In a new study, researchers found that elderly people with diabetes who contract COVID-19 are at a much higher risk of dying from the disease.
In addition, the virus may actually trigger the onset of diabetes in normally healthy people.
The research was conducted by an international team involving Monash University.
The team 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 percent higher in people with diabetes, particularly elderly 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 hospitalized with the virus had diabetes.
The team says 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 study is important because it draws together what is currently known across the world about the impact of COVID-19 on people with diabetes and the increased risks they face given that this pandemic is very recent.
Most of the emphasis on this review focussed on people with type 2 diabetes. Most of the current information so far focus on this older group.
The team noted the risk from COVID-19 in young people with type 1 diabetes appears to be much less.
Providing they have access to satisfactory health care and good control of their diabetes, parents of children and adolescents with type 1 diabetes should be reassured on this issue.
The report noted that damage to pancreatic β cells (the cells that make insulin) may lead to direct damage to the function of the pancreas.
Although this has not been verified in humans, they suggest that diabetes might not only be a risk factor for a severe form of COVID-19 disease but also that infection could result in causing new-onset diabetes.
The new 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.
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.
There should also be a warning to health professionals with diabetes who are engaged in the care of COVID-19 patients to ensure they have the protection they need to prevent contracting the virus.
The team says 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 cause 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 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.
One author of the study is Monash University Professor Paul Zimmet AO, from the Department of Diabetes.
The study is published in The Lancet Diabetes & Endocrinology.
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