Recommended New Guidelines Regarding Type 1 Diabetes and Coronavirus

The American Diabetes Association and other national diabetes advocacy organizations have recommended updated coronavirus guidelines for people with type 1 diabetes. The current recommendations from the Centers for Disease Control and Prevention prioritize individuals who have type 2 diabetes above those with type 1 diabetes.

Some research shows that people with both types of diabetes should be prioritized as high-risk. Currently, the CDC ranks people with type 1 diabetes among those who might be at increased risk for illness. However, other nations, including the United Kingdom, place everyone with diabetes in the same priority category for the COVID 19 vaccine. Learn more about the position of these diabetes advocacy groups and explore strategies to stay safe and healthy.


Research on COVID 19 and Type 1 Diabetes

Although the CDC has yet to update the guidelines based on pressure from the ADA and other groups, clinical research associates type 1 and type 2 diabetes with a higher risk of SARS COV 2 illness. 

Researchers reviewed 61 million medical records from the National Health Service in England to study COVID 19 risks. The study, published in August 2020 in the journal Lancet Diabetes & Endocrinology, found a 200% COVID 19 fatality rate for people with type 2 diabetes and a 300% higher fatality rate for people with type 1 diabetes compared to COVID-19 patients who did not have diabetes. 

In a subsequent study published by the same peer-reviewed journal, Scottish researchers found that COVID 19 patients with type 2 diabetes have a 150% chance of critical care hospitalization or death from the disease than people without diabetes. For people who have type 1 diabetes, the risk rises to 200% above the non-diabetes COVID population. In February 2021, a study by Vanderbilt University published in the journal Diabetes Care found similar results. The researchers reported that people who have either type 1 or type 2 diabetes

have a 300% to 400% higher risk of serious illness and hospitalization from SARS COV 2 infection than adults who do not have diabetes.

A study in the Journal of Clinical Endocrinology and Metabolism also found racial disparities among COVID 19 illnesses for people with type 1 diabetes. Researchers found that black patients with type 1 diabetes and coronavirus are four times more likely to develop the dangerous complication diabetic ketoacidosis, than white people with type 1 diabetes and COVID 19. 


Understanding How COVID Impacts Diabetes

An article in PBS NewsHour reports that up to 95% with diabetes have type 2. With this condition, the body does not make enough of a substance called insulin to convert blood glucose to energy. The body may also make enough insulin but fail to respond to its signals. About 5 to 10% of the diabetic population has type 1. This condition destroys the body’s pancreatic islet cells, which produce the body’s insulin.

Research findings thus far indicate that people with either type of diabetes experience internal inflammation when infected with the COVID virus. This impacts the organs and potentially creates worse outcomes for this population. In addition, when people who have diabetes get sick, they have impaired circulation, a weaker immune response, and limited glucose control. Sugar elevation in the blood can damage tissues and organs, resulting in severe complications that include limb neuropathy and possible amputation, eye issues, kidney failure, heart attack, and stroke. People who have obesity and diabetes have a higher risk for these complications than the general population with diabetes if they become infected.

Justin Gregory, one of the authors of the Vanderbilt study, theorizes that malfunctioning vascular endothelial cells in diabetic individuals cause an outsized immune response in the case of COVID 19 infection. These cells assist with blood clotting and support the body’s immune response, so limited function can result in significant virus complications.


Diabetes Care and Prevention for SARS COV 2

Based on the research outlined above and other ongoing scientific studies, advocates believe that people with both types have a higher risk of severe illness when they get COVID-19 than people without diabetes. As these organizations push for the CDC to update recommendations during the COVID vaccine process, they would like people with diabetes to know they can take steps to reduce their risk of severe illness from the COVID 19 pandemic

Both type 2 and type 1 diabetes patients should follow these CDC recommendations:

  • Call your doctor or let your caregiver know if you don’t feel well or think you have been exposed to the virus.
  • Keep a 30-day supply of insulin and other diabetes medications at home, and keep taking these medications as recommended by your doctor.
  • Keep your blood glucose under control, and call your doctor if you have trouble doing so.
  • Stay home whenever possible. If you do have to go out, wear a mask and stay at least 6 feet away from other people.
  • Wash your hands often either with 60%-alcohol hand sanitizer or soap and water.
  • Register for the COVID 19 vaccine according to the procedures in your county or state.
  • Frequently disinfect the objects in your home you often touch, like your phone, TV remote, countertops, and doorknobs.
  • Avoid close contact with people who do not live in your household.
  • Get a flu vaccine during the 2020-2021 flu season if you have not already done so.
  • Work at home if your job will allow you to do so. One endocrinologist, Mary Elizabeth Patti of Joslin Diabetes Center, has requested this reasonable accommodation for her patients.

The ADA reports that people with uncontrolled blood glucose are more likely to get sick and experience complications than people who can control their blood sugar. If you struggle to manage this disease, ask your medical provider for guidance.


Steps To Take if You Get Sick

If you have type 1 or type 2 diabetes, you are not necessarily more likely to contract COVID 19. However, if you do get sick, you will likely experience higher illness severity along with the potential for other complications. The ADA says you should be familiar with the symptoms of COVID 19 so you can seek immediate medical attention. Signs of the disease include blue-tinged face or lips, fatigue, inability to be awakened, confusion, chest pressure or pain, and difficulty breathing. 

Depending on your illness severity, your doctor may recommend that you recover at home for both those with type 1 and type 2. The ADA recommends self-care measures to ease symptoms and reduce the increased risk of severe complications:

  • If your blood sugar levels drop below the target range for glucose control recommended by your doctor, eat 15 g of sugar, wait 15 minutes and check again. If your levels remain low, call your health care team.
  • Drink plenty of fluids or chew on ice chips, so you remain hydrated. Avoid dehydrating liquids like coffee and soda. 
  • Review the signs of diabetic ketoacidosis. You need emergency medical care if you experience confusion, sweet-smelling breath, difficulty catching your breath, fatigue, muscle weakness, stomach pain, nausea, vomiting, frequent urination, or uncontrollable thirst.

If you become ill with COVID 19 or have concerns about the spread of the disease in your community, make sure you have the medical supplies you need to keep your condition under control. Explore the full line of high-quality supplies and continuous glucose monitors from MedEnvios Healthcare for convenient delivery to your door. We’re ready to help you manage your diabetes during the COVID crisis.



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