Recent studies show those suffering from T2D require more medical interventions and had a higher mortality rate during the pandemic. Can this be used to guide preventative strategies to safeguard the health of those with Diabetes? Please share your thoughts
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Posting on behalf on the NNEdPro Nutrition & COVID-19 Taskforce
According to the available evidence, people with diabetes do not have a higher susceptibility to SARS-CoV-2 infection. However, we have observed that people with diabetes and related comorbidities are at increased risk of complications and severe COVID-19 illness. Alongside older age, multi-morbidity, including many conditions associated with diabetes, are severe predictors of poor outcome.
Specific to diabetes, it appears that the level of diabetes control has an influence on outcomes. NHS England data comparing COVID-19 outcomes in patients with higher HbA1c (>86mmol/mol) versus those with HbA1c between 48 and 53 mmol/mol, found mortality increased with higher HbA1c in patients with both T1DM and T2DM. In a retrospective analysis of T2DM patients in Wuhan, maintaining in-hospital glycaemic variability within 3.9 to 10.0 mmol/L, was associated with a significant reduction in adverse outcomes and death (1% vs. 11%) These observations suggest that glycaemic control should be an important consideration in COVID-19 illness.
It is also important to recognise people with diabetes as a vulnerable group, at risk during times of lockdown and social restrictions. Measures such as telemedicine services and drug dispensing by home delivery can be adopted to reduce exposure of diabetes patients to infection while ensuring uninterrupted continuity of care.
In those with diabetes and other co-morbid conditions, nutrition can be viewed as a modifiable risk factor contributing to good disease control and with that reducing the risk of complications. Healthy dietary practices, safe physical activity and regular glucose monitoring should be encouraged. These can be viewed not as a replacement, but as an adjunctive treatment to routine public health measures such as vaccination, social distancing and mask wearing.