Staying safe with diabetes from Covid-19 – latest government guidelines

[Northerner]

This week the government have announced further measures across England following a rise in cases of Covid-19.

With a surge in new cases of Covid-19 reported in recent weeks the government has prepared a list of measures recommended to protect people from the spread of the virus.

During the Covid-19 pandemic people with diabetes have had an additional health concern to consider – healthcare professionals advise to look after yourself as best as you can as an additional safety measure against contracting the virus this winter.

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.

A follow-up NHS report confirmed that people living with diabetes are at a significantly increased risk if they get Covid-19 compared to people without the condition.

News and Events - Diabetes Research & Wellness Foundation

www.drwf.org.uk

 

[atoll]

sounds more like a legal disclaimer than advice.........

 

[Docb]

My reading of the data suggests that risk is dependent on HbA1c level and not simply on having diabetes. The risks for those with diabetes but who manage it well and keep their HbA1c close to the diabetes diagnosis limit are not statistically different to anybody else. You need an HbA1c of 85+ for things to get really significant and only then are the risks for T1 greater than T2.

My usual disclaimers.... COVID is a nasty disease and you should not catch it if you can help it no matter who you are and I wish people would stop shoving everybody with a diabetes diagnosis into the same box.

 

[Northerner]

My reading of the data suggests that risk is dependent on HbA1c level and not simply on having diabetes. The risks for those with diabetes but who manage it well and keep their HbA1c close to the diabetes diagnosis limit are not statistically different to anybody else. You need an HbA1c of 85+ for things to get really significant and only then are the risks for T1 greater than T2.

My usual disclaimers.... COVID is a nasty disease and you should not catch it if you can help it no matter who you are and I wish people would stop shoving everybody with a diabetes diagnosis into the same box.

The problem if you are insulin-controlled is that ANY illness can send your control completely haywire 😱 A few years back I had what appeared to be something like norovirus and I was unable to eat without being sick. In fact I was unable to even sip water without being sick This meant that, although I had to continue taking my insulin to try and keep my BG levels down and ketones under some semblance of control (insulin also plays a part in that process), should my levels fall too low I would be unable to treat the hypo 😱 This was over the Christmas/New Year period, and though I knew I needed assistance - to be put on a glucose/insulin drip and monitored - the ambulance service would not take me. The illness went on for 3 weeks and I lost over 20 pounds in weight My consultant was outraged when he heard that I had not received the care I needed, particularly as I live alone So I know how any virus can make things 100 times worse as an insulin-controlled diabetic

No pub for me, whatever time they close! 😱 Stay safe people 🙂

 

[Docb]

Thanks for that Northerner, something that we as humble, non insulin dependent, T2's do not appreciate. It does leave me with a conundrum in that the data published refers to HbA1c as a factor in COVID outcome and short term erratic blood glucose levels as a result of the infection will not be reflected in that number. Don't know if there is any data on COVID severity and spot glucose average readings.

 

[helli]

Thankfully, I don't have personal experience of C19.
However, I find high BG (spot glucose readings) will exaggerate any ache, sniff. cough, itch, ... So, I expect, if I did get C19, managing my BG would be key to minimising the severity of the symptoms.
The advantage of having a pump is the flexibility to adjust my basal dose within 30 minutes rather than waiting to see if I got yesterday's basal tweak correct.
Hey, the advantage of taking insulin is I have the tool to quickly lower my spot glucose reading unlike t2s managing their condition through diet.

I guess there are pros and cons for all of us.

Stay safe.

 

[Eddy Edson]

Thanks for that Northerner, something that we as humble, non insulin dependent, T2's do not appreciate. It does leave me with a conundrum in that the data published refers to HbA1c as a factor in COVID outcome and short term erratic blood glucose levels as a result of the infection will not be reflected in that number. Don't know if there is any data on COVID severity and spot glucose average readings.

Even though this is a study from just one Chinese region and is from June & therefore relatively ancient, it's still one of the clearest and most comprehensive-seeming studies I've seen for T2D risk as moderated by BG levels and variability:

Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes

Type 2 diabetes (T2D) is a major comorbidity of COVID-19. However, the impact of blood glucose (BG) control on the degree of required medical interventions and on mortality in patients with COVID-19 and T2D remains uncertain. Thus, we performed a retrospective, ...

www.ncbi.nlm.nih.gov

Conclusions
In conclusion, T2D is an important risk factor for COVID-19 progression and adverse endpoints, and well-controlled BG, maintaining glycemic variability within 3.9 to 10.0 mmol/L, is associated with a significant reduction in the composite adverse outcomes and death.

I think they do need to work on their data-viz but anyway:



The "10 mM" limits in that pic are actually "10 mmol/L" and the result it's trying to show is that T2D's hospitalised with COVID-19 who had "well controlled" BG varying within the 3.9 mmol/L - 10 mmol/L range had a 1.1% chance of death, versus 11% for T2D's with BG going above 10 mmol/L.

That 1.1% chance of death was actually better on the face of it than the general non-T2D population in this study.

The paper has a whole lot more detail on reduced risks for other nasty outcomes besides death and a nice, succinct discussion of possible mechanisms tied in to an anaysis of various inflammatory etc etc markers.

Well worth a look, IMO.

 

[trophywench]

The original article doesn't even mention that hospitals discovered that with Covid, ketones appeared in diabetic patients' blood at a far lower level of BG than 'normal' - like under 10 and this was - quietly! - publicised - because we discussed it on here.

The Dr quoted at the end of the same article advises patients to always be guided by their meter results - clearly he doesn't live in the UK then, does he?

Red cross/Lord have mercy on us, anyone?

 

[grovesy]

The

The original article doesn't even mention that hospitals discovered that with Covid, ketones appeared in diabetic patients' blood at a far lower level of BG than 'normal' - like under 10 and this was - quietly! - publicised - because we discussed it on here.

The Dr quoted at the end of the same article advises patients to always be guided by their meter results - clearly he doesn't live in the UK then, does he?

Red cross/Lord have mercy on us, anyone?

If you mean the one @Northerner posted as he is in Southampton.

 

[mikeyB]

Who cares? If you don't get the illness you won't die from it. That is up to us, whatever the government says or advises.

 

[AJLang]

Who cares? If you don't get the illness you won't die from it. That is up to us, whatever the government says or advises.

A lot of people have no choice but to go to work, or their partner goes out to work. Therefore they are at risk from coronavirus through no choice.

 

[mikeyB]

Aye, but you can still wear a mask and sanitise your hands wherever you are.

 

[trophywench]

We're both getting down in the dumps, again. Not allowed to physically meet up with family or friends for fear of who they may have been in contact with whilst leading THEIR lives.

 

[grovesy]

A lot of people have no choice but to go to work, or their partner goes out to work. Therefore they are at risk from coronavirus through no choice.

Exactly and not everyone lives in isolation, my son still lives at home and faces classes of 30 + Secondary School children.