Diabetes and Covid-19

Catching up on diabetes and found several interesting studies.

CONCLUSIONS: Diabetes status, both type 1 and type 2, independently increases the adverse impacts of COVID-19. Potentially modifiable factors (e.g., HbA1c) had significant but modest impact compared with comparatively static factors (e.g., race and insurance) in type 1 diabetes, indicating an urgent and continued need to mitigate severe acute respiratory syndrome coronavirus 2 infection risk in this community.

COVID-19 Severity Is Tripled in the Diabetes Community: A Prospective Analysis of the Pandemic’s Impact in Type 1 and Type 2 Diabetes — http://Diabetes Care 2021 Feb; 44(2): 526-532. https://doi.org/10.2337/dc20-2260

CONCLUSIONS: Social vulnerability contributes considerably to the probability of hospitalization among individuals with COVID-19 and diabetes with associated comorbidities. These findings can inform mitigation strategies for populations at the highest risk of severe COVID-19.

Incremental Risk of Developing Severe COVID-19 Among Mexican Patients With Diabetes Attributed to Social and Health Care Access Disadvantages — http://Diabetes Care 2021 Feb; 44(2): 373-380. https://doi.org/10.2337/dc20-2192

This study shows that diabetes is associated with a greater risk of fatal COVID-19, influenza/pneumonia, and CHD in both sexes. However, unlike for CHD, there are no sex differences in the association between diabetes and death from COVID-19 or influenza/pneumonia. Our finding that diabetes is associated with higher risk of COVID-19 mortality is consistent with other studies (14). A study of 61 million individuals in England showed that over a third of all in-hospital COVID-19–related deaths occurred in those with diabetes, and those with diabetes had higher odds of in-hospital COVID-19–related death than those without diabetes (1). In contrast to our study, however, that study suggested that women with diabetes were at higher risk of COVID-19–related mortality than men (1). Our results suggest that worse glycemic control might further increase risk of COVID-19 mortality among those with diabetes. Some studies have also reported that individuals with undiagnosed diabetes are particularly at increased risk of severe COVID-19 infections (3,4). Although relatively few participants had undiagnosed diabetes in the current study, we showed that undiagnosed diabetes was associated with a 3.5-fold excess risk of COVID-19 mortality in men. Although there were no sex differences in the association between HbA1c levels and COVID-19 mortality, the finding that associations are broadly similar across sexes and diseases with the exception of women with CHD is interesting, and it is important when considering mechanistic explanations of the female disadvantage in CHD. Overall, these findings indicate that strategies to prevent diabetes, to promptly identify individuals with diabetes, and to improve glycemic control among those with diabetes could lead to better COVID-19 outcomes for both sexes.

Diabetes and COVID-19–Related Mortality in Women and Men in the UK Biobank: Comparisons With Influenza/Pneumonia and Coronary Heart Disease — http://Diabetes Care 2021 Feb; 44(2): e22-e24. https://doi.org/10.2337/dc20-2378

Take home lesson: don’t develop diabetes.

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