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Type 1 Shielding for diabetics

Discussion in 'Ask A Question' started by jane1950, May 25, 2020.

  1. Devonmade

    Devonmade Type 2 · Member

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    This is an interesting discussion for me. I was sent home from work 17 March. I have T2, chronic asthma and ME. Originally, government said diabetes and asthmatics would be classed as high risk, now they call it clinically vulnerable. Like Tricia said above, how does your "bracket", for want of a better word, change if you have several underlying health conditions? I wasnt aware of a tool being developed, but it would be very useful to help determine how risky it is to return to work. I still feel I am in the clinically vulnerable group, but with added issues. any thoughts? (I didnt get a letter and didnt expect one, surgery have gone into meltdown and are pretty hopeless anyway so I havent asked them for guidance)
     
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  2. zibi1

    zibi1 · Member

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    I see a lot of fear in this discussion. Surely, a blanket shielding to all diabetics is not the right way of doing it. As the data clearly shows , age is the primary factor at play. Being under 40 with Type 1 is still an extremely low risk scenario. Even being 60s with a decently controlled diabetes presents with a risk level that is - in an absolute sense - low. The average age of sadly deceased people with T1D is 72yo, 78yo for T2D.
    As my math teacher used to say, if you multiply zero by a big number, you still end up with zero.

    For example, for 30-39 years old the infection fatality rate seems to be 0.08%. Multiply this by 3 and it's still 0.24%. These are extremely low odds. Higher than the seasonal flu for sure, but shielding on the basis of these odds until there is a vaccine i.e. years is a risky proposition. You are pretty much guaranteed to survive Covid, but the mental health costs would be enormous.

    The situation might be different if you are over 60 or 70 and have diabetes, with possibly other conditions. Under those circumstances, shielding might be justified, considering that the odds of a negative outcome might approach the 5% range.
     
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  3. Devonmade

    Devonmade Type 2 · Member

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    Yes, I do agree with that. I am lucky my employer is paying me but I do feel vulnerable and haven't been anywhere since I came home in March. It would be useful for me and others with additional health issues to have guidance, for us and the employer, what category we are in. Does having additional chronic illnesses make you more susceptible or not? You would think yes but it's the unknown
     
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  4. Jamie H

    Jamie H · Well-Known Member

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    Tend to agree with this.. On balance without being complacent and diminishing the seriousness of things... When weighing up risk (not guaranteed outcome) blanket shielding doesn't make sense. Note also that the risk for under 40s diminishes a bit further if you're well controlled and not obese (at least this is my understanding of it).

    Note that when x3. 5 it is against the hazard ratio of an under 40 (compared to a 60-69 year old which is the ref. age and carries a HR of 1) which is 0.01(or 1%). The numbers are ratios not overall mortality % but these would also be very low for this age group.

    In short my non diabetic twin aged 31 has a 1% chance of dying compared to a 60-69 year old. I in turn have a 3.5x chance compared to my 31 year old twin.... So still very very small.

    Not sure how this all works when looking at paper 2 though... Which is HR within diabetics alone??
     
  5. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    But not all over 70's with diabetes have uncontrolled diabetes, nor are they all obese, and nor do they all have other significant illnesses. To shield all the over 70 diabetics is yet another blanket approach. I speak as a well controlled T2, aged 72, with no other illnesses, no hypertension, no other metabolic issues, and with a BMI of just over 22. I would be very unhappy to be told to shield.
     
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  6. UK T1

    UK T1 Type 1 · Well-Known Member

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    As many have said, I don't expect all diabetics to be told to shield. Also, you have the choice not to follow the advice and not to shield.

    My consultant told me it would be wise to shield, and when I asked my GP whether to expect a letter they said they were sending one. Everyone's situation is different. I have type 1, under 40, no other conditions and 'very good control' according to my consultant. (Just for information, not wanting to sound big headed!!)

    I have been shielding (without the letter) since March anyway and haven't found it hard. Others will disagree, and it may well not have been necessary, but I wanted to feel more secure in the knowledge that there would be a bed available for me in hospital should I need it. I see it as inevitable that I will at some point contract coronavirus, I realise the current research suggests I am in a far better place to deal with it than many others.

    As I say I've found it easy to shield and I know others wouldn't, but then you also don't have to do it if you get the letter. It is only guidance, and everyone has different situations to contend with after all.
     
  7. Horacethesheep

    Horacethesheep Type 1 · Member

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    This topic is so interesting, I’m also wondering if anyone knows how long a person has had diabetes plays a part in the risk? I’m 36, well controlled but I’ve been diabetic for almost 24 years and because of that (according to my consultant) am starting to see minor signs of complications here and there. Does that put me more at risk than, say someone of the same age who has been diabetic for three years?
    I’d love some clarity on where I stand from the government, as I’m self employed and can’t do my job at all while social distancing, so at least then I might have a chance at getting some financial help, or I can think about a plan B. At the moment in a few weeks time I’ll be “choosing” not to go to work, though I really don’t feel that it’s safe for me to return.
     
  8. RachaelRodgers

    RachaelRodgers Type 1 · Member

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    I’ve been self isolating and social distancing since the 18th March, I’m fortunate that I work in education and I can work from home and still be paid. I’ve made face masks and used those when I’ve gone to the shop, I stay local and avoid people when I’m out walking the dog. I think it’s took too long for scientists to decide we are at risk. I’m not going back to work until September/October and I’ve pretty much always been a social distance kind of person so it’s life as normal for me.
     
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  9. Injector1

    Injector1 Type 1 · Active Member

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    No, only Cummings qualifies for that!
     
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  10. tim2000s

    tim2000s Type 1 · Expert
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    While the headline number said that Type 1s had 3.5 times the risk of non-diabetics, when you break that out by age, you get a very different image.

    Those under the age of 50 appear to have no significant increase in risk, and those under 50 with 48mmol/mol Hba1C levels are also not particularly at risk. The number of deaths in these populations for both t1 and general population is so small in these groups that it statistically looks random.

    Where it gets more tricky is once you get above 50, and then above 60. And when you factor in BMI and Hba1C.

    Your risk blows out significantly. compared to the non-diabetic population as you get older and also with other confounding factors.

    It's also worth noting that duration of diabetes was reviewed in these papers and the conclusion drawn was that it didn't play a part.

    With all this in mind, I don't think they will shield all type 1s, or Type 2s. If they decide to shield anyone, it will be related to age and also BMI, Hba1C, and other co-morbidities.

    Given that, it's unlikely to be a huge additional number and is likely to be a very similar population to those who are already being asked to shield.
     
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  11. LizLola

    LizLola Type 1 · Well-Known Member

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    I was reading somewhere that 26% of people over 60 have diabetes. Which could explain the vast number of deaths in that light - older PLUS diabetes = makes you more likely to die. At the very beginning of this, I also saw a post somewhere where you could add up your vulnerabilities and get a true figure (well, more realistic figure) of your own likely mortality rate. Mine was based on type 1 diabetes for 50 years, asthma, and being over 60. It gave something like a 15% likelihood of mortality. So yes, it does depend on how many comorbidities you have, and probably also depends on luck.
     
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  12. duranie

    duranie Type 1 · Well-Known Member

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    I was sent a text by my GP telling me to stay at home, avoid all contact with anyone from outside the home etc etc fir 12 weeks as they considered me to be ‘at a high risk of becoming extremely unwell’ if I contracted the virus.
    I do have other medical conditions, however I believe my local CCG contacted all type 1 diabetics and type 2 patients on insulin with the same advice.
    I’m ‘fortunate’ in that, as a result of the other conditions I’m unable to work - but if I were still working there’s no way I’d be risking my health if it was suggested I stay home.
    Of course everyone if different but if a doctor suggests you stay home, I’d take their advice.
     
  13. tim2000s

    tim2000s Type 1 · Expert
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    I'd ask the doctor for their reasoning as to why I should, rather than diretly heed their advice.

    If the answer was "You have type 1" then I'd ask them again why they felt that I needed to stay at home, as the data doesn't support that at my age and current state of health. I think it's possible to take advice from healthcare professionals, but they aren't always the best arbiter of what risk looks like.
     
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  14. PaulAshby

    PaulAshby Type 1 · Active Member

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    Bit of a strange one both me and my brother are type 1 while I got the pdf sent directly to myself my brother who lives in N IRL hasn't received anything?
    I work as a theatre health care assistant and am off until July but can't see me being allowed back as social distancing is impossible in my job so I'm a bit worried about my future employment at the trust, I hope they find a vaccine but not hopeful at present.
     
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    #34 PaulAshby, May 28, 2020 at 12:00 PM
    Last edited by a moderator: May 28, 2020
  15. kev-w

    kev-w Type 1 · Well-Known Member

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    #metoo & I'm 53.
     
  16. Picci

    Picci Type 1 · Well-Known Member

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    I work in a school. I’m type 1, age 51, pump user.....just thought I’d add that! My headteacher told me he will go at my pace and doesn’t expect me to be back anytime soon. I do feel, when we know more about the virus and schools are more prepared that September could be a possibility.
    My GP has refused to give me a letter, they said they have enough to do and it’s not their job. ****** charming.

    Edited by moderator to comply with forum rules on acceptable language
     
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    #36 Picci, May 28, 2020 at 12:17 PM
    Last edited by a moderator: May 28, 2020
  17. bazza1966

    bazza1966 Type 1 · Member

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    I contacted my GP as I have CHD as well as TD1 and was told I don't need to shield although this is the same GP who said there is no proof CGM helps BS control!!
     
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  18. rebecca4152

    rebecca4152 Type 2 · Newbie

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    NHS England has published breakdown of covid deaths with pre existing conditions. Their data shows 26% of those who died in the hospital were diabetics, 18% with dementia, 15% with pulmonary disease and 14% with kidney disease. Im a nurse and still working at the hospital. Aside from being diabetic , I am on BAME group too who are known to be on greater risk from covid infection. So I am afraid.
     
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  19. Andy V

    Andy V Type 1 · Newbie

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    I'm Type 1. I work in an NHS Community Team. Since early April I've worked from home because I elected to have "no patient contact". My colleagues whom I allocate cases to have been going out on home visits for 5 weeks wearing PPE and none are ill. As of today I have decided to return to work beginning of July. I'm done with home working, I can sense a change in mood, motivation, optimism etc.

    Since all the statistics are at best small samples and most not adjusted for hazard or other I'm not going to sacrifice my sanity based on hamfisted reporting, incomplete data and in the face of actual evidence from frontline colleagues who remain covid negative.

    Stuff it. I've had enough.

    There, got that one off my chest.
     
  20. heydave140

    heydave140 · Newbie

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    I''m type 1, not had a letter from the GP when they first came out a couple of months ago. I don't go out very much, only for a mile and half walk each day, give people a wide birth if they walk on the same side of the road as me. Luckily can work from home full time and cannot see myself travelling into London for work for quite some time yet. Blood sugars are usually ok, may have the odd high or low but usually in the normal range.
     
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