Consultants: Individuals with diabetes inclined to extreme COVID-19

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As a nurse, Julia Schulman is already at a higher risk of contracting the coronavirus. As a nurse with diabetes, she has a greater chance of getting seriously ill or dying from the disease.

“I was very nervous the whole time,” said Schulman, who works with diabetes patients as a nurse manager at Northwell Physician Partners Endocrinology in Great Neck.

Diabetes is the second most common underlying disease among New Yorkers who have died from COVID-19 and the most common among those under the age of 40, according to the New York State Department of Health.

Experts say people with diabetes are particularly susceptible to severe COVID-19, largely because the coronavirus can cause dangerous inflammation of blood vessels. Most people with diabetes already have inflammation, which creates a potentially fatal combination.

Schulman said many of her diabetes patients are afraid of their increased susceptibility to the virus. Part of their job is to calm them down and help them reduce their risk.

Of the 33,907 New Yorkers who died of COVID-19 on Friday, more than 91% had one or more underlying illnesses, according to the health department. More than 37% of patients with an underlying disease had diabetes and nearly 12% had kidney disease, which is often caused by diabetes. Some people had several underlying illnesses.

The only underlying disease that was more common than diabetes was high blood pressure, or high blood pressure, which 58% of those who died from COVID-19 had. According to the American Diabetes Association, about two-thirds of people with diabetes have high blood pressure or take medication to lower their blood pressure.

Governor Andrew M. Cuomo said Jan. 12 that immunocompromised people would be eligible for vaccines next, but has not said when they will be added.

The health department didn’t respond directly to questions about the schedule, but instead sent a statement from senior Cuomo advisor Rich Azzopardi accusing the federal government of recommending people with underlying diseases to qualify for vaccinations without providing enough vaccines.

Cuomo said the state is looking into which diseases are eligible for the list.

A list of the Centers for Disease Control and Prevention with patients with underlying diseases who are at higher risk for severe COVID-19 includes type 2 diabetes. Type 1 diabetes is listed with high blood pressure, asthma, and other conditions that could increase your risk of severe COVID-19. The CDC said there isn’t enough data to be sure.

Schulman, who has type 1 diabetes, qualified as a healthcare worker for a vaccine and received her first of two shots almost three weeks ago.

“I think it will certainly give me a little rest,” she said.

According to the National Institute for Diabetes and Digestive and Kidney Diseases, 95% of adults with diabetes have type 2 diabetes, which means the body is not producing insulin or using it well. The bodies of people with type 1 diabetes don’t make insulin and need insulin shots to survive.

The body breaks certain foods down into blood sugar, and insulin is needed to transfer this sugar to cells where it is converted into energy. Too much sugar remains in the blood in people with diabetes.

The frequent spikes and drops in blood sugar that many people with diabetes experience lead to inflammation, said Dr. Joshua Miller, Medical Director of Diabetes Care at Stony Brook Medicine and Assistant Dean of the Renaissance School of Medicine at Stony Brook University.

“Your blood vessels and organs have been damaged for years from this increased burden of inflammation,” said Miller, who has type 1 diabetes. “So if you take someone with longstanding diabetes, uncontrolled diabetes, very high blood sugar … and add a deadly virus to that person that causes significant inflammation in and of itself, this is a recipe for disaster.”

Miller said people who have had diabetes for longer and whose diabetes is less controlled are likely at higher risk for severe COVID-19 than younger people with controlled diabetes.

Not only does COVID-19 endanger the lives of people with diabetes, but it also appears to help cause diabetes. Miller said he saw people who have never had diabetes or had prediabetes in the past come to the hospital, “and their blood sugar is going through the roof because of COVID. The virus has something that makes them not enough To produce insulin. “

They then leave the hospital with a diagnosis of diabetes that they didn’t have when they arrived, he said.

Some people with diabetes need dialysis, usually three to four hours, three times a week, said Dr. Susana Hong, nephrologist at North Shore University Hospital in Manhasset.

Dialysis centers have taken precautionary measures such as making masks mandatory, banning eating to store masks, as well as health exams and temperature controls before each visit, she said.

Schulman said she had emphasized to her patients the critical importance of general COVID-19 precautions as well as measures to control their diabetes.

“I tell them that at this time of year it is more important than ever to have strict blood sugar controls, that we make sure they follow their rules and that we stay in touch when their blood sugar is high so we can do something about it. ” She said.

INCREASED RISK

People with diabetes are at higher risk of severe or fatal cases of COVID-19.

  • Number of New Yorkers who have died from COVID-19: 33,907
  • Percent of those who died from COVID-19 and had at least one underlying disease: 91.4%
  • Percent of those who died of COVID-19 with an underlying disease with diabetes: 37.2%
  • Number of Americans with Diabetes: More than 34 million

SOURCES: New York State Department of Health, Centers for Disease Control and Prevention

David Olson covers health care. He has been with Newsday since 2015 and was previously responsible for immigration, multicultural issues and religion at The Press-Enterprise in Southern California.