What about corona virus makes it so much worse for diabetics?

Seeing the death rate numbers its clear the older you are the more risk.

It’s also been shown that Diabetes is one of the top risk.

What I haven’t seen is Diabetes deaths overlaid against patient age.

I’m just wondering what about having diabetes makes the virus so much more dangerous?

Since I got diagnosed and got my sugar under control I haven’t been sick in 2 years. I don’t feel like I have a compromised immune system but maybe I do?

Just curious if anyone has insights and especially numbers to share.

thanks

I don’t. I rarely get sick. I can go years and years with not much other than a sinus infection. I think there are very ill diabetics and there are us “healthy” diabetics.

3 Likes

Yeah, but it bugs me that they don’t go any farther than that. “Diabetes” is not one undifferentiated thing, so I never know what they’re referring to with this stuff. 9x out of 10 it actually means Type 2, because in the media and popular conception that’s what it refers to and they don’t see any need to specify one or the other. I suspect what really is at stake is associated conditions—cardiovascular, obesity, high BP—rather than the disease (whichever kind) per se. People talk about T1s being “immune compromised,” but I’ve never quite understood that. Yes, it was caused by an auto-immune reaction, but that was an over- reaction, not my immune system laying down on the job. I don’t find myself any more prone to every cold that comes along than anyone else. With a really nasty flu, keeping BG in control can get to be a royal PITA, so that could be a problem if you’re prone to DKA.

I really wish they could be more specific, but this stage I suspect it’s mostly a matter of statistics: of the people reacting most severely or dying, what other factors or conditions does that track with? Age, check. “Diabetes,” check.

I think this article is helpful.

“what actually happens to your body when it is infected by the coronavirus? The new strain is so genetically similar to SARS that it has inherited the title SARS-CoV-2. So combining early research on the new outbreak with past lessons from SARS and MERS can provide an answer.…”

Below is talking about SARS specifically, but the article also discusses how SARS and the COVID-19 are similar.

"…That’s when phase two and the immune system kicks in. Aroused by the presence of a viral invader, our bodies step up to fight the disease by flooding the lungs with immune cells to clear away the damage and repair the lung tissue.

When working properly, this inflammatory process is tightly regulated and confined only to infected areas. But sometimes your immune system goes haywire and those cells kill anything in their way, including your healthy tissue.

“So you get more damage instead of less from the immune response,” Frieman says. Even more debris clogs up the lungs, and pneumonia worsens. (Find out how the novel coronavirus compares to flu, Ebola, and other major outbreaks).

During the third phase, lung damage continues to build—which can result in respiratory failure. Even if death doesn’t occur, some patients survive with permanent lung damage. According to the WHO, SARS punched holes in the lungs, giving them “a honeycomb-like appearance”—and these lesions are present in those afflicted by novel coronavirus, too."

4 Likes

See other threads about how most NON diabetics, including many doctors, have little to no understanding of diabetes. Let alone a “healthy” diabetic.

Accept the idea that the older, and sicker you are the higher your risk factor. Just like with the flu.

Stay healthy and reduce your risk.

Very helpful, thanks!

The gist of the article is that a huge amount of damage to the lungs and other organs can occur when the virus triggers a hyperactive response from the immune system, which then proceeds to punch holes in the lungs. They didn’t say this, but it does seem to follow that those of us who have auto-immune diabetes or other disease resulting from an overactive immune system would be of higher risk. And the description of what actually happens sounds seriously ugly and not fun.

3 Likes

That was my conclusion as well. I wish they would clarify that when they describe people most at risk.

For now, I think isolation is a good policy for those of us with an auto-immune disease.

1 Like

Yeah I don’t think this time it necessarily is about how controlled your diabetes is, but rather the abnormal immune response. I have also seen though that people with CVD are at higher risk for death, so it’s conceivable that both T1 and T2 diabetics might both have elevated risk but via different means.

Anyone with a history of smoking is also at higher risk, even if they have stopped and even if they stopped a long time ago.

2 Likes

I had heard it was the over response of the immune system that is the most problematic. I have a feeling that the young are mostly exempt because their immune systems are usually at peak performance and responds like it should as it does with any new virus it runs across.

But I think one of the problems with diabetes even in the well controlled, that once you are sick your BG level isn’t so well controlled any more. I think it was Gary Scheiner? that touched on that. Personally it’s better to be safe than sorry.

I brought this up in another topic. This article literally answers this exact question. Our risk of hospitalization or death, if you only have diabetes and not other comobidities, is 1.59 X your age group.

People in 20’s : 1.59 x .2
People in 30’s: 1.59 x .2
People in 40’s: 1.59 x .4

People in 80’s: 1.59 x 14.8

Age is the real factor here it seems. It pisses me off how they lump diabetes into one category, young and old, t1 and t2…

What these numbers show is that age plus diabetes is bad but just diabetes makes barely any difference.

.2% for regular population of 20’s and 30’s (or 1 in 500 chance of hospitalization or death)

Vs.

Diabetic 20’s and 30’s

.31% chance or 1 in 325

@ChrisP tagging so you see my above post. Please tell me if you think this answers it. This was on my mind yesterday as well. This is the age question you had asked, overlaid with the chart if hospitalization and/or death. The author did a good job explaining

Additional data has been released, analyzing the impact of various health conditions in a study of 1,590 patients with COVID-19 from China. After adjusting for age and smoking status, diabetes was one of the things that was associated with a greater risk of infection compared to someone without diabetes. This study is interesting because it is looking at the risk for hospitalization, need for ventilation, and death combined, whereas the other data has solely reflected the rate of death of the disease or age group (but not both combined). The study shows that on average, having one health condition increases the risk by 1.79 times, and two health conditions increases the risk by 2.59 times – all compared to individuals without pre-existing conditions. However, diabetes itself is calculated to increase risk by 1.59 times. This means that compared to someone in your age group who doesn’t have diabetes, you are 1.59 times as likely to develop a case of coronavirus that requires hospitalization or ventilation.

How might you use this data? You can look up your age group risk and multiply that risk by 1.59 (if diabetes is your only chronic illness) to assess what your risk might be compared to others in your age group. Note again – this is the increased risk of being hospitalized or dying if you do get infected with COVID-19; it does not represent share of deaths by pre-existing condition.

@Marie20 @katers87 @DrBB

3 Likes

That looks like exactly what I wanted. Thank you for pointing this out.

1 Like

Type 1 Diabetes is usually caused by some immune disfunction, so quite naturally our immune response may not be inline with that of general healthy population. How exactly? As usual the answer is - it depends;).

Two interesting articles on that matter:

  1. Immune dysfunction in patients with diabetes mellitus: https://academic.oup.com/femspd/article/26/3-4/259/638202
  2. Influence of diabetes mellitus on immunity to human tuberculosis:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5543489/
    Naturally COVID is different from tuberculosis but both affect lungs heavily in heavy cases. A good ilustration of immunological mechanisms of diabetes affected patients in the case of a much better researched pullmonary disease.

Diabetes makes everything worse. Thats just how it goes. You might as well assume higher risk for EVERYTHING. We just live on the edge, ChrisP, lol.

Here are the risks of using a hot tub for diabetics, in case you have ever wondered why those signs single us out: https://www.healthgrades.com/right-care/diabetes/what-people-with-diabetes-should-know-about-hot-tubs

I have been thinking about this a lot and I just found an article from the ADA that supported my personal belief.

In general, diabetics are NOT any more likely to get the coronavirus than the general population. (However, those with diabetic complications, or whose diabetes is poorly controlled, such as cardiovascular disease, may be at higher risk because the diabetic complication could affect your body’s ability to fight off the infection.)

The primary problem is diabetics are at a higher risk of worse outcomes if they DO get it. Infections can cause make blood sugars hard to manage, it can result in more severe complications or, in Type 1s, can lead to DKA.

https://www.diabetes.org/diabetes/treatment-care/planning-sick-days/coronavirus

1 Like

Here’s the very latest (dated March 22) revision of CDC guidance on what constitutes high risk. Diabetes is called out with the “PARTICULARLY IF NOT WELL CONTROLLED”.

Based upon available information to date, those at high-risk for severe illness from COVID-19 include:

  • People aged 65 years and older
  • People who live in a nursing home or long-term care facility
  • Other high-risk conditions could include:
    • People with chronic lung disease or moderate to severe asthma
    • People who have heart disease with complications
    • People who are immunocompromised including cancer treatment
    • People of any age with severe obesity (body mass index [(BM]I)≥40) or certain underlying medical conditions, particularly if not well controlled, such as those with diabetes, renal failure, or liver disease might also be at risk
2 Likes

Same here. I barely ever get sick. I may get some allergies, cough/cold, or and sore throat…but nothing the docs will do besides saying get over it and take over the counter stuff.

1 Like