Health Why people with diabetes are being hit so hard by Covid-19

Why people with diabetes are being hit so hard by Covid-19 For people with diabetes, a thicket of biological and socioeconomic factors make them more likely to suffer severe illness and die of Covid-19. Elizabeth Cooney STAT

Sme of Mary-Elizabeth Patti’s patients with diabetes are in a bind. Careful to practice social distancing, they tell her during telehealth visits they don’t feel safe exercising outdoors in their congested neighborhoods — though they know staying active and maintaining good blood sugar levels may be their best defense against severe Covid-19.

“I’m always happy when patients say, yes, I’m not going out, I’m wearing a mask, I’m doing as much as I can. But it makes it harder for people to meet their fitness goal, which is such a critical element of overall health and metabolic health,” said Patti, an adult endocrinologist at Joslin Diabetes Center in Boston. “It underscores the health inequity problem,” she added: “Their exposures may be increased due to living in a densely populated neighborhood with multigenerational families [and] more essential workers who cannot work from home.”

There are no easy answers to the coronavirus pandemic, but for people with diabetes, it’s dismayingly difficult to untangle the thicket of biological and socioeconomic factors that make them more likely to suffer severe illness and die should they catch the virus that causes Covid-19. That leaves prevention — controlling blood sugar through diet, exercise, monitoring, and medication — as the leading tactic to protect people, until a successful vaccine proven to work in people with diabetes, too, reaches a population bearing multiple burdens of chronic illness.

The numbers are alarming. A Lancet Diabetes & Endocrinology study mining 61 million medical records in the U.K. says 30% of Covid-19 deaths occurred in people with diabetes. After accounting for potentially relevant risk factors such as social deprivation, ethnicity, and other chronic medical conditions, the risk of dying from Covid-19 was still almost three times higher for people with type 1 diabetes and almost twice as high for type 2, versus those without diabetes.  ...