Type 1 Shielding for diabetics

Jamie H

Well-Known Member
Messages
126
Get you now.

It was reported in newspapers it was being discussed. It does not say anywhere that scientists are or were reccomending a blanket approach to shield all those with diabetes. A very subtle difference in my opinion. I've read on numerous platforms that many are not suggesting a blanket approach as it doesn't tie in with the results of the study done by partha kar and colleagues etc
 

Dexterdobe

Well-Known Member
Messages
305
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Being unwell and seeing BG levels soar
Scientists are now suggesting that diabetics should be in the shielded group as extra vulnerable as it has been found that diabetics are 3 and a half more likely to die if they get coronavirus, but how could they make all diabetics shield, it could be hard, unless they only tell the diabetics who have not got good control over the their glucose levels to shield, it could be difficult for people who work
I am T2. I control my condition with diet and exercise and my HBA1c has been below 42 for the last two years.
I hear that I am at much higher risk if I get severe Covid-19 than the average person. It seems odd that the experts think that a well controlled T2 is at the same risk as one who isn't controlled at all.
Now, I am well controlled, but that is only because I keep myself fit and I avoid carbohydrates. If I was rushed into hospital with Covid-19, I would get no exercise at all and the NHS would not doubt feed me their balanced diet, based on the 'Eat Well Plate' theory of good eating. I know from experience that their balanced diet would shoot my BG through the roof. Just eating a few potatoes puts my BG up from 6 to 9. Question: Is this why controlled T2's are at the same risk as uncontrolled T2's?
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
Question: Is this why controlled T2's are at the same risk as uncontrolled T2's?

My suggested answer: because the healthcare professionals who ask 'are you diabetic?' when a patient is admitted to hospital with COVID-19 do not have the time or the resources to ask such detailed questions as 'are you T1 or T2, LADA? 3c? MODY? Bronze? Is your HbA1c above 80? 70? 60? 50? 40? Do you experience many hypos? If so, how many times have you required assistance in the last year?'

Plus of course the additional admin required entering the data.

I suspect that the reality is much more pragmatic. a few questions, just enough to get the person into a bed and onto a ward, with the expectation that staff on the ward will fill in the gaps - which of course they won't have time to do.

Don't get me wrong, it would be absolutely wonderful if every patient was subjected to the third degree, at the time of their admission, enabling a beautifully comprehensive database to build up. It would help tremendously, and enable joined up thinking around the world.

But even if all the questions were asked, and answered, and recorded, in the words of that well known TV doc, House 'patients lie. All the time.'
And at the moment, there is a lot of bickering about when/if/whether coronavirus infections are even mentioned on a death certificate, and how that mention should be made. Different countries are handling it completely differently.
 

Jamie H

Well-Known Member
Messages
126
The risk decreases if your diabetes is well controlled according to the NHS study, which just legitimises what was assumed by most beforehand. For both type 1 and type 2. One of the key takeaways is to ensure good glycemic control and optimal weight. So to me that says the risk isn't the same.
 
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Mr_Pot

Well-Known Member
Messages
4,573
Type of diabetes
Type 2
Treatment type
Diet only
I am T2. I control my condition with diet and exercise and my HBA1c has been below 42 for the last two years.
I hear that I am at much higher risk if I get severe Covid-19 than the average person. It seems odd that the experts think that a well controlled T2 is at the same risk as one who isn't controlled at all.
Now, I am well controlled, but that is only because I keep myself fit and I avoid carbohydrates. If I was rushed into hospital with Covid-19, I would get no exercise at all and the NHS would not doubt feed me their balanced diet, based on the 'Eat Well Plate' theory of good eating. I know from experience that their balanced diet would shoot my BG through the roof. Just eating a few potatoes puts my BG up from 6 to 9. Question: Is this why controlled T2's are at the same risk as uncontrolled T2's?
If you are rushed into hospital with severe Covid-19 and in danger of dying I very much doubt you will be sitting up in bed tucking into huge helpings of sausage and mash, apple pie and custard. More likely on a drip with just enough glucose to keep you alive.
 

UK T1

Well-Known Member
Messages
334
Type of diabetes
Type 1
Treatment type
Insulin
Sorry where are these facts from? Is it true that t1ds have 3.5 times the risk?

Sorry I haven't been on for a little while. I believe it has been posted various times across this forum but here are the latest, and largest ranging studies which has been released about diabetes and Covid-19: https://www.england.nhs.uk/publicat...es-and-covid-19-related-mortality-in-england/
The 3.5x was from the first paper. There are numerous threads that discuss these papers (including limitations). It is important not to let the numbers alarm you, and I agree with what Brunneria said above. In terms of gathering data, here are some of my thoughts. Firstly, there needs to have been a test to confirm the patient actually has CV, so lots of studies so far are only talking about hospital admissions as these were the only places testing for a long time. It then depends on the patient's records being complete, as Brunneria says. It also depends on the numbers. In these papers there are lots of categories where the patient numbers are so low they have had to put categories together.

My point is that it is important to differentiate between what we think might be the case (so also what researchers and medical professionals are predicting but don't yet have the data to support), and what the data so far shows us. I have heard lots of people saying things along the lines of 'why aren't the experts advising us ...x y and z' which in my opinion is only answered by reminding them that the data so far is quite limited. We can make educated guesses about risk factors, but if the data hasn't been recorded in enough detail, 'experts' can't easily recommend what we think might be the most sensible course of action anyway.

I hope my ramblings make sense. I will again remind anyone who is worried about getting a shielding letter that they don't *have* to follow the advice - it isn't a prison sentence! In my case it just means I can continue to work from home, which I have been doing the whole time anyway. It has been a huge relief to receive it, eventhough I appreciate I have so far got a lot of the stats on my side.
 

Dexterdobe

Well-Known Member
Messages
305
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Being unwell and seeing BG levels soar
If you are rushed into hospital with severe Covid-19 and in danger of dying I very much doubt you will be sitting up in bed tucking into huge helpings of sausage and mash, apple pie and custard. More likely on a drip with just enough glucose to keep you alive.
Most patients who are hospitalised never get onto a ventilator. The majority never get beyond the assisted oxygen stage. They still have to eat unhealthy hospital food.
 
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Dexterdobe

Well-Known Member
Messages
305
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Being unwell and seeing BG levels soar
My suggested answer: because the healthcare professionals who ask 'are you diabetic?' when a patient is admitted to hospital with COVID-19 do not have the time or the resources to ask such detailed questions as 'are you T1 or T2, LADA? 3c? MODY? Bronze? Is your HbA1c above 80? 70? 60? 50? 40? Do you experience many hypos? If so, how many times have you required assistance in the last year?'

Plus of course the additional admin required entering the data.

I suspect that the reality is much more pragmatic. a few questions, just enough to get the person into a bed and onto a ward, with the expectation that staff on the ward will fill in the gaps - which of course they won't have time to do.

Don't get me wrong, it would be absolutely wonderful if every patient was subjected to the third degree, at the time of their admission, enabling a beautifully comprehensive database to build up. It would help tremendously, and enable joined up thinking around the world.

But even if all the questions were asked, and answered, and recorded, in the words of that well known TV doc, House 'patients lie. All the time.'
And at the moment, there is a lot of bickering about when/if/whether coronavirus infections are even mentioned on a death certificate, and how that mention should be made. Different countries are handling it completely differently.
I would love to see statistics which tell how many have been admitted to each hospital, how many went on to need oxygen, how many sedation and a ventilator and how many died. That would be truly enlightening. BUT, if such statistics exist, they are impossible for the public to access.
 

Jamie H

Well-Known Member
Messages
126
Wondering is anyone has seen this? Interesting in perhaps moving away from the one size fits all approach. Fully appreciate that there are many on this forum at higher risk so its not in anyway to come across as insensitive. Just shows varying degrees of risk in line with the recent NHS studies. It's about risk assessment and potential return to work but would ultimately apply to decisions around shielding too?

Fully appreciate risk will never be zero and doesn't guarantee outcome but it helps shape our everyday decisions I guess

https://alama.org.uk/covid-19-medical-risk-assessment/
 
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Getting_Fit

Member
Messages
20
Type of diabetes
Type 1
Treatment type
Insulin
And yet this is dated 20th May and states exactly that.

https://www.england.nhs.uk/2020/05/...le-with-diabetes-during-coronavirus-outbreak/

the reason your linked document is later is because it directly relates and references the document I’ve referenced. It’s diabetes UK response. And it DOESNT say type 1 or 2 diabetics should shield. It says we are not one big melting pot- there are cluster of risk factors.... it depends ... as I originally stated!
Type 1 diabetic for 47 years
 

Paula_2609

Newbie
Messages
1
Type of diabetes
Type 2
Scientists are now suggesting that diabetics should be in the shielded group as extra vulnerable as it has been found that diabetics are 3 and a half more likely to die if they get coronavirus, but how could they make all diabetics shield, it could be hard, unless they only tell the diabetics who have not got good control over the their glucose levels to shield, it could be difficult for people who work
 

Ladybird1

Well-Known Member
Messages
48
Type of diabetes
Type 1
Treatment type
Insulin
Type 1s have 3.5 times the risk. I think type 2 is twice the risk. Due to low numbers of other diabetes types in studies they were put together as 'other types of diabetes' and I think also had twice the risk of non diabetics. This is for the stats of dying in hospital at least... (paper released on NHS England website last week).

Lots of type 1s who have contacted their GPs have been given shielding letters. Like has been said I think it will be a 'don't ask don't get' scenario due to taking too many out of the workforce otherwise. I think it will also depend on your job and working conditions. Someone lucky enough to be able choose to continue working from home might not be deemed as high risk as someone who has no choice but to interact with others. The concern will come as people are more complacent with lowdown easing measures. If you're concerned about your workplace then contact your GP. Of course you might choose not to shield, that is everyone's personal choice.
I asked my GP what my position was and was told to look at the government website. They told me that they didn't give letters for shielding out. So much conflicting advice, who and where do you get advice from??
 

UK T1

Well-Known Member
Messages
334
Type of diabetes
Type 1
Treatment type
Insulin
I asked my GP what my position was and was told to look at the government website. They told me that they didn't give letters for shielding out. So much conflicting advice, who and where do you get advice from??
It is so difficult. Ultimately I thought GPs give out letters but can add patients not on the official guidance. My consultant has advised type 1s under his control to shield and my GP said this was appropriate advice and I got my letter this week. It doesn't change my behaviour but means I can continue to work from home. I don't quite understand why I have the letter compared to others, as I am under 40, no other conditions, HbA1c between 47-52 over the years so by all accounts low risk. But my consultant had advised it so I assume that influenced my GP, and my job.
 
Last edited:

Josie66

Well-Known Member
Messages
70
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diabetes!!
My gp sent me a letter to sheild. Also got one from NHS England. I've been sheilding since start of lockdown. My hba1c is above 90 .uncontrolled T2. Also have other health problems Bp and thyroid.
I am an NHS key worker and would be unable to self distance in my job. All of my diabetic colleagues in my area of work have been sheilding since March. My occupational health department also advised sheilding. Am extremely lucky to be receiving full pay in these unusual circumstances
 

Josie66

Well-Known Member
Messages
70
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diabetes!!
I asked my GP what my position was and was told to look at the government website. They told me that they didn't give letters for shielding out. So much conflicting advice, who and where do you get advice from??
GPS can give letters out. I would query this with them