During the last quarter of 2020 — one of the worst periods of the COVID-19 pandemic — people with diabetes were more likely to die from the viral infection than from any other cause in the United States, according to new research published in the journal Diabetes Care.
Even though the latest article has many new findings, it has long been clear that COVID-19 has had a devastating effect on people with diabetes. That’s especially true for people with less-than-optimal blood glucose control — studies have shown that people with a higher A1C level (a measure of long-term blood glucose control) are more likely to be hospitalized with COVID-19, and blood glucose control over the previous two to three years is linked to the risk of needing admission to the intensive care unit (ICU) after being hospitalized. Overall, men with diabetes are more likely than women to die from COVID-19, and older people with diabetes are more likely to die from the infection than younger people. And people with diabetes who also have advanced kidney disease are at especially high risk for poor outcomes.
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For the latest study, researchers looked at trends related to the cause of death in people with diabetes both before and during the COVID-19 pandemic. Their goal was to figure out the true impact of the pandemic on death in people with diabetes — something that isn’t necessarily simple, since people with diabetes who died during the pandemic could have had their cause of death listed as COVID-19, diabetes, cardiovascular disease, or something else. And when it comes to deaths related to COVID-19, a death certificate would be unlikely to mention the viral infection unless that person was hospitalized for it at the time of death.
So the researchers looked at the pattern of deaths in people with diabetes before the COVID-19 pandemic, and looked at how these trends changed during the pandemic. Overall, they found that deaths from all causes in people with diabetes increased from the third quarter of 2019 (before the pandemic) through the fourth quarter of 2020, mostly due to a large increase in deaths with COVID-19 as the listed cause, as noted in an article on the study at Healio.
Significant increase in deaths attributable to COVID-19
The researchers found that compared with before the COVID-19 pandemic, the rate of death attributed to diabetes, cardiovascular disease, or kidney disease in people with diabetes remained stable during the pandemic. But the rate of death from cancer in people with diabetes, while stable before the pandemic, increased at a rate of 3.9% during the pandemic. That didn’t compare, though, with the increase in the rate of death due to COVID-19 in people with diabetes, which rose from 0.4 per 100,000 people in the first quarter of 2020 to 9.7 per 100,000 in the fourth quarter of 2020 — meaning there were over 24 times as many death from COVID-19 during the fourth quarter.
In fact, during the fourth quarter of 2020, COVID-19 was the listed cause of death for 24.7% of people with diabetes — surpassing diabetes as a cause of death at 24.1%, and cardiovascular disease as a cause of death at 24.0%.
The researchers concluded that “all-cause mortality for diabetes remained stable before the COVID-19 pandemic but surged abruptly during the COVID-19 pandemic,” almost entirely due to deaths attributed to COVID-19. This finding confirms that COVID-19 represented an unprecedented danger to people with diabetes in 2020, and that the deaths attributed to COVID-19 were not simply deaths that would have occurred otherwise during the same time period.
Want to learn more about coronavirus and diabetes? Read our latest COVID-19 updates.