Men with diabetes are more likely than women with diabetes to die from COVID-19, according to a new analysis presented at the 2021 meeting of the European Association for the Study of Diabetes and described in an article at CTV News.
Researchers have long known that people with diabetes are more likely to have poor outcomes — including hospitalization, admission to the intensive care unit (ICU), and death — if they develop COVID-19. In fact, recent studies show that people with diabetes have accounted for 30% to 40% of hospitalized patients with COVID-19 during the course of the pandemic, and that among hospitalized patients with diabetes, 21% to 43% end up requiring intensive care. The COVID-19 fatality rate among hospitalized patients with diabetes is estimated to be 25%. Overall, the risk for severe disease or death due to COVID-19 is 100% to 250% higher in people with diabetes than in people without diabetes.
For the latest analysis, researchers were interested in whether COVID-19 tends to affect men and women differently among people with diabetes. They also looked at how age affects COVID-19 outcomes in people with diabetes. By combining data from 21 previously published studies and performing their own analysis, the researchers found that men with diabetes were 39% more likely than women with diabetes to die from COVID-19 — a difference that closely resembles the gender gap for death from COVID-19 in people without diabetes. It isn’t well understood why men — with or without diabetes — are more likely to die from COVID-19, but it’s likely than hormonal differences play a role.
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The analysis also found that with each year of increased age, a person with diabetes is 5% more likely to die from COVID-19 if they develop the viral infection. Based on eight studies with enough data on age and death risk, the researchers found that people with diabetes over age 65 are more than three times as likely to die from COVID-19 (if they develop it) than people with diabetes under age 65.
When looking at how other health conditions affect the risk of death from COVID-19 in people with diabetes, the researchers found that having obesity increases the death risk by 47%, compared with normal-weight people with diabetes. Having cardiovascular disease increased the COVID-19 death risk by 39% among people with diabetes, and having chronic obstructive pulmonary disease (COPD) increased the death risk by 23%.
People with diabetes who use insulin were also found to be 79% more likely to die from COVID-19 than those who don’t use insulin — which can probably be explained by the fact that insulin users tend to have more severe diabetes, rather than any risk directly caused by insulin use. Still, this connection may be worth exploring more in future research since people who use insulin are potentially at greater risk for hypoglycemia (low blood glucose), which may play a role in COVID-19 death risk.
People with diabetes who take metformin, on the other hand, were 37% less likely to die from COVID-19 than those who didn’t take this oral diabetes drug. Again, this difference may be explained by differences in diabetes severity, but it could also be due to some beneficial effect from metformin itself.
Another major finding was that people with diabetes who take statins — a group of widely prescribed cholesterol-lowering drugs — were 75% more likely to die from COVID-19. This difference may reflect the fact that having cardiovascular disease increases the risk for death from COVID-19, but future studies could also explore whether taking statins in some way directly increases the death risk.
Want to learn more about coronavirus and diabetes? Read our latest COVID-19 updates.