Fort Berthold Diabetes Program

New research studies worldwide exploring the correlation between COVID-19 and Diabetes

By Nyamka Reese, MPM – Grant Manager of the Good Health 

and Wellness in Indian Country (GHIWC) Program

The Coronavirus Disease 2019 (COVID-19) is a new strain of coronavirus that researchers continue to learn more about every day. One thing that is known about the virus is that individuals with underlying health conditions are at increased risk of developing severe illness and complications. One such underlying health condition that researchers are paying closer attention to is diabetes. According to the Center for Disease Control and Prevention (CDC), individuals with diabetes are at higher risk for severe illness and poorer health outcomes with COVID-19. Since the beginning of the COVID-19 pandemic, the number of research studies has increased immensely. Worldwide, well over two thousand ongoing and completed COVID-19 studies are listed on the World Health Organization’s International Clinical Trials Registry Platform. This article will be exploring the results and insights of some of the major studies that have been conducted this year regarding the correlation between COVID-19 and diabetes. 

One of the first major studies of COVID-19 to specifically analyze the effect of the disease in hospitalized patients with diabetes was conducted at the University of Nantes, France. The study found that one in ten patients passes away within seven days of hospital admission, and one in five is intubated and mechanically ventilated by this point. The study shows that two-thirds of COVID-19 patients with diabetes admitted to hospital are men, and the average age of all patients is 70 years. Worse blood sugar control did not impact a patient’s outcome, however, the presence of diabetic complications and increasing age increase the risk of death. Increased body mass index (BMI) is associated with both increased risk of needing mechanical ventilation and with increased risk of death.

Another major study conducted in Leishenshan Hospital, Wuhan, China supported the above finding that diabetes did not significantly impact the prognosis of COVID-19 patients but negatively affected their clinical course. The study data also supported that the proportion of severe or critical COVID-19 cases among patients with diabetes was higher than that among those without diabetes. The researchers predicted that high glucose levels may play a role in the impaired antibacterial neutrophil function and complications caused by chronic diabetes. 

The majority of the studies are focused mainly on individuals with type 2 diabetes, although recent studies have shown that people with type 1 diabetes are also at risk of severe COVID-19. The first U.S. based multicenter surveillance study was published in June 2020. This study aimed to examine patient characteristics and adverse outcomes among patients with type 1 diabetes with confirmed COVID-19. The study result shows that the most common presenting symptoms for people with type 1 diabetes who have confirmed or suspected COVID-19 were hyperglycemia and diabetic ketoacidosis.

Another research study was conducted at the United Kingdom’s National Health Service (NHS) discovered that hospitalized individuals with type 1 diabetes are significantly more likely to pass away from COVID-19 than those with type 2 diabetes. Researchers concluded that hyperglycemia may enhance the immune system’s overresponse thereby exacerbating the impact of severe infections. 

People with diabetes with COVID-19 are at a greater risk of worse prognosis and mortality. Given the high worldwide prevalence of diabetes, these individuals represent a large vulnerable segment of the COVID-19 population. The above studies concluded that hyperglycemia, older age, comorbidities, hypertension, obesity, and cardiovascular disease all contribute to increasing the risk in individuals with diabetes. The recommendation is for physicians to account for not only the health status of the person with diabetes but also to carefully balance glucose-lowering treatments with specific treatments for the viral infection.

To conclude, COVID-19 has rapidly spread since its initial identification in China and has shown a broad spectrum of severity. Early isolation, early diagnosis, and early management might collectively contribute to better control of the disease and outcome. There are still a lot of unknowns about the correlation between diabetes and COVID-19. Therefore, future research studies are needed to conduct clinical studies aimed to understand the relationship and to figure out the extent to which specific mechanisms of the virus might contribute to the worsening of glycemic control, development of diabetic ketoacidosis, and possibly the development of new-onset diabetes. 

If you have diabetes, following preventive measures can help you protect from the COVID-19. 

Continue taking your diabetes pills and insulin as usual. 

Test your blood sugar and keep track of the results, as directed by your healthcare provider. 

Make sure that you have at least a 30-day supply of your diabetes medicines, including insulin. 

Follow your healthcare provider’s instructions if you are feeling ill as well as the sick day tips for people with diabetes.

Call your healthcare provider if you have concerns about your condition or feel sick.

If you have any questions about our Diabetes Program activities or if you would like to set up an appointment with a registered dietitian for support in your nutrition and health goals, please give the Diabetes Program a call at 701-627-7931.