Covid and Diabetes, Colliding in a Public Health Train Wreck | New York Times - Andrew Jacobs:
April 3, 2022 - "After older people and nursing home residents, perhaps no group has been harder hit by the pandemic than people with diabetes. Recent studies suggest that 30 to 40 percent of all coronavirus deaths in the United States have occurred among people with diabetes....
"People with diabetes are especially vulnerable to severe illness from Covid, partly because diabetes impairs the immune system but also because those with the disease often struggle with high blood pressure, obesity and other underlying medical conditions that can seriously worsen a coronavirus infection....
"Diabetes patients hospitalized with Covid spend more time in the I.C.U., are more likely to be intubated and are less likely to survive, according to several studies, one of which found that 20 percent of hospitalized coronavirus patients with diabetes died within a month of admission. Though researchers are still trying to understand the dynamics between the two diseases, most agree on one thing: Uncontrolled diabetes impairs the immune system and decreases a patient’s ability to withstand a coronavirus infection.
"Diabetes is a pernicious disease that is at once ubiquitous and invisible, partly because most people with the condition do not appear outwardly ill. It affects 34 million Americans, or 13 percent of all adults, ... annually claims 100,000 lives and soaks up one in four health care dollars spent.... [T]he burden of diabetes falls more heavily on Latino and Black Americans, highlighting systemic failures in health care delivery that have also made the coronavirus far deadlier for the poor, said Nadia Islam, a medical sociologist at NYU Langone Health. 'It’s not that diabetes itself makes Covid inherently worse but rather uncontrolled diabetes, which is really a proxy for other markers of disadvantage,' she said. Compounding the concerns, some studies suggest that a coronavirus infection can heighten the risk of developing type 2 diabetes, a disease that is largely preventable through a healthy diet and exercise....
"More than 90 percent of all diabetes cases in the United States are type 2. One study published last month found that patients who recovered from Covid were 40 percent more likely to be diagnosed with type 2 diabetes within 12 months compared with the uninfected.... Over the past two years, doctors have also reported a sharp rise in young people being diagnosed with type 2 diabetes, an increase that many believe is tied to the drastic spike in childhood obesity during the pandemic.... About 1.5 million Americans are diagnosed with diabetes each year, according to the C.D.C., and roughly 96 million, about one in three adults, are at high risk for developing the disease....
"Diabetes is an insidious disease that significantly increases the risks of premature blindness, stroke, and circulatory and neurological problems that can lead to infections requiring amputation.... Black and Latino Americans are more than twice as likely to receive a diabetes diagnosis as whites, and inadequate access to medical care can make it harder for them to juggle the complex dietary, monitoring and treatment regimens that can stave off its devastating complications. Although there is much researchers don’t understand, many believe that uncontrolled diabetes greatly amplifies the perils of a Covid diagnosis. That’s because a sedentary lifestyle, putting on extra weight or failing to keep close tabs on blood sugar levels fuel chronic inflammation inside the body, which can increase insulin resistance and weaken the immune system.
"Inflammation triggers the release of cytokines, tiny proteins that regulate the body’s immune response to infection or injury. Cytokines are a critical component of the normal healing process, but for people with diabetes and underlying chronic inflammation, all those cytokines can damage healthy tissue. Covid, it turns out, can provoke an uncontrolled release of cytokines, and the resulting “cytokine storm” can wreak havoc on vital organs like the lungs, leading to dire outcomes and death."
Read more: https://www.nytimes.com/2022/04/03/health/diabetes-covid-deaths.html
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