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Diabetes linked to increased risk of COVID-19 related death in hospital

By Editor
24th September 2020
Coronavirus, Type 1 diabetes Type 2 diabetes

Type 1 and type 2 diabetes were both independently associated with a significant increased odds of in-hospital death with COVID-19, according to new research.

The study findings led by Jonathan Valabhji, the National Clinical Director for Diabetes and Obesity at NHS England and NHS Improvement, were unveiled at the European Association for the Study of Diabetes Annual Meeting 2020.

Although diabetes has been associated with COVID-19-related mortality, the absolute and relative risks for type 1 and type 2 diabetes are unknown.

The team assessed the independent effects of diabetes status, by type, on in-hospital death in England among people infected with COVID-19 during the period from March 1 to May 11, 2020.

Future studies should establish the key pathophysiological mechanisms underlying the determinants of more severe outcomes of COVID-19 and inform potential clinical and public health responses to the pandemic

They included all individuals registered with a general practice in England who were alive on February 16, 2020. They applied multivariable logistic regression to examine the effect of diabetes status, by type, on in-hospital death with COVID-19, adjusting for demographic factors and cardiovascular comorbidities.

Mortality rates

Because of the absence of data on total numbers of people infected with COVID-19 during the observation period, the team calculated mortality rates for the population as a whole, rather than the population who were infected.

The findings suggested that a third of all COVID-related hospital deaths in England between March 1 and May 11, 2020 occurred in people with diabetes.

Unadjusted mortality rates over the 72-day observation period were significantly higher for people with type 2 diabetes than for people with type 1 diabetes, with both being significantly higher than for people without diabetes.

After adjustment for age, sex, deprivation, ethnicity, and geographical region, people with type 1 diabetes had 3·5 times the odds of in-hospital death with COVID-19 and people with type 2 diabetes had twice the odds, relative to people without diabetes.

Further adjustment for cardiovascular comorbidities slightly attenuated the odds for people with type 1 and type 2 diabetes, but these remained significantly greater than for people without diabetes.

‘Higher risk’

The researchers concluded: “People with diabetes are at higher risk of COVID-19-related mortality than people without diabetes. However, mortality risk was very low for people younger than 40 years with either type 1 or type 2 diabetes.
“Future studies should establish the key pathophysiological mechanisms underlying the determinants of more severe outcomes of COVID-19 and inform potential clinical and public health responses to the pandemic.”

Helen Kirrane, Head of Policy, Campaigns and Mobilisation at Diabetes UK, said: “We know that some people with diabetes, particularly those of older age, are more likely to experience poor outcomes if they catch coronavirus.

“But it’s very important to remember that the overall risk of dying from coronavirus – for people with and without diabetes – remains very low, but as cases are increasing it is important to stay vigilant.

“The most important thing anyone with diabetes can do is work with their healthcare team to manage their condition carefully, keeping their blood sugar in range as much as possible. We do still recommend that people with diabetes take additional steps to maintain social distancing, keeping 2 metres apart from people outside their household or support bubble, using face coverings in public and maintaining good hand hygiene, to reduce their risk of catching the virus.”

To read the study, which has been published in The Lancet Diabetes & Endocrinology journal, click here.

Photo by Prasesh Shiwakoti (Lomash) on Unsplash

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