NHS study highlights importance for people with diabetes to stay safe within self-isolation recommendations during Covid-19 pandemic

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 latest breakdown of the figures confirms that people with type 1 diabetes who are diagnosed with Covid-19 (coronavirus) are more likely to die from the illness than people with type 2 diabetes.

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.

Read the ISPAD Summary of recommendations regarding COVID-19 in children with diabetes

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

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