Report follows news that almost a third of Covid-19 deaths in England have been associated with diabetes.
A new NHS report has confirmed that people living with diabetes are at a significantly increased risk if they get Covid-19 than people without the condition.
The news highlights the importance for people with diabetes to self-isolate as much as possible in line with government Covid-19 lockdown guidelines.
As previously reported, almost one in three of all deaths from coronavirus among people in hospital in England during the Covid-19 pandemic have been associated with diabetes.
Further analysis of these figures has found that people with type 1 diabetes – the autoimmune form of the disease – are three-and-a-half times more likely to die if they catch Covid-19 than people without diabetes.
People with type 2 diabetes – closely linked to lifestyle – are twice as likely to die from the virus than people without diabetes.
Nine out of 10 people with diabetes have type 2, and many are overweight.
According to the study, age is the biggest determining risk factor for death among people with diabetes with either form of the condition who contract Covid-19.
The NHS England study reported that people under the age of 40 have a very low risk compared with aged 40 and above, and especially compared with older people.
People with type 1 diabetes, which is usually diagnosed in childhood, tend to be younger than those with type 2.
Last week, separate findings suggested that a quarter of deaths related to Covid-19 were among people living with diabetes.
Read the NHS report Type 1 and type 2 diabetes and Covid-19 related mortality in England
A time of writing, 7,466 people who died in hospitals in England related to Covid-19 had type 2 diabetes and 365 had type 1.
Professor Jonathan Valabhji, National Clinical Director for Diabetes and Obesity at NHS England and lead author of the study, said: “This research shows the extent of the risk of coronavirus for people with diabetes 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.”
Jon Cohen, Emeritus Professor of Infectious Diseases at Brighton and Sussex Medical School, said: “Bacterial infections are more common and more severe in diabetes. This has generally not been thought to be such a problem with viral infections such as coronavirus, but any severe infection can cause problems with insulin control so this too will likely contribute to the increased mortality rate in patients with type 1 diabetes.
“So patients with diabetes are probably not at greater risk of catching Covid-19, but do have a greater risk of becoming seriously ill if they do catch it.”
The overall death rate for people with diabetes doubled in the early stages of the pandemic, according to the study.
Among people with both type 1 and type 2 diabetes, men, BAME people (black, Asian and minority ethnic communities) and those living in more deprived communities were at higher risk.
People living with diabetes (either type 1 or type 2), with additional health complications, including underlying kidney disease or heart failure and/or who previously had a stroke, were also at higher risk.
A recently published report from the International Society for Paediatric and Adolescent Diabetes (ISPAD) about children with type 1 diabetes and Covid-19 indicated that there were few cases among young people. In the early stages of the pandemic, the report was based on input from Paediatric Endocrinologists in Italy and China who stated that to date “no cases of Covid-19 in youth with diabetes” had required admittance to hospital.
In response to the report, Professor Partha Kar, National Specialty Advisor for Diabetes with NHS England and Consultant in Diabetes and Endocrinology at Portsmouth Hospitals NHS Trust, said: “People living with diabetes face a significantly higher risk of dying with Covid-19 with type 1 diabetes having higher risk than type 2 diabetes. 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.
“To help assure parents with young children? The absolute risk of death remains very low under the age of 40 – with no recorded death (in data set analysed) below the age of 20.
“Higher blood glucose levels and obesity are linked to higher risk.
“Too tight control or low BMI (body mass index) associated with increased risk.
“The overall death rate for people with diabetes doubled during the early stage of the pandemic.”
He added: “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 bothe type 1 and type 2 diabetes, those with pre-existing kidney disease, heart failure and previous stroke, were also at higher risk.”
Read First breakdown of figures by NHS reveals there may be a higher risk for people with diabetes contracting Covid-19
NHS has issued the following recommendations to help prevent the spread of the virus:
How to avoid catching or spreading coronavirus
- Wash your hands with soap and water often – do this for at least 20 seconds.
- Always wash your hands when you get home or into work.
- Use hand sanitiser gel if soap and water are not available.
- Cover your mouth and nose with a tissue or your sleeve (not your hands when you cough or sneeze).
- Put used tissues in the bin straight away and wash your hands afterwards.
- Try to avoid close contact with people who are unwell.
- Do not touch your eyes, nose or mouth if your hands are not clean.
Handwashing advice to reduce the spread of COVID-19:
Wash your hands with soap and water more often for 20 seconds following these steps:
- Palm to palm
- The backs of hands
- In between fingers
- The back of the fingers
- The thumbs
- The tips of the fingers
To isolate your household, the advice is to stay at home -
If you or anyone in your household has a high temperature or a new and continuous cough – even if it is mild
- Everyone in your household must stay at home for 14 days and keep away from others
- Go to NHS.UK to check your symptoms and follow the specialist medical advice. Only call NHS 111 if you cannot get online or your symptoms worsen
- Protect older people and those with existing health conditions by avoiding contact
- Put a sign in your door advising others Please DO NOT enter this building
Public Health England has published a range of Coronavirus (COVID-19) public information materials to inform the general public about how they can help protect themselves and others and help prevent the spread of virus.
While aimed at all members of the public, the guidelines are also relevant for people living with diabetes.
If you need medical help or have a query regarding the virus, the NHS 111 has an online coronavirus service that can tell you if you need medical help and advise you what to do.
Do not go to a GP surgery, pharmacy or hospital. Call 111 if you need to speak to someone. If there is a chance you could have coronavirus, you may be asked to stay away from other people (self-isolate) for up to 14 days.
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The DRWF team is now working remotely. COVID-19 guidance, particularly where it aligns or impacts with diabetes guidance, is shared as quickly as possible through the DRWF website and social media channels with the aim of making it as easy to understand as possible and a reliable source of latest news.