A third of COVID-19 deaths in England linked to diabetes

People with diabetes do face a significantly higher risk of dying with COVID-19 with a third of deaths in England associated with the condition, according to new NHS research.

Published in the Lancet, the two world-leading studies led by Professor Jonathan Valabhji, National Clinical Director for Diabetes and Obesity at NHS England and Professor Kar, National Specialty Advisor, Diabetes with NHS England, have been looking in depth at the number of people who died from coronavirus in hospital also had diabetes. People with diabetes are no more likely to contract COVID-19 than anyone else providing they social distance.

The researchers discovered that those with type 1 diabetes are at three and a half times the risk, and people living with type 2 are at double the risk of dying in hospital with the virus, compared to people without diabetes.

This research shows the extent of the risk and the different risks for those with type 1 and type 2 diabetes. Importantly, it also shows that higher blood glucose levels and obesity further increase the risk in both types of diabetes Professor Jonathan Valabhji

However, by far the strongest risk factor for dying with the virus is age, and people with type 1 diabetes are on average younger than people with type 2 diabetes.

Overall, 7,466 of those who died in hospitals in England had type 2 and 365 who died had type 1 diabetes, and the research suggests that the threat for those under 40 with type 1 or type 2 diabetes is very low.

Infectious conditions

It is thought that the risk to people with diabetes and the virus is in line with the extra risk seen in other infectious conditions such as pneumonia.

The studies also show that in people with both type 1 and type 2 diabetes, even when all other known factors are taken into account, higher blood glucose levels and obesity are linked to higher risk.

The study findings also show:

• The overall death rate for people with diabetes doubled during the early stage of the pandemic.
• In both type 1 and type 2 diabetes, men, people of black or Asian ethnicity, and people living in more deprived communities, were at higher risk.
• In both type 1 and type 2 diabetes, those with pre-existing kidney disease, heart failure and previous stroke, were also at higher risk.

Professor Valabhji said: “This research shows the extent of the risk and the different risks for those with type 1 and type 2 diabetes. Importantly, it also shows that higher blood glucose levels and obesity further increase the risk in both types of diabetes.

“This can be worrying news but we would like to reassure people that the NHS is here for anyone with concerns about diabetes – and has put extra measures in place to help people and keep them safe, including online sites to support people to care for themselves, digital consultations, and a dedicated new helpline for advice and support for people treated with insulin.”

The helpline launched together with Diabetes UK and Novo Nordisk has been developed to give people with diabetes advice during the pandemic.

Video consultations and online appointments, as well as routine discussions with GPs, are among a range of measures that the NHS has also adopted so that diabetes care can continue throughout the pandemic.

People with diabetes are also advised:

• If you are concerned about your diabetes during the coronavirus pandemic, the NHS is here to help. Contact your GP Practice or Diabetes team.
• If you have diabetes and have been contacted by your specialist eye or foot care team, please go to your appointments to receive treatment to avoid these problems getting worse. Clinics are taking extra protective measures to keep people safe.
• The 4Ts – toilet, thirsty, tired and thinner – are signs of a life-threatening diabetic emergency, diabetic ketoacidosis or ‘DKA’. If you recognise these signs, seek urgent medical advice from your GP Practice (or 111 out of hours); if you already have diabetes, contact your Diabetes team; or if you feel very unwell, call 999.
• If you have diabetes and see a cut or blister on your foot, it may be a sign of a foot ulcer. Call your GP Practice to get it checked as soon as possible. If you do have an ulcer or other serious foot problem, you will be referred to see a specialist urgently.
• If you are experiencing a serious or life-threatening emergency – call 999.

Click here to read ‘Type 1 and Type 2 diabetes and COVID-19 related mortality in England: a whole population study’

Click here to read ‘Type 1 and Type 2 diabetes and COVID-19 related mortality in England: a cohort study in people with diabetes’

Photo by CDC on Unsplash