During the COVID-19 pandemic, it is important to remember those people who are more vulnerable to the adverse effects of infection. To tie in with Diabetes Awareness Week 2020 which took place from 12-18 July, we spoke to Dr Oliver Treacy to understand the risks of living with diabetes at this time. Dr Treacy is a chemical pathologist at Mater Pathology in Brisbane and explains the importance of monitoring and managing diabetes at this time.
“There is currently no clear evidence to suggest that people living with diabetes are at increased risk of being infected with COVID-19, however people with diabetes are at higher risk of more severe COVID-19. This means that diabetic patients are at increased risk of adverse outcomes and of being admitted to ICU if they contract COVID-19. The risk is not the same for everyone living with diabetes,” said Dr Treacy.
Around 1.7 million Australians have diabetes. This includes all types of diagnosed diabetes (1.2 million known and registered) as well as silent, undiagnosed type 2 diabetes (up to 500,000 estimated). In New Zealand, it is estimated that the number of people diagnosed with diabetes exceeds 200,000 people. Data in Australia shows that people with diabetes represent 7% of diagnosed cases of COVID-19, 17% of hospitalised cases, 24% of ICU stays, and 25% of deaths.
“There are a number of hypotheses as to why diabetic patients may have a more severe response to COVID-19. In general, diabetes weakens the immune system so these patients will have an impaired immune response to infection, both in relation to cytokine profile and to changes in immune responses. Many patients with type 2 diabetes are obese, which is a risk factor for severe infection of COVID-19. Obesity can also cause mechanical respiratory problems, resulting in reduced ventilation of the basal lung sections and therefore increasing the risk of pneumonia.
“In addition, one of the more common long-term complications of diabetes is kidney damage. This means that these patients are already at increased risk of baseline renal impairment in the face of an infection that may potentially cause acute kidney injury. This further increases the severity of COVID-19 disease and the need for significant medical intervention and care, such as acute dialysis,” said Dr Treacy.
There are some things people with diabetes can do to ensure they are as healthy as possible, and to reduce their risk of severe symptoms from COVID-19. It is recommended that those with diabetes should try to stick to their usual diabetes care plan as much as possible. This includes closely monitoring and managing their diabetes and trying to ensure that blood glucose levels are well managed. This is very likely to be helpful in reducing the risk of the more severe complications from COVID-19.
“It is important that people living with diabetes continue to have their routine pathology tests and follow-up appointments with health professionals. During the current pandemic, there have been concerns that patients were not attending these important appointments, putting them at risk of developing serious health problems,” said Dr Treacy.
Professional AFL player and GWS Giants star, Sam J Reid, teamed up with the Royal College of Pathologists of Australasia to discuss his experience of living with type 1 diabetes. During the short video, Sam explains the importance of pathology in the healthcare of everyone. To view the video, visit: https://www.youtube.com/watch?v=l6fFLG8OHYs&feature=youtu.be