COVID-19 can strike anyone. But it is increasingly clear that people with conditions like diabetes are at greater-than-average risk for serious illness or death if they contract COVID-19, the disease caused by the coronavirus.
“The available data suggests that people with diabetes are at a higher risk for complications from COVID-19,” says Dr. Jacqueline Y. Lonier, adult endocrinologist at the Naomi Berrie Diabetes Center at NewYork-Presbyterian/Columbia University Irving Medical Center. “This could be due to the effects of high blood glucose levels, but it could also be related to age and to other common comorbidities like hypertension, heart disease, or obesity.”
Among 5,700 people hospitalized with COVID-19 in the New York region, nearly a third had diabetes, according to a new report in the Journal of the American Medical Association.
Uncontrolled diabetes has been associated with increased risk of respiratory failure due to COVID-19, Dr. Lonier says. Patients with diabetes who contract COVID-19 are also are at a greater risk for diabetic ketoacidosis (DKA), a life-threatening complication that occurs when the body does not make enough insulin and consequently produces high level s of acids called ketones.
“We are seeing a large number of patients with type 2 diabetes being admitted to the hospital for COVID-19 who have DKA,” says Dr. Lonier, who is also an assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons. “This is something that is typically associated with type 1 diabetes but can also develop in people with type 2 who are severely ill, not just with COVID-19, but with other kinds of serious infections, or who are under significant physiologic stress like a heart attack or a stroke.”
DKA can be challenging to address. “It requires frequent blood sugar checks and additional monitoring that may be challenging in these kinds of circumstances,” Dr. Lonier says.
It’s uncertain whether maintaining tight control over blood sugar will keep diabetic patients out of the hospital if they contract COVID-19, says Dr. Lonier, but it can only help. “We know it can be more difficult to recover from infection if blood sugars are high,” she says.
Dr. Lonier has developed specific guidelines for people with diabetes to help them avoid the worst consequences of COVID-19. “They do have an additional condition that they need to be monitoring and making sure is as controlled as possible,” she explains. She suggests patients with diabetes do the following: