medwireNews: The risk of severe COVID-19 in people with type 1 diabetes is limited to the elderly and people with diabetic complications.
“The results of the present study give the younger type 1 diabetes population without diabetes complications security with regard to their risk of severe COVID-19,” the researchers write in Diabetologia.
Only five (7%) of the 67 people under the age of 55 died after being admitted to hospital with or for COVID-19, and 24% had serious illness, defined as death or ICU admission.
Three of the younger deceased were hospitalized for COVID-19 and two for diabetic ketoacidosis (DKA). All had microvascular and / or macrovascular complications. The team adds, “There were no deaths in people with type 1 diabetes under the age of 55 without any diabetic complications. “
In contrast, the elderly had a 38% mortality rate and up to 45% had serious illnesses.
Rustam Rea (Oxford University’s NHS Foundation Trust, UK) and coworkers used national audit data to identify 194 people with type 1 diabetes who were hospitalized with COVID-19 and had outcome data.
“We recognize that the hospitalized patient population is vastly different from the broader type 1 diabetes population, so conclusions should be limited to this subset of people,” say the researchers.
They found that their cohort had a similar gender and ethnicity distribution as the general type 1 diabetes population, but was older and had poorer glycemic control.
After considering age, Rea and team found that higher BMI and serum creatinine levels and the presence of microvascular disease were significantly associated with a higher risk of serious illness, with the latter two also being associated with a risk of mortality.
In addition, they found an “unexpected” association between lower blood sugar levels and serious outcomes, due to the fact that blood sugar levels in people with DKA were on average lower than those in people without DKA.
The researchers find that 29% of the 171 people with available data had DKA at admission, compared with only 7% of those hospitalized specifically for the treatment of type 1 diabetes in 2019.
“Our results underscore the importance of helping people with type 1 diabetes in the community during the pandemic to minimize the frequency of avoidable admissions,” they conclude.
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Diabetology 2021; doi: 10.1007 / s00125-021-05463-x