Covid 19 & diabetes.

[Steve Hudson]

In May an NHS report highlighted the large percentage of diabetics in the Covid 19 death statistics. At a subsequent Downing Street daily press conference, a member of the public asked the question "will diabetics now be added to the shielding list?"
Jenny Harries answered, stating that this was currently being reviewed.
In the following days, at least 3 daily newspapers printed articles about diabetics possibly having to start shielding when the general lockdown ends.
Since then I have been unable to find any information about the review.
Can anybody enlighten me please.

 

[Becka]

There has been no change to the list of diseases and conditions considered to be a very high risk.

I would assume that what Harries meant was that the list is constantly under review as more is learned about the virus, rather than there being a formal process regarding diabetes.

There were reports at the end of May that some people with forms of cancer, asthma, or who had received transplants had been told by text message they no longer needed to shield. But I do not remember any follow up to those reports, and those changes were for individual patients rather than everyone with those conditions.

However any change is unlikely now. There will be an easing of measures for those who are shielding from Monday in England. And from the end of the month it will be "paused" entirely in England and Northern Ireland, meaning it that it will no longer be required but be aware that may have to be reintroduced.

More importantly, if it is reintroduced a new model will be used to determine who needs to shield. That will based on individual circumstances rather than a blanket isolation for everyone with specific conditions. It is therefore very unlikely all diabetics will be asked to shield, and the original list may no longer apply.

So some people with diabetes who have not been advised to shield now may be asked to do so in future, because of the overall assessment of their health. Similarly some of those who have been shielding may no longer be asked to do so. Where diabetes alone is likely to be a factor requiring shielding is for older age groups and where it is out of control.

You would probably need to make a freedom of information request though to ask what form a review took and, if possible, to see the outcome of it.

 

[everydayupsanddowns]

Welcome to the forum @Steve Hudson

Diabetes UK are working hard to keep this page up to date with the latest guidance for people with diabetes, and links to the relevant .gov website pages.

Coronavirus and diabetes updates

All the coronavirus information below applies to the whole of the UK, unless specified. We've noted where are some differences in guidance and diabetes services across the UK.

www.diabetes.org.uk

It is important to remember that while the headline figures were quite alarming, the T1s deaths in the research report you mention were predominantly in an elderly population (I think the average age was mid-late 70s).

The risk to T1s in their 40s was not much different to the general population, and there were no recorded deaths of T1s in their 20s in the data at the time.

 

[Bruce Stephens]

(I think the average age was mid-late 70s)

72, so young 70s. And these were people who'd died after being admitted to hospital (a small subgroup of who had Type 1). So presumably a small fraction of the number of people with Type 1 who've had the virus.

 

[trophywench]

Unless you actually have access to the clinical info on the patients concerned you (we!) have no idea of anyone's personal circumstance eg co morbidities, obesity, street dweller etc - were they ready to pop their clogs any time? Had they the mental capacity to socially distance when they needed to?

 

[Bruce Stephens]

Unless you actually have access to the clinical info on the patients concerned

The authors of the studies did. See https://www.england.nhs.uk/publicat...es-and-covid-19-related-mortality-in-england/

I'm sure there's some element of people dying just a little before their time, but I don't think anyone believes that's the whole story (or even the largest part).

 

[trophywench]

I've plodded through a lot of that link. The more socio economically deprived we are, the greater the risk. The greater the HbA1c the greater the risk. Previous hospital admission for cardio vascular reasons the greater the risk. We are arranged in age groups, but the HbA1c tests were those current at some point in 2019, so do they take your age at that point, or at the date in 2020 when they did that study?

You had to catch it first and die, in order to even be included and there were thus only 419 individual T1s in the study group, ie as a %age of T1s only marginally over 10% of all T1s in the country, cos we're pretty rare for starters. Generally so I've read elsewhere, to begin with everyone was much more likely to have actually been exposed to the lurgy in the first place if they happened to be a hospital in patient for something else. This latter description has applied to me only 3 times during the last 70 years. First time was in 1972 when initially presenting with T1, 2nd time in 1995 ish for a hysterectomy and the last time 3 or 4 years ago when I broke my patella - hence I have not been exposed whatsoever to that Risk Factor. Since then of course, infection control within health care facilities has been ramped up by an enormous amount, so that Risk Factor presumably is now and in the foreseeable future, considerably reduced.

It ain't going away and that's a Fact. Frankly I'm much more scared of going to Tesco in August when they let me out again, where I haven't been since 12th March, than I am of visiting the hospital diabetes clinic in August. I haven't needed to visit a healthcare establishment in the interim, my husband needed a blood test re a planned oncology OP appointment in May, the consultant's secretary gave him the first names and contact nos of two peripatetic testers, the first one had a convenient vacancy so she came clad in single use plastic and a mask and did the deed and the consultant rang him the next day instead of the following one as planned, cos he knew it would be a quick one he may as well get rid of PDQ since the result he'd just received was excellent, Phew.

We each have to minimise our own risk and should we discover anyone we happen to know isn't, tell them they aren't and then avoid em like the plague!

 

[Bruce Stephens]

We are arranged in age groups, but the HbA1c tests were those current at some point in 2019, so do they take your age at that point, or at the date in 2020 when they did that study?

Ages will be ages at death, I assume. HbA1c would be whenever the latest recorded one was. As you say, the major factors are age, weight, CVD events. HbA1c yes, but the comparison they give is >86 and 48-53, and I imagine most of us are nearer 48-53 (though not necessarily quite there) than 86, so probably not that significant a risk.

 

[Becka]

You had to catch it first and die, in order to even be included

A few days ago I was looking at the latest N.H.S. covid-19 data for England and initially thought it odd that still only 3% of those who died from a severe acute respiratory syndrome had existing respiratory conditions. Then I realized that most of those who do would have been shielding.

Although shielding was not required for diabetes alone, I wonder how many people did voluntarily?

We have seen a lot of topics posted over the last few months from people who have been very worried or thought diabetes should be a listed condition. So I would not be surprised if a lot of diabetics avoided going out as much a possible, and took as many precautions as possible whenever they absolutely had to.

That is the problem with only being able to produce data after measures (mandatory and individually) have already been introduced.

 

[mikeyB]

This is all becoming a bit silly. The one certain thing about life is death. What you die of, and when you die can be marginally affected by what you do - don't smoke, don't drink alcohol, don't get fat, don't drive, don't work as a scaffolder, and don't have children. The main one currently troubling folk is getting Covid. That's easy to avoid. Except in a care home - and the only exit route from a care home is in a box.

Covid is currently causing some people to die, but currently the average death rate for this time of year is unaffected. Folk are still busy dying of cancer, Alzheimer's, and cardiac events. So let's stop looking through the wrong end of the telescope and theorising about whether diabetes makes covid infection worse, just don't get covid.

Diabetes shortens your lifespan anyway, statistically, but not by much if you're careful.

 

[Totalwar]

I thought they said 25% of covid deaths had diabetes.Now I think there just too many of us for the Gov to add us to the shielding list. remember There is millions of us they just don’t have the resources to help us all.

 

[trophywench]

Both my husband and I are on the shielding list, he has COPD and even if I wasn't included, I'd have shielded anyway to protect him. One of our daughters has been doing the shopping and fetching both our prescriptions throughout. We've consistently made sure we've covered fuel costs and told her if she fancies buying her family something nice whilst doing our shopping, we'll pay for it. sometimes she has and sometimes she hasn't. We have not cost the UK Government a single penny piece extra, throughout. We only ever 'cost' them our State pensions (which ISTR we contributed towards for a good many years - well I know we never have, our own) and still do only cost them that and I daresay there are shedloads of other folk the same as us.

We've also made B sure in the past that at this stage in our lives, neither of us would need to rely 100% on State pension - exactly the same as again a helluva lot of other people.

 

[everydayupsanddowns]

I thought they said 25% of covid deaths had diabetes.Now I think there just too many of us for the Gov to add us to the shielding list. remember There is millions of us they just don’t have the resources to help us all.

Welcome to the forum @Totalwar 🙂

I think it’s important to remember that age is pretty much still the biggest determining factor, not diabetes.

So at age ‘x‘ a person with diabetes is relatatively at a higher risk if they have a severe reaction to covid19 than someone without D - but the absolute risk varies massively, and not everyone who gets covid-19 has a severe reaction.

For myself, I am not sure it’s particularly illuminating to focus on one element of the complex and interwoven tapestries of clinical cases where risk is affected by age, medical history, diabetes management, presence or absence of diabetes complications, comorbidities etc etc.

While it has an impact on the relative risk (hence why we are all advised to be particularly careful with handwashing and social distancing) diabetes itself doesn’t appear to be the dealbreaker. I believe that’s why we aren’t on the shielding list. It seems to be more diabetes and... and... and... than just diabetes itself?