Diabetes - Covid

Hi @DCB 2. Totally understandable that you want to know why having diabetes puts us into the high risk category.

Many of us have been discussing this in various forums in here, and I have been following links from other members and following links on those links... so sorry if below isn't properly sourced (I wrote these things on the back of a used envelope!) as it should be, but here goes:

1. The principle factor, from my understanding, why those with diabetes (whether metabolic/type 2, drug or surgery induced type two, or auto immune/type 1 not specified) sometimes don't do well when contracting Covid-19 is that having high blood glucose affects white cell function in a negative way, ie immunity is further compromised by high blood glucose, and it is harder with those with high blood glucose to fight the virus off.

2. Body fat can affect the immunity response in a negative way, as obesity can bring about inflammation, and inflammation is associated with lowered immunity.

3. Insulin resistance, the condition underlying many type two diabetes cases, if affected badly by infection, ie insulin resistance increases, making blood glucose and insulin levels increase, bringing about inflammation and compromising immunity.

4. This from Dr Anne Peters in a talk on youtube - some diabetes medications can sometimes affect the person with diabetes with a Covid-19 infection negatively in that it makes them prone to ketoacidosis, a life-threatening condition for those with diabetes normally, when ketones and glucose levels get dangerously high (with low accessible insulin? - I believe so).

Those four issues are about, to some degree, what we call blood glucose control, however you personally do that. Body fat and insulin resistance I would say is not or not hugely under our conscious control, even if controlling those things are big things those with type two try to have in their control as much as possible.

This is why those with diabetes are being told to keep their blood glucose as much as possible under control and as low as possible, in order to be able to fight off covid-19 with your immune system functioning as well as possible.

Good for you Dave, stick at it.

AloeSvea said:

some diabetes medications can sometimes affect the person with diabetes with a Covid-19 infection negatively in that it makes them prone to ketoacidosis

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We've discussed hospital food on this forum before and my greatest fear would be having no control of what nutrition I'd get should I ever catch this virus. Not just the carb content but the calories as well because I would never be able to eat the 2300 calories as recommended by the Harris Benedict formula.

Some of the reports I'm reading are suggesting that people are turning up in hospital with un-diagnosed Type II diabetes and that in itself is a big problem.

Hi. Like you I have been wondering as well. I suspect it is the risk of infection etc with high blood sugar. I suspect there are other subtle changes with diabetes. In addition there is the usual 'thing' about diabetes. I remember in some theme parks in the USA there are warnings about those with diabetes not going on thrill rides? I'd love to know the science behind that.

I have added a link above to the wonderful Dr John Campbell who does some very insightful videos on You Tube and this one in particular was to be honest of some concern. There are links below the video which show the studies and the tables can be accessed via PDF on the studies pages, far too much Info to post here.

In a nutshell on this particular study in the UK it concentrated on a study on a fair amount of people admitted to hospital with Covid 19. Interestingly what is called in the study "Uncomplicated diabetes" which I assume is no obvious complications seemed to fare worse than "Complicated diabetes" which I find quite baffling. It also concerningly had "uncomplicated diabetes" second in the table behind heart disease and ahead of cancer as far as I can see which begs the question why ALL persons with diabetes are not on the Governments shielding list but according to these tables other conditions below diabetes are?! Until we know more at least!

Sorry to hijack your thread @DCB 2 but thought it might be helpful as you have said in your original post " I have made sure that my blood sugar are the correct range along with my blood pressure to mitigate things"
Well as a T2D Diagnosed in 2000, that was diet only controlled, not on any diabetic meds due to lifestyle changes, was Diagnosed with Covid 19 (April) sent to ICU within a day of being admitted, severe drop of oxygen levels from 92-50% (even though was on supplemental Oxygen,), put on a ventilator , put on Insulin and survived..

I have post in T2D "Covid 19 Survival post ICU/Ventilator T2 D " not to shock but to give my very real personal experience with Covid as a well controlled individual and it is not just based on theory but a very real experience. I hope it to adds to the debate.
It in a condensed personal diary form that gives a real timescale of how quick and dangerous this disease is in reality to those with Diabetes, no matter( it would appear), how well controlled BG levels and weight control are.
And for those whose glucose levels shoot off the charts and those may be battling with drops in oxygen levels whilst the immune system battling against a complete onslaught that this disease brings at the same time. I don't think as to the theories of why matters only to be vigilant of symptons and react quickly, very quickly.

DCB 2 said:

OK what would happen if your blood sugars where controlled?

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They were,that just it. All these theories go out the window, it messes with oxygen saturation, completely messes with well controlled BG levels, causes inflammation of the lungs and pneumonitis too. On the positive side, it is the best weight loss program I have ever been on. That's the point I am making.

Robert_D said:

I don't think as to the theories of why matters only to be vigilant of symptons and react quickly, very quickly.

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Those theories do matter if it involves factors we can mitigate, respond to quicker, earlier or better or if we can’t do anything then we need to know that as we are at higher risk as a result and be even more vigilant to avoid exposure til something in the equation improves.

HSSS said:

Those theories do matter if it involves factors we can mitigate, respond to quicker, earlier or better or if we can’t do anything then we need to know that as we are at higher risk as a result and be even more vigilant to avoid exposure til something in the equation improves.

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I had mitigated by what I believed was good practice but tell my fiancee when she was told I only had a 50/50 chance about theories 3 days after being admitted in to hospital..
The fact in my case was that I didn't have a cough, just very fatigued. She called the ambulance and I didn't want to go to ER because of the wait. Was on 94% Oxygen level that night. The next day she secretly went to the pharmacy to get them to request an Ambulance where they tested my oxygen levels again and they had dropped to 92% They called my doctor who instructed I should go straight to hospital but I said no and my fiancee said to the Paramedics "Ask him to walk to the toilet" 14 feet away and I couldn't without assistance (and that was with no previous history of any mobility issues at all!)
The rest is history but if not for her I would've of waited another day and probably my recovery would have been non existent.
Those are the facts no mater how well controlled, no matter how well controlled weight,The Immune system is overloaded Fact.. Raised Blood sugar levels hamper a diabetics immune response to the virus which causes inflammation in the lungs causing the oxygen levels to drop-Fact. It simply overwhelms you on all fronts at the same time and the body can't in some cases cope if not treated quickly to reduce inflammation raised BG etc Fact

Did my previous well control help in my speedy discharge and adaptability to recover better than most when home? No doubt but on its own it wasn't enough and I was lucky because I had a good woman behind me who saved me (and the excellent NHS staff in the ICU here in the UK too)

In conclusion, Test, Test, Test. BG levels, Ketones, Temperature, Oxygen levels with an Oximeter , and react quickly. Don't wait just because you just feel fatigued or don't have a cough. but are well controlled is my recommendation

Robert_D said:

I had mitigated by what I believed was good good practice but tell my fiancee when she was told I only had a 50/50 chance about theories. The only fact in my case was that I didn't have a cough, just very fatigued. She called the ambulance and I didn't want to go to ER because of the wait. Was on 94% Oxygen level that night. The next day she secretly went to the pharmacy to get them to request an Ambulance where they tested my oxygen levels again and they had dropped to 92% They called my doctor who instructed I should go straight to hospital but I said no and my fiancee said to the Paramedics "Ask him to walk to the toilet" 14 feet away and I couldn't without assistance (and that was with no previous history of any mobility issues at all!)
The rest is history but if not for her I would've of waited another day and probably my recovery would have been non existent.
Those are the facts no mater how well controlled, no matter how well controlled weight,The Immune system is overloaded Fact.. Raised Blood sugar levels hamper a diabetics immune response to the virus which causes inflammation in the lungs causing the oxygen levels to drop-Fact. It simply overwhelms you on all fronts at the same time and the body can't in some cases cope if not treated quickly to reduce inflammation raised BG etc Fact

Did my previous well control help in my speedy discharge and adaptability to recover better than most when home? No doubt but on its own it wasn't enough and I was lucky because I had a good woman behind me who saved me (and the excellent NHS staff in the ICU here in the UK too)

In conclusion, Test, Test, Test. BG levels, Ketones, Temperature, Oxygen levels with an Oximeter , and react quickly. Don't wait just because you just feel fatigued or don't have a cough. but are well controlled is my recommendation

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Not disputing your experience whatsoever. No doubt your vigilant and determined fiancée made a huge difference. Quite possibly if covid had hit you with anything other than good bgl control you wouldn’t have made the recovery you did.

My point was any knowledge the medics can learn and share about how and by what mechanisms diabetes makes outcomes less favourable is valuable. Valuable to mitigate severity, to be alert for relevant issues, to make decisions about which treatments best apply for that issue etc.

@DCB 2 have you seen this https://www.cell.com/cell-metabolism/fulltext/S1550-4131(20)30238-2#.XqxOw3EasVI.twitter