Why is Coronavirus more dangerous for diabetics? There's
a lot of information out right now about the coronavirus. It's safe to say
almost everyone in the world is worried about either contracting or spreading
the virus. It can be terrifying for an average healthy person. But what about
those who are high-risk? And the people who get into trouble, namely who need
to be hospitalized, some of whom need intensive care, are very heavily weighted
towards elderly people and those with underlying conditions like chronic heart
disease, chronic lung disease, kidney disease and diabetes. But why is diabetes
on that list when coronavirus is described as a respiratory illness?
The
WHO and the CDC putting out a blanket statement
that people have diabetes are at a higher risk. That is very scary to people.
And I don't know that it fully paints the real picture of what's happening
here. Actor Tom Hanks, who has Type2 diabetes, was diagnosed with the virus,
bringing even more attention and concern for those living with diabetes as a
Type 1 diabetic. I've been sheltering in place, but I'm still anxious as to why
I'm at higher risk than everyone else. So we wanted to explore why is
coronavirus more dangerous for diabetics?
Diabetes
is a complicated disease. There are different types and many ways to treat it.
In 2019, 463 million adults were living with the disease globally. When someone
has diabetes, their body's ability to produce insulin is impaired or completely
stops. Type 1 diabetics make no insulin at all and need to inject it. Type 1
makes up 10 percent of those who are living with diabetes globally. The more
common type is type 2. This could mean the body doesn't use insulin properly or
make enough. It has many forms of treatment that could include medication,
diet, exercise, and many need to start insulin injections. Either form come
with high blood sugar can make people more susceptible to other illnesses. And
this is a big concern with people with diabetes is that people with higher
blood sugar levels could be more susceptible to coronavirus.
Managing
diabetes isn't as simple as taking insulin. A lot of other
factors come into play. That's probably one of the few topics that make the
coronavirus different in people with diabetes. Assuming the immune system is
the same. Is that we have to deal with the blood sugars. Many things influence
how blood sugar rises and falls. Some are obvious, like the amount of carbs
digested and correctly dosing insulin to the amount of carbs eaten. But there's
also exercise, stress. Just sitting out in the sun too long can have dramatic
effects.
Keeping
blood sugars in range reduces the high-risk of contracting coronavirus, but the
chance of getting sick is still as likely as the average person.
We spoke to a type1 diabetic who was recently diagnosed with the coronavirus. He
started feeling symptoms like slight symptoms Sunday night. He had been at his girlfriend's
Sunday and Monday. That's when they saw the 103 fever. And she took him to the
doctors where they gave him an antibiotic and antiviral. The next night, his
fever had gone up to 103. And by the Wednesday morning at 5 or 6 am, he was 93
and sweating. So they decided to call 9-1-1. They took him to a hospital. But
because the type 1, I think that's why they admitted him to the ICU and tested.
Patrick is a 30-year-oldtype 1 diabetic with well-controlled blood sugars. We
spoke to him five days after testing positive for the coronavirus. Luckily, he
is now recovered but because of his diabetes, he was put in the intensive care
unit for two nights. Yesterday was the first day he woke up without a headache
and everything. And he pretty much feels the same today. He hasn't had a fever.
He has been monitoring his temperature. His cough is small. He feels good.
The
American Diabetes Association states people with diabetes are not more likely
to get covid-19 than the general population. The problem person
with diabetes face is primarily a problem of worse outcomes, not greater chance
of contracting the virus. One of the things, particularly very high blood sugar
levels suppress your immune system and make people more susceptible to
infection. And we see this obviously, for example, with wound healing, with
diabetes that has gone on for a long time or has high levels of blood sugar. So
this is a concern when you have a novel infection like corona, people with
diabetes are obviously concerned. Illness is a very common reason for elevated
blood sugars. If you're sick with the flu or the coronavirus, the lack of
appetite, sleep and just the stress of sickness make it harder to manage your
diabetes.
If
you have chronically elevated blood sugar levels, let's say over 200. Not just
one time. You know, I'm talking about months and months and months. Then your
immune system just doesn't work that well. The antibodies that usually attack foreign
bodies just don't work as well. And so those folks are more susceptible, but
the actual immune system is exactly the same. Type 2 diabetes, there's this
kind of chronic pro-inflammatory situation that underlies the type2 diabetes
and this kind of chronic low grade pro-inflammatory state, the patients for
type 2 diabetes have ultimately a response to an infection may be somewhat
delayed and modified. And that modification is unfavourable, typically with an
inadequate immune response to say agents like the covid-19 virus.
The
coronavirus could also affect the $24 billion insulin market.
Before the pandemic sent shockwaves through the economy, millions of diabetics
were facing a crisis, the price and the availability of insulin. The number one
concern I hear in the diabetes community, it's actually even beyond an
infection is access to insulin. A person with diabetes, type 1 can essentially go
just a day or two without insulin at the most. And diabetes was a fatal disease
before insulin. The good news is the manufacturers are stating publicly that
the supply chain is safe right now. Another part of that is people are insecure
about their employment right now and in the United States. If you're under,
under or unemployed, you may lose insurance coverage and insulin is too
expensive. That's another story that was in the news quite a bit before this
happened. But it's still a problem. Because of the high price of insulin in the
United States some diabetics have turned to Canada to get it at a lower cost.
But now that the border is closed, it creates yet another hurdle for people to
find cheaper options.
The
two biggest manufacturers of insulin, Eli Lilly and Novo Nordisk,
both stated that they have policies in place for long term supplies of insulin
and plans for those who can't afford it. I mean, we absolutely need to keep our
business running for our patients. If we were to quit manufacturing product and
eat into all the stock that we have and wake up one day with no product in a
time of need like this is out there, it would just be horrible. So we feel a
very, very important responsibility to do that. Dexcom manufactures continuous
glucose monitors that allow users to see their blood sugar 24/7. The company
said it had close to 650,000 patients using its CGM at the end of 2019. I don't
think there's ever been a more important time for somebody to keep themselves
within a very narrow band of glucose control, and the only way to do that is
with the sensors. People need this product. So we've kept our manufacturing
operations open. At the moment, everything seems to be running smoothly, but
the uncertainty about how long this will go on is making lots of diabetics
concerned for their future.
They're
concerned about having diabetes and with the coronavirus situation, being
quarantined in home or at least trying to stay away from every body, as you
know. Do you have enough medication? You've got to have insulin. You got to have
the pills if you have type 2 diabetes. Pharmacies like Walgreens and CVS remain
open and have waived their delivery fees. There are also smaller businesses
stepping up to help get medicine to those in need. Here's what 90 days of
supplies looks like for me. This will keep me alive for the next three months.
Some diabetics live day-to-day and week-to-week on supplies. So it's incredibly
important that manufacturers and pharmacies stay open during this time. The
biggest takeaway for any diabetic is to do your best to avoid getting sick.
The
American Diabetes Association says diabetics are not more likely to get the
virus, but will struggle in recovery if they do.
If you look at people who die that we've had reports the medical literature
from covid-19 virus at this time. Diabetes did independently standout in one
study. It was suggestive. Another study, it was patients who were older with
diabetes who also had coronary heart disease. We are really trying to reassure
people with diabetes in a time of incredible fear. You can imagine this is a pandemic
like we've never seen before. People with diabetes live with a chronic disease
that puts them at risk for complications that can be serious. And what we're
trying to do is get information out there. It starts with the fundamentals.
Stay as healthy as possible. Isolate. Maintain Distance. Wash your hands for 20
Seconds when you come to home.
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