Covid/Coronavirus and diabetes - the numbers

tim2000s

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Hi @Lupf the paper (2) does state total T1 deaths on page 2 at 418 deaths, then from the table on page 17 you can see the breakdown by age groups 50+ summing to 396 deaths; the data for under 50s is obfuscated for confidentiality reasons, but the balance is 22 deaths for T1s under 50 (a further check is that the deaths for T1s over 50 in that table only sum to 94.6%).

So 22 deaths for T1 aged under 50 (though these can't be broken down further to under 40 and 40-49 groups).

Thank you for this thread, it is good to have this detailed discussion.
Amongst the tables there's a statement that says values with a * have not been included as they mean 5 or fewer and would allow identification of individuals. This is true in both the full population data and in the T1 and T2 only cohort data.
 
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KK123

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That is a massive difference between male and female. People over 70 are told to shield, but maybe it should be women over 70 and men over 60 (or men over 65 and women over 75)? Given the massive influences of age and sex, I don't think a diabetes diagnosis on its own should be enough to be told to self isolate. Plug in your age and sex and then decide whether you need to panic....

Stay safe and well everyone.

Ah but Ellie, that would mean most of the Cabinet would be out of action. :)
 
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KK123

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My head hurts......I am a simple person and what I take from this is that if the general public are being told to social distance in a certain way, then as someone with diabetes I need to do a little bit extra. x
 
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Lupf

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@Lupf

Not as widely accepted in the scientific community as one may think for one thing blood samples from fetuses in the first trimester are for the most part unobtainable so animal studies have to be relied on.

https://www.sciencemag.org/news/201...nger-length-can-reveal-personality-and-health
Interesting, I only checked a couple of papers and they seemed to be in legit medical journals. The science mag article raises scepticism, but I couldn't find a study which claims that it is all wrong. Not all claims of correlations with 2D:4D are well established, some may be non-existing. This seems to be what the literature is about. @Bill_St do you have an opinion on this?
 

Bill_St

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Interesting, I only checked a couple of papers and they seemed to be in legit medical journals. The science mag article raises scepticism, but I couldn't find a study which claims that it is all wrong. Not all claims of correlations with 2D:4D are well established, some may be non-existing. This seems to be what the literature is about. @Bill_St do you have an opinion on this?

While the first impression is that this is just a prank, it becomes clear from the data and sources that there is some genuine science behind it.
Where it is particularly relevant is with the scare stories.
Small differences can have a big psychological effect and we have to be particularly careful with even larger apparent differences when they are applied to small data sets.

Examples of such differences would be :
Death rates of PWD in hospitals
Immunity resulting from vaccination.

Taking the first, many are panicking that twice as many T2 and 3 1/2 times as many T1, die of Coronavirus and translate that into T2 are at double the risk and T1 are at almost 4x the risk.
But the data set is just of those PWD treated in hospital, more specifically in ICU, because those were the only ones tested in the small data set used from early China.
It ignores the vast numbers who do not go to hospital and thus were not tested.

The second is even more important that we take great care.
The Abbott antibody test seems highly useful with percentages such as 100% and 99.6% quoted.
(reliable results with 99.6% specificity and 100% sensitivity)

But can we say those percentages mean that if we get a positive from the test then we are quite safe to just ignore the virus until we can find out if the antibodies are in fact long lasting?
To make such assumptions would be wrong and potentially dangerous.
Statistics can be misleading which may be why the Government statisticians put a hold on these tests.
I’ll leave it up to them with their fancy diagrams to explain ;) why lower prevalence means you are less safe.
https://assets.publishing.service.g...ponses-covid-19-antibody-testing-13042020.pdf

Numbers can be so misleading - particularly to the vast majority.
Just look at how many try to believe that BGM and HbA1c readings are accurate to a fraction of a percent just because the number is shown to a decimal place.
Just look at the crazy reliance on giving detailed numbers of deaths and infections to a single figure when considering hundreds of thousands. Is this deliberate?

Numbers can be used by Both “scientists” and politicians to obscure information.

What I particularly liked about the 2D/4D paper is that here was something simple that everyone could just look at their hand and make a judgement of comparative risk.
What I particularly disliked was the attending mass of numbers that completely obscured the level of that risk.

All too often papers are not written to be understood by many people. How many actually contain a clear diagram or graphical abstract?
Such as this which I really like : Not often you see such as this published in a peer reviewed paper in a Medical Journal
upload_2020-5-30_17-9-47.jpeg


We can give information rather than just numbers.

A similar confusion I regularly see is the BG level for driving- How often do we hear “Five to Drive” in the U.K.?
Catchy phrase that is easy remembered and often quoted But something that is wrong.
Just Four to Drive does not sound right.

How much better than the numbers and text put out by the DVLA (and most D organisations) is the one put out by the CAA for aircraft pilots (who you would reasonably expect to fully understand numbers and texts)
upload_2020-5-30_17-15-31.png


We can use numbers but particularly now should do so with care to ensure understanding and clarity.
 
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Draco16

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Taking the first, many are panicking that twice as many T2 and 3 1/2 times as many T1, die of Coronavirus and translate that into T2 are at double the risk and T1 are at almost 4x the risk.
But the data set is just of those PWD treated in hospital, more specifically in ICU, because those were the only ones tested in the small data set used from early China.
It ignores the vast numbers who do not go to hospital and thus were not tested.

Hi, this statement seems to be confusing a few different things. Those recent findings (2x and 3.5x) came from the large dataset UK study in hospitals (Paper linked again below) not sure why the references to China and ICU?

The key UK study finding again:
"People with Type 1 diabetes have 3·5 (95% CI 3·15-3·89) times the odds, and people with Type 2 diabetes 2·0 (9% CI 1·97-2·09) times the odds, of dying in hospital with COVID-19, compared to the population without known diabetes, independent of age, sex, socioeconomic status and ethnicity"

Deaths in hospital do represent the majority of coronavirus deaths in the UK. Deaths outside of hospital (vast yes, but a minority), we don't yet know: maybe the 2x and 3.5x ratios are not the same.

https://www.england.nhs.uk/wp-conte...D-19-and-Diabetes-Paper-2-Full-Manuscript.pdf
 

Antje77

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Hi all, a couple of posts have been moved. They were interesting but had nothing to do with this thread.

May I once again remind everyone the topic of this thread is "Covid/Coronavirus and diabetes - the numbers"
Meandering off on to other topics - interesting or not - only waters down the focus and impact of this thread.

Thank you all.
 
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Tallyhoo

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If you're referring to the NHS figures released on Friday there has been no hazard adjustment. That is what has caused the uproar and panic. Nothing about age, sex, BMI, control etc. All the areas required to perform hazard adjustment. They are just raw figures.
I would love to know how many of those who have died as a result of Covid with diabetes as an underlying health condition didn't know they had it until they were tested in hospital and therefore were not being treated for it and that's why it was not 'controlled'. Too many people still don't know about diabetes, and docs should not be frightened of offending overweight/obese patients by getting them tested in the first place surely?!
 

JohnEGreen

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I would love to know how many of those who have died as a result of Covid with diabetes as an underlying health condition didn't know they had it until they were tested in hospital and therefore were not being treated for it and that's why it was not 'controlled'. Too many people still don't know about diabetes, and docs should not be frightened of offending overweight/obese patients by getting them tested in the first place surely?!
Not every obese person is of necessity diabetic and many people who are diabetic are thin I am talking of course about T2 diabetes so such a strategy would not by any means cover every one and would be discriminatory. My doctor would have to test himself first.
 
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Brunneria

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I would love to know how many of those who have died as a result of Covid with diabetes as an underlying health condition didn't know they had it until they were tested in hospital and therefore were not being treated for it and that's why it was not 'controlled'. Too many people still don't know about diabetes, and docs should not be frightened of offending overweight/obese patients by getting them tested in the first place surely?!

Why would running a routine HbA1c offend patients? And it is by no means only the 'obese' that need health checks.

In the UK, the NHS has a system of regular monitoring for patients (which includes an HBA1c test as part of the list of tests).
https://www.nhs.uk/conditions/nhs-health-check/
Everyone between the ages of 40 and 74 years is invited to attend a health check every few years.
Not everyone accepts the invitation.

Those who already have conditions that need monitoring are excluded from the health check invite, on the expectation that their scheduled monitoring will cover the same ground as the health check.
 
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TDavies

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It's a fascinating subject and in view of the research paper that @Mike d linked to in the Covid thread which discusses the prevalence of increased insulin resistance in the BAME community I have taken a quick look at the immune system and glucose requirements.

It would seem that the immune system is 'glucose hungry' and I presume that we may need glucose for energy to fight the invaders. But if you can't use insulin efficiently then where does that leave you?

Similarly, if one's a1c is very low, would a person have enough glucose to mount an efficient immune response? With our old friends the mice, glucose was “required for survival in models of viral inflammation, it was lethal in models of bacterial inflammation."

Some bedtime reading.

https://www.google.com/amp/s/amp.theatlantic.com/amp/article/498965/

https://www.scientificamerican.com/...e-response-in-the-flu-and-possibly-covid-191/
I agree with this. My mum is very sensitive to insulin. She also seems to do better when unwell if she has a higher blood sugar. She is an older person (over 80) with Type 1 (diagnosed age 50 as Type 2)
Also I don't know if this is relevant but she has almost never has high ketones.
 
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derry60

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What heart medication do you take? Some medications cause you to go on the shielding list.
Propolol, Ramipril, Thyroxine, Atorvastatin, Lansolprazal
 

derry60

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Am I missing something or can't you just decide to shield yourself if you think you need to?
How can one shield themselves if they have to go shopping? If people are not on the list, they cannot get shopping delivered. We can now because slots have opened up.
 

derry60

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How can one shield themselves if they have to go shopping? If people are not on the list, they cannot get shopping delivered. We can now because slots have opened up.
I meant to say. On the daily updates, they said that they have put people in the vulnerable category, they have now realised this. These people should not of been on the list. If we get a second wave then Diabetics and people with heart disease will be put on the list. Bit late now lol
 

derry60

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Hi, well you could obviously, but you would then be at the mercy of your Employers thinking you were trying to pull a fast one, without the 'letter' you would be classed as any other employee. Why then would an Employer say 'oh, yes, off you go for 12 weeks, we'll still pay you just because you're worried'. Personally, for anyone working (and especially those in a high risk occupation or those who would not be paid if they stayed at home, etc) the letter is at the very least an instruction to the Employer that they have a very vulnerable person whom they need to support and if not the letter, then being in the clinically vulnerable category which (should) force them to seriously consider your welfare. Whether anyone gets that support is a different matter of course! x
Exactly
 

derry60

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The GP does not decide who is on the "extremely vulnerable" list. That is decided by the Government, doubtless decided by their scientific and medical advisers. Those are on the list: https://www.gov.uk/government/publi...ng-extremely-vulnerable-persons-from-covid-19. This does not include heart disease. Things that only increase the risk slightly, like T2 (which doubles the basic 1% risk to 2%) are not considered sufficient to merit staying indoors completely, which is considered bad for health as well as difficult to do. Those at the very highest risk, next to the extremely vulnerable are the elderly. Over 80's have an 18% higher risk than the rest of the population but are still not classed as "extremely vulnerable"
Actually. My doctor told me that I am at a very very high risk but not vulnerable. Now on one of the daily updates, they have said that some people were on the vunerable shield list when they should not have been, and as time has gone on, they have missed some medical conditions who should of been on it. Heart Disease and type 2 diabetes. If we get a second wave they said these will be added to the list. 29% people with type 2 died when getting Covid, 30% with Heart Disease. As time has gone on they have found out what health conditions are affected by this virus. Well seeing that it attacks the heart and lungs, I would of thought that is not rocket science. We should of been on the list
 

Mr_Pot

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29% people with type 2 died when getting Covid
That is 29% of people ill enough from Covid-19 to be admitted to hospital and who happened to have Type 2 diabetes. It doesn't necessarily mean that diabetes hastened their demise. The 29% doesn't apply to Type 2's in general, those who caught the virus and had mild or no symptoms are not included in any calculation.
 
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