Post-op mortality rates improved by metformin

A French study suggests one in ten COVID-19 patients with diabetes who have been hospitalised with the virus die within seven days.

This latest research revealing the adverse impact of coronavirus on people with diabetes further highlights the need for tight self-management of both type 1 and type 2 diabetes. Managing blood glucose levels tightly will improve the outcomes of people with diabetes who catch coronavirus, experts have said.

This study showed that people with a higher body mass index (BMI) were more likely to either be ventilated or die by day seven. Of those studied, 89% had type 2 diabetes.

Researchers analysed the outcomes of 1,300 people with diabetes a week after being admitted to hospital and found that nearly 30% needed a ventilator or lost their life to the virus during the seven-day period.

The findings also revealed 18% went home within the timeframe, but people with diabetes who had long-term complications had double the risk of dying.

This was one of the first studies to examine the impact on people with diabetes hospitalised due to coronavirus.

It has been suggested that the reason why people with diabetes are at a higher risk of severe symptoms of COVID-19 could be because they may be slower at responding to infections as their key immune cells struggle to pass through blood.

As the majority of patients were admitted to hospitals five days on from the beginning of their symptoms, it is likely that 10 per cent died within two weeks of getting infected.

According to the results, one in five had been intubated and placed on a ventilator in intensive care within seven days, compared with the average time from hospital admission to ventilation being 12 days.

There was only 39 people with type 1 diabetes in the study and this small sample revealed no deaths in COVID-19 patients under 65 years old with the condition.

Professor Duncan Young, from the University of Oxford, is a professor of intensive care medicine. Commenting on the study, he told the MailOnline: “On day seven… by far the majority were still in hospital at this point. The mortality of 10.3 per cent is very low and is only patients who died by day seven, many more would likely have died after.”

Speaking to the MailOnline, GP with a special interest in diabetes Dr Hajira Dambha-Miller said: “If blood vessels are blocked by sugar, the body can’t get blood around to where the immune cells are needed to fight off the virus. It’s also slower at responding. Additionally, the long-term high glucose damages the immune system so the immune cells don’t work as well.”

University of Oxford professor of gerontology Sarah Harper added: “Being male, over 70, with a high BMI and diabetes, all increase the risk of becoming ill, needing intensive care and, sadly, dying from the Covid 19 disease. Indeed, these are all risk factors for increasing the likelihood of death from other causes.  UK data shows that regardless of age, having diabetes doubles the risk of death from disease, though that risk is very small in the young and middle age.

“Similarly is being overweight – so that a very overweight or obese British man in his early 60’s has the same mortality risk – or chance of dying – as a slim man in his early 70s. And we know that being overweight increases your chances of getting type 2 diabetes.”

An NHS spokesperson said: “The risk from COVID-19 for people living with diabetes is clear, and the NHS has put extra plans in place to help people and keep them safe, including clinical guidelines for patients who are admitted to hospital, online sites to support people to care for themselves and a dedicated new helpline for advice and support.”

 This research was published in the Diabetologia journal.

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