Type one may be less risky than thought wrt C19

[LooperCat]

A new study of people with diabetes hospitalized with COVID-19 has found that Type 1 diabetes may be significantly less dangerous than Type 2 diabetes:

https://asweetlife.org/new-study-sh...W_4mxJ8U_HSP9w9HWIOXTPkDoWZoLdJXyIAHOKkhE-VOA

Link to actual paper:

https://care.diabetesjournals.org/content/diacare/early/2020/08/24/dc20-1217.full.pdf

Thoughts?

 

[kev-w]

As one of the articles says, it's reassuring although we still carry a higher risk than a non D.

 

[LooperCat]

As one of the articles says, it's reassuring although we still carry a higher risk than a non D.

Definitely. But keeping non-diabetic levels as far as we can can only help with that. I’d be interested to see a decent sized study between levels of control of T1 and mortality.

 

[EllieM]

Definitely. But keeping non-diabetic levels as far as we can can only help with that. I’d be interested to see a decent sized study between levels of control of T1 and mortality.

I think the decent sized is most relevant here. Though that article is very reassuring, 50 patients just isn't very many....

I'd love to know the figures for undiagnosed diabetics, who often seem to have very high hba1cs pre diagnosis. I suspect they may be influencing the mortality figures against T2s. At least we T1s can inject more insulin if we get sick, if you're a prediabetic (or don't even know that you have prediabetes) your bgs can get very high very fast if you get seriously ill...

 

[Goonergal]

Definitely interesting but would be even more interesting to see a larger analysis not just of those hospitalised, but all those who contracted the virus with type1/type2 to look at rate of hospitalisation/death etc. That would be a clearer view of overall risk.

 

[Jaylee]

I feel the trick is not to get hospitalised in the first place.
We know our own D managment. How many can be confident an HCP dapping between different patients could do the same.?

 

[sno0opy]

I think from the bulk studies it was suggesting weight/overall health was one of the biggest factors in Covid taking a significant hold. I know its been talked round before, but fundamentally allot of Type 2's are over weight or very over weight so that may be why they are at high risk.

The link to diabetes may have more to do that that and those whos condition has progressed to complications that make them implicitly weaker to such attacks then anything to do with blood sugar control.

 

[LooperCat]

In time there will be more data to go on, but based on what we have so far, this is still valid science in my opinion. Type one isn’t a metabolic disease in the same way as t2, it’s just an inability to make a specific hormone, which can be adequately replaced with a synthetic version. So we’re not in more danger of catching it, just that blood sugars would be harder to manage if we do. And because we can’t make insulin, DKA is much more of a risk, things can go pear shaped very fast for us.

 

[JaneC]

I feel the trick is not to get hospitalised in the first place.
We know our own D managment. How many can be confident an HCP dapping between different patients could do the same.?

I totally agree with not allowing yourself to get hospitalised in the first place, I've never been impressed by hospital staff decisions for type 1's and have briefed my other half not to leave my side if ever admitted, to follow my instructions for maintaining my sugars and to say no to sliding scale, bossy, arrogant but hey!

 

[Circuspony]

I totally agree with not allowing yourself to get hospitalised in the first place, I've never been impressed by hospital staff decisions for type 1's and have briefed my other half not to leave my side if ever admitted, to follow my instructions for maintaining my sugars and to say no to sliding scale, bossy, arrogant but hey!

I've also given my OH direction not to leave my side - but with a no visitor rule right now I'd rather stay away!

 

[NicoleC1971]

Definitely interesting but would be even more interesting to see a larger analysis not just of those hospitalised, but all those who contracted the virus with type1/type2 to look at rate of hospitalisation/death etc. That would be a clearer view of overall risk.

This has been done by Professor P Karr in the Lancet published study in May (I think). Again limited by studying hospitalised cases only but a much larger sample and does include data about the number of diabetics in the country and covered until May too.
I guess we will never know how many people had the virus but estimates based on the natural experiments such as the Diamond Princess suggested that the virus hit about 20% of the population which we could extrapolate to the same % of the diabetic population. The anti body test does not pick up all of those people but we do know that the crew and passengers of this ship were tested on disembarkation so its a reasonable case study of how this spreads when unchecked.
The study did not unpick the relationship between hypertension, diabetes and complications hazard ratios either but did make the point that for those under 80 the risk is small in absolute terms.

 

[Jamie H]

The associated risk of type 1s being 3.5 times a non D is driven a lot by older patients. It is likely older patients with type 1 hadn't the access to technologies type 1 patients have now during what could be a span of 50 years or longer... Most likely resulting in complications and associated comorbidities being added to the overall risk associated with age.

In short I think the risk for a well controlled type 1 diabetics under 50 is still overall very low... A fact backed up by both papers whichever way you look at them.

That's not to say there aren't regretful exceptions.. And well all fear we may be one of them

 

[LooperCat]

In short I think the risk for a well controlled type 1 diabetics under 50 is still overall very low... A fact backed up by both papers whichever way you look at them.

That's not to say there aren't regretful exceptions.. And well all fear we may be one of them

Aye, I’m more than happy to be out and about doing my thing - pop a mask on, wash hands and off we go. Some of the necessary precautions are a PITA but it won’t be for too long, hopefully.

 

[Robinredbreast]

I too am happy to be out and about with a mask, hand gel and washing hands, I am over 60, still active and hoping to get back to work soon. BS has been a bit of a roller coaster, a few things have been going on in my life but trying my best to keep things on an even keel and not...................keel over !

 

[Fairygodmother]

It’s reassuring to see this @LooperCat! As an oldie, diagnosis aged 20 and now very nearly 71, I’ll go on taking special care when out and about: FFP3 for places where there’s more likelihood that I’ll encounter non-distancers, hand sanitiser etc. Really really don’t want to end up on a Covid ward even though I have no complications and I’m not obese. I think we oldies often have a decline in immune system’s effectiveness, and if that’s so then I don’t want to test just how good mine is.