Are people who have diabetes at greater risk of contracting the COVID-19 virus? It’s a timely question, but the virus has not been around long enough for researchers to conduct the long-term studies that would be required to answer the question.
A study just published in the British medical journal Lancet, however, has offered some preliminary indications. In an article titled “Are Patients with Hypertension and Diabetes Mellitus at Increased Risk for COVID-19 infection?” the authors examined possible links between infection with the virus and certain health conditions — cerebrovascular disease, hypertension, heart disease and diabetes. In one study the authors looked at 32 people in China who died from COVID-19 and found that 22% had cerebrovascular disease and the same percentage had diabetes. The authors also referred to another report that included 1,099 patients with COVID-19 and said 173 of them had severe disease along with hypertension (23.7%), diabetes (16.2%), coronary heart disease (5.8%) and cerebrovascular disease (2.3%). Finally, they reported on a third study of 140 hospitalized COVID-19 patients and said that 30% had hypertension and 12% had diabetes.
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Does that mean that all people with diabetes are at a higher risk of contracting COVID-19? It’s much too early to say. The researchers speculated on a possible role for drugs known as ACE inhibitors, which are medications that relax the blood vessels by preventing an enzyme in the body from producing angiotensin II, which narrows blood vessels. It’s known that ACE inhibitors increase the production of angiotensin-converting enzyme 2 (ACE2) and it’s also known that coronaviruses bind to target cells through ACE2. For that reason, the authors of the study conjectured that treating diabetes and hypertension with ACE2-stimulating drugs raises the risk of developing severe and fatal COVID-19. But that is pure speculation, because the researchers did not determine whether the patients in these reports were actually taking ACE2-stimulating drugs. Nevertheless, the authors suggested that patients with diabetes, heart disease or hypertension who are being treated with ACE2-stimulating medications should be closely watched for signs of COVID-19.
At about the same time as the Lancet study was published, the American Association of Clinical Endocrinologists (AACE) issued a “Position Statement” titled “Coronavirus (COVID-19) and People with Diabetes.” It did not address the issue of whether people with diabetes are more likely to contract COVID-19, but it did say, “Diabetes and high glucose levels are associated with increased complications, respiratory failure and mortality in hospitalized patients with COVID-19.” In other words, people with diabetes might not be more likely to get the disease, but they are more likely to have severe complications. The statement then went on, “Because people with diabetes may also have other comorbidities such as organ failure and cardiovascular disease, it is imperative they follow specific COVID-19 precautions and prevention guidance from the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and their endocrinologist or healthcare providers.”
Among the actions suggested by the AACE were the following:
· Continue to take your prescribed medications.
· Refill prescriptions and be prepared with medications and testing supplies. If you can’t visit the pharmacy, consider having medications mailed to you.
· Stay home as much as possible to reduce your risk of being exposed. If you do have to go out, avoid crowds and limit close contact with others.
· Wash your hands regularly for at least 20 seconds. If you don’t have soap and water handy, use a hand sanitizer with at least 60% alcohol.
· If you cough or sneeze, cover your nose and mouth with a tissue or a flexed elbow. Throw the tissue into the trash.
· Avoid touching your eyes, mouth or nose when possible.
· If you have fever, cough, shortness of breath or wheezing, especially if you believe you may have been exposed to COVID-19, call or see a healthcare professional immediately.
Finally, the AACE advised, “Your state may provide the opportunity to purchase an additional 30-day supply of insulin and other diabetes medications when a state of emergency is declared. Please check with your individual state’s department of health website.”
Want to learn more about coronavirus and diabetes? Read “Coronavirus and Diabetes: What You Need to Know,” “Healthy Eating During Hard Times” and “Avoiding Coronavirus With Diabetes: Stock Up and Stay Home, CDC Says.”