical contact, and phone calls may follow… Empathy was a driving principle in design. Comments suggest that the service helps people to understand and self-manage their individual risk and to limit disruption in lifestyle and care.”

Looking beyond COVID-19 with diabetes

The Journal of Diabetes Science and Technology (JDST) reached out to 48 diabetes clinicians, scientists, and business people. They asked them what they have learned from the COVID-19 pandemic and what they predict for the future. The authors come from 23 countries in North America, South America, Europe, Africa, Asia, and Australia. Here’s what they agreed on:

Read the full article here: The Coronavirus 2019 Pandemic and Diabetes: An International Perspective

So what does the diabetes and COVID-19 research tell us? People with diabetes have been proven to be at greater risk from COVID-19, both in and out of hospital. Our best defence is to keep on top of our blood glucose control, using all the diabetes tech available to us.

What to read next?

• The one article you should read about COVID-19 and diabetes
• Should diabetics get the COVID-19 vaccine? 
• What do we know about COVID-19 and diabetes?
• COVID-19 diabetes advice from a doctor
• COVID-19 diabetes update from a doctor
• Fast facts about diabetes and COVID-19
• 12 COVID-19 precautions and tips for people with diabetes
• Free COVID-19 resources for people with diabetes
• 10 diabetics share how coronavirus affects their diabetes
• Diabetes survivors of COVID-19

Photo by Prasesh Shiwakoti (Lomash) on Unsplash