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When the pandemic began, many people with diabetes wondered what COVID-19 meant for them. Diabetes was already known to increase the risk of other infectious diseases, including influenza. Could the same be true for COVID-19? At the time, all scientists could do was make educated guesses.
The situation will be very different in 2024. Further research availableas well Effective vaccinesAnd life has returned to nearly normal in many ways.
But COVID-19 hasn't gone away. 400 million people For people with diabetes around the world, the very real risks and impacts of the pandemic remain.
I specialize in extracting and combining existing evidence. Informing health policy They are active in a variety of fields. COVID-19 and diabetes research Since the pandemic began And I've experienced firsthand some of the different impacts that COVID-19 has had on people with diabetes. I've lived with type 1 diabetes for the past 30 years, and when the pandemic began, I had a lot of questions about what COVID-19 meant for me.
Defining the Types of Diabetes
Diabetes is characterized by higher than normal blood sugar levels, and this can be caused in different ways depending on the type of diabetes.
Type 1 diabetes It occurs when the body attacks the cells that produce insulin.
Insulin is a hormone that converts sugar into energy. Without insulin, sugar remains in the blood and the body doesn't get the energy it needs. Type 1 diabetes can only be treated with insulin injections and is irreversible. If left untreated, type 1 diabetes is fatal. There is no cure. No one knows for sure why some people get type 1 diabetes and others don't.
in contrast, Type 2 diabetes This is the most common type. Your body still produces insulin but has a reduced ability to use it. You are more likely to develop type 2 diabetes. If you are living with obesityHowever, people who are not obese can also develop type 2 diabetes, and many people who are obese do not develop diabetes.
Type 2 diabetes It often occurs within familiesIt can be treated in a variety of ways, including: Weight loss for obese people, Diet and exercise changesand PharmaceuticalsIn some cases, Type 2 diabetes is treatable.
Type 1 diabetes is most likely to develop during childhood or adolescence, while type 2 diabetes is most likely to develop in later life. However, older people May develop type 1 diabetesand Children may develop type 2 diabetes.
There are other types of diabetes. Gestational diabetes It develops during pregnancy and disappears after birth. Like type 2 diabetes, the body continues to produce insulin but its ability to use it decreases.
Diabetes in general is on the rise, with most cases being type 2. It is estimated that by 2050, 1.3 billion people worldwide will have diabetes.
Diabetes is Damage to many parts of the bodyIt helps maintain the health of many organs, including the eyes, heart, blood vessels, nervous system, feet, and kidneys. Mitigate these risks.
Diabetes and COVID-19
In our 2023 study, my colleagues and I reviewed a wide range of literature to determine the extent to which people with diabetes are at increased risk for COVID-19 and whether some people with diabetes are at higher risk than others.
Overall, people with diabetes have about Twice as likely to develop severe COVID-19 symptoms It has also been consistently shown that people with diabetes are more likely to die from COVID-19 than those without diabetes.
Some people with diabetes appear to be at higher risk than others, with higher blood sugar levels either before or during COVID-19 infection. The outcome is likely to be poorIn addition, the risk is generally It is even higher in people with type 1 diabetes and People who use insulin.
There are several possible reasons. High blood sugar levels: To help people's bodies fight infectionsOn average, blood sugar levels are higher in some people. Type 1 diabetes is more common than type 2 diabetesInfections can make it harder to control your blood sugar levels.
People with type 1 diabetes tend to have lived with the disease longer than those with type 2 diabetes, which may mean their bodies are less able to fight off COVID-19. Complications of diabetes For example, damage to the heart and kidneys may occur.
Pandemic disruption
The pandemic has caused widespread disruption for people with diabetes, with many finding it difficult to make appointments with their health care providers. Access to medicinesFor many people, their diet and physical activity were also disrupted.
We conducted an extensive systematic review of 139 studies involving more than one million people to examine the impact of pandemic disruptions on people with diabetes. Diabetes deaths during the pandemic More than before Diabetes causes vision loss More people are suffering from diabetes during the pandemic than ever before. People with diabetes need to get regular eye exams to protect their vision. These exams are That didn't happen during the pandemic.As a result, people's eyesight has deteriorated.
And we found that young people with diabetes fared particularly poorly: Children and young people with type 1 diabetes are more likely to be hospitalized with the life-threatening disease. Diabetic ketoacidosisThis is a condition where the body does not have enough insulin and the blood becomes toxic.
Admission to the pediatric intensive care unit due to diabetes Higher during the pandemic than beforeThe chaos caused by the pandemic may have caused people to delay seeking medical care or not get it at all, meaning young people with diabetes may already be seriously ill by the time they reach the hospital.
I'm looking forward to
But there is still plenty of reason to be optimistic. COVID-19 vaccines are The chances of death were significantly reduced Or really COVID-19And in many countries, people with diabetes Priority for vaccination.
There have also been advances in diabetes care: improved diabetes management through technologies such as insulin pumps and continuous glucose monitors, behavioral changes, and medications can help reduce the risk of COVID-19 and other infectious diseases.
Weight loss drugs may also help prevent diabetes, but it is too early to say for sure.
Only time will tell what long-term effects the pandemic will have: because diabetes complications often don't develop until years later, researchers like me may see more people suffering from diabetes complications over the next 5 to 10 years as a result of challenges in diabetes management during the pandemic.
Regular monitoring, especially among groups most affected by the pandemic, is likely to be helpful: if detected early, many of the complications of diabetes can be successfully treated.
My team found that among people with diabetes, women, young people, and people from racial and ethnic minorities are more likely to be adversely affected by the pandemic — groups that are also more likely to struggle to access care in terms of insulin affordability and access. It remains a particularly significant problem.
Efforts to ease access to insulin and healthcare will help improve diabetes outcomes before, during, and after the pandemic.
