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.

Science Daily Covid-19 Links – 11.06.20

Massachusetts Institute of Technology. “COVID-19 ‘super-spreading’ events play out-sized role in overall disease transmission: Mathematical analysis suggests that preventing large gatherings could significantly reduce COVID-19 infection rates.” ScienceDaily, 2 November 2020. www.sciencedaily.com/releases/2020/11/201102173232.htm.

Journal Reference: Felix Wong, James J. Collins. Evidence that coronavirus superspreading is fat-tailed. Proceedings of the National Academy of Sciences, 2020; 202018490 DOI: 10.1073/pnas.2018490117

University of Alberta Faculty of Medicine & Dentistry. “Review finds almost 20 percent of COVID-19 patients only show gastrointestinal symptoms: Radiologists encouraged to remain watchful for signs of the virus.” ScienceDaily. ScienceDaily, 3 November 2020. www.sciencedaily.com/releases/2020/11/201103104734.htm.

Journal Reference: Kevin Lui, Mitchell P. Wilson, Gavin Low. Abdominal imaging findings in patients with SARS-CoV-2 infection: a scoping review. Abdominal Radiology, 2020; DOI: 10.1007/s00261-020-02739-5

Brigham and Women’s Hospital. “Study uncovers subset of COVID-19 patients who recover quickly and sustain antibodies: Researchers identify patients who cleared the disease faster and had a persistent antibody response, with important implications for immunity.” ScienceDaily. ScienceDaily, 3 November 2020. www.sciencedaily.com/releases/2020/11/201103121044.htm.

Journal Reference: Yuezhou Chen, Adam Zuiani, Stephanie Fischinger, Jyotsna Mullur, Caroline Atyeo, Meghan Travers, Felipe J.N. Lelis, Krista M. Pullen, Hannah Martin, Pei Tong, Avneesh Gautam, Shaghayegh Habibi, Jillian Bensko, Deborah Gakpo, Jared Feldman, Blake M. Hauser, Timothy M. Caradonna, Yongfei Cai, John S. Burke, Junrui Lin, James A. Lederer, Evan Christopher Lam, Christy L. Lavine, Michael S. Seaman, Bing Chen, Aaron G. Schmidt, Alejandro Benjamin Balazs, Douglas A. Lauffenburger, Galit Alter, Duane R. Wesemann. Quick COVID-19 Healers Sustain Anti-SARS-CoV-2 Antibody Production. Cell, 2020; DOI: 10.1016/j.cell.2020.10.051

Texas A&M University. “Four major predictors of COVID-19 emerge in new study: Researchers identified socioeconomic predictors that could inform future pandemic response.” ScienceDaily. ScienceDaily, 4 November 2020. <www.sciencedaily.com/releases/2020/11/201104114724.htm>.

Journal Reference: Richard S. Whittle, Ana Diaz-Artiles. An ecological study of socioeconomic predictors in detection of COVID-19 cases across neighborhoods in New York City. BMC Medicine, 2020; 18 (1) DOI: 10.1186/s12916-020-01731-6

Brigham and Women’s Hospital. “Rapid changes in biomarker of inflammation may be a key predictor of COVID-19 outcomes: Results provide insight into underlying mechanisms of inflammation that may help anticipate clinical trajectories of COVID-19 patients.” ScienceDaily. ScienceDaily, 5 November 2020. www.sciencedaily.com/releases/2020/11/201105112947.htm.

Journal Reference: Alisa A. Mueller, Tomoyoshi Tamura, Conor P. Crowley, Jeremy R. DeGrado, Hibah Haider, Julia L. Jezmir, Gregory Keras, Erin H. Penn, Anthony F. Massaro, Edy Y. Kim. Inflammatory Biomarker Trends Predict Respiratory Decline in COVID-19 Patients. Cell Reports Medicine, 2020; 100144 DOI: 10.1016/j.xcrm.2020.100144

Executive Summary

  • Super spreading events are real so avoid large crowds when possible and wear a mask.
  • I had the worst stomach bug in my entire life back in February. I ate only to keep my strength up but no foods were appealing. The thought of alcohol made me cringe. It lasted a week and I lost five pounds. Covid?
  • Did I develop and sustain antibodies?
  • The socioeconomic predictors of Covid-19 are pretty much what they have been for many years. The virus has merely put a spotlight on existing economic and other inequalities in the world.
  • C-Reactive Protein (CRP).

Richard Lehman’s Journal Review – October 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 3 October 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 10 October 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 17 October 2011

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 24 October 2011

Here are the links.  Happy reading.

Richard Lehman’s Journal Review – Late Links

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 6 December 2010

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 29 November 2010

BMJ Group blogs: BMJ » Blog Archive » Richard Lehman’s journal review – 22 November 2010

Sorry for the late links.  But better late than never.

As an enthusiastic regular drinker of wine, I am delighted to note the PRIME study which confirms that by doing so I halve my chance of myocardial infarction. I suppose I also increase my chance of pancreatitis, cancers of the GI tract and stroke. Perhaps liver disease too, though the literature is surprisingly obscure at levels of intake below about 100u/week. The thing not to do is binge drink, which is a common pattern in Northern Ireland, and probably increases your baseline risk of MI. I think the further north you travel, the more dysfunctional alcohol use becomes, as warm oblivion becomes ever more desirable. As if to illustrate this point, a review of frostbite finds that nearly half of it is associated with alcohol use. I bet that means vodka or whisky in most cases, and wine alone hardly ever.