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Global recommendations for people with diabetes during the Covid-19 pandemic

Global recommendations for people with diabetes during the Covid-19 pandemic

A new study looks at how people with diabetes could be at more risk from the virus and recommends how healthcare professionals can help to manage the condition.

Published: Jun 25, 2020
Category: Research

A recently published report has highlighted that living with diabetes can be one of the main health conditions to have more likely complications among people diagnosed with Covid-19.

The study follows a previous report from the NHS that revealed people with the condition could be at a higher risk of severe complications from contracting Covid-19.

In the results of a recently published report in The Lancet researchers found that people living with diabetes were more likely to suffer severe side effects if diagnosed with Covid-19.

If diagnosed with the condition, also known as coronavirus, people with diabetes could have an increased risk of developing severe complications including Adult Respiratory Distress Syndrome and multi-organ failure.

Reports from around the world found that 20–50% of patients diagnosed with Covid-19 during the pandemic also had diabetes. The international team of researchers was led by Professor Stefan Bornstein, from the Department of Medicine III, University Hospital Carl Gustav Carus, in Germany and included Professor Kamlesh Khunti, Professor in Primary Care Diabetes and Vascular Medicine at the University of Leicester.

The study team said: “Given the importance of the link between Covid-19 and diabetes, we have formed an international panel of experts in the field of diabetes and endocrinology to provide some guidance and practical recommendations for the management of diabetes during the pandemic. We aim to briefly provide insight into potential mechanistic links between the novel coronavirus infection and diabetes, present practical management recommendations, and elaborate on the differential needs of several patient groups.

“From January 2020, we have been facing an unprecedented outbreak of Covid-19 caused by a novel coronavirus, which has now become a global catastrophe. Data from the early months of 2020 suggest that most people with Covid-19 have additional health conditions, the most prevalent of which are diabetes, cardiovascular disease, and hypertension.”

The authors of the international study found from published figures that the risk of a fatal outcome from Covid-19 was up to 50% higher in people living with diabetes than in those who do not have diabetes.

Researchers said: “There are several hypotheses to explain the increased incidence and severity of Covid-19 infection in people with diabetes. In general, people with all forms of diabetes are at increased risk of infection.

“The high frequency of diabetes in serious cases of Covid-19 could potentially reflect the higher prevalence of type 2 diabetes in older people. Furthermore, diabetes in older age is associated with cardiovascular disease, which in itself could help to explain the association with fatal outcomes of Covid-19.”

In conclusion researchers said: “The clinical relevance of the aforementioned mechanisms is currently uncertain, but healthcare practitioners should be aware of their implications for patients with diabetes.”

The team suggested a range of recommendations regarding both the need for primary prevention of diabetes in addition to the avoidance of severe consequences of diabetes triggered by unidentified or poorly managed diabetes.

The researchers also highlighted that special considerations on prescribing anti-diabetes drugs commonly taken by people with type 2 diabetes should be made in view of Covid-19.

Recommendations for healthcare professionals treating people with Covid-19 who are living with diabetes were suggested in the report to help manage the condition.

Researchers added: “We realise that all our recommendations and reflections are based on our expert opinion, awaiting the outcome of randomised clinical trials. Executing clinical trials under challenging circumstances has been proven feasible during the Covid-19 pandemic, and trial networks to provide evidence-based therapies are arising.

“Investigating subgroups with diabetes and how these relate to Covid-19 outcomes will be important, in particular investigating if some of the various management approaches would be particularly effective in managing diabetes in a Covid-19 context.”

Read the report in The Lancet
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Category: Research

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