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International study highlights diabetes risks in COVID-19

Health Industry Hub | April 27, 2020 |

Medical News: An international review involving Monash University has found older patients with diabetes who contract COVID-19 are at a much higher risk of dying from the disease, and the virus may actually trigger the onset of diabetes in normally healthy people.

The study, published in The Lancet Diabetes and Endocrinology, found that depending on the global region, 20% to 50% of patients diagnosed with COVID-19 during the pandemic had diabetes.

It also noted the risk of dying from COVID-19 was up to 50% higher in people with diabetes, particularly type 2 diabetes cases.

In Australia, one third of the 46 people who had died from COVID-19 by April 12 had diabetes, while 20% of the 752 people hospitalised with the virus had diabetes.

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Monash University Professor Paul Zimmet, who is also an Honorary President of the International Diabetes Federation, said the data highlights the real dangers COVID-19 poses to people with diabetes, as they are more susceptible to developing severe pneumonia and a septic course.

“The evidence showed the risk of a fatal outcome from COVID-19 is up to 50% higher in patients with diabetes than in those who do not have diabetes,” said Professor Zimmet.

Most of the emphasis on this review focused on people with type 2 diabetes. Most of the current information so far focuses on this older group. He noted the risk from COVID-19 in young people with type 1 diabetes appears to be much less.

Professor Zimmet said the review proposed implementing testing for diabetes in people with the COVID-19 infection to identify if previously healthy individuals have developed diabetes as a result of contracting the virus.

“We should consider everyone who gets sick with COVID-19 is also tested for diabetes. They should be tested at the time they become ill as it clearly will influence their medical management and health outcome,” he said.

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According to the study, patients with diabetes have an increased risk of severe complications including Adult Respiratory Distress Syndrome and multiple organ failure, including lung, heart and kidney.

Professor Zimmet said there should also be a warning to health professionals with diabetes  who are engaged in care of COVID-19 patients to ensure they have the protection they need to prevent contracting the virus.

The consensus group noted some sub-groups of people with diabetes may also require specific attention. They include:

  • Persons with poor metabolic (blood sugar) control of their diabetes. 
  • Diabetes with complications, and overall, there is a high risk of kidney failure in those critically ill with COVID-19 infection.
  • A significant number of persons with type 2 diabetes are obese and this may cauise problems in management.
  • Management of persons with diabetes who have had bariatric surgery for obesity will require special attention.
  • Persons who have had transplantations of the pancreas and kidneys, or are on regular dialysis.
  • Those on immunosuppressive therapy for other disorders, and/or on cortisone.
  • Those on certain diabetes medications which may affect progress if they are very ill.
  • Most patients with type 2 diabetes have other components of the metabolic syndrome including hypertension and high blood lipid (fats). Therefore, continuation with an appropriate antihypertensive and lipid-lowering regimen in all these patients is of crucial importance.

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