Selection of Studies
Impact of a Vaccine Strategy Prioritizing T1D
- Reduces the individual burden of severe illness
- Decreases hospitalizations that strain health care systems
- Mitigates health inequities present among disadvantaged subgroups of T1D patients
The Risk of Death
The risk of dying from Covid-19 was almost three times higher for people with type 1 diabetes and almost twice as high for type 2 than for those without diabetes.
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30272-2/fulltext
1 in every 5 hospitalized COVID-19 patients with diabetes die within 28 days of admission
1 in 10 hospitalized COVID-19 patients with diabetes die in the first 7 days
1 in 5 people with diabetes are intubated and mechanically ventilated for coronavirus within the same length of time.
https://diatribe.org/1-10-people-covid-and-diabetes-die-within-seven-days-hospital-admission
Rate of Hospitalization
People with either type 1 or type 2 diabetes have a three to four times higher risk of severe illness and hospitalization due to COVID compared to people without diabetes.
https://pubmed.ncbi.nlm.nih.gov/33268335/
Scotland studied it's entire population and found, after adjustment for age and sex, people with type 1 diabetes had 2.4 times the odds of dying or requiring intensive care for COVID-19compared to people without diabetes.
Diabetes Complication and COVID
47% of patients with type 1 diabetes who were hospitalized with COVID had DKA, a life threatening condition of diabetes.
https://t1dexchange.org/preliminary-findings-from-the-t1d-exchange-covid-19-study/
Why People with Diabetes are Being Hit so Hard by COVID-19
https://www.statnews.com/2020/10/01/why-people-with-diabetes-are-being-hit-so-hard-by-covid-19/
Racial Inequities Among Patients with T1D and COVID
Racial disparities in COVID-19 hospitalizations due to the four conditions: obesity, diabetes (type 1 and 2), hypertension, and heart failure.
A recent study found African American and Latino patients with T1D were four times more likely to be hospitalized for diabetic ketoacidosis than Caucasians.
https://newsroom.uw.edu/postscript/diabetes-patients-color-face-higher-covid-19-risks
https://www.dailyuw.com/news/article_56514ba6-780b-11eb-b910-df3eb3966ea2.html
From Diagnosis through Complications: Disparities in Health Care
Links Between T1D & COVID
Diabetes and the Long Haul
Can COVID Cause New Onset Diabetes?
https://www.nature.com/articles/s42255-020-00339-7
Insulin Resistance in Type 1 Diabetes
Insulin resistance is a defining characteristic of Type 2 Diabetes
https://diabetes.diabetesjournals.org/content/60/1/306
Unique inflammation patterns emerging in patients with type 1 diabetes
https://www.eurekalert.org/pub_releases/2018-03/mcog-uip030518.php
Letters
A Second Letter from 19 Health Organizations to the CDC
"Those with T1D have a 330 percent greater risk of severe illness, are 3.9 times more likely to be hospitalized with COVID-19, and a three-fold increase in mortality compared to those with T2D" https://www.diabetes.org/sites/default/files/2021-03/CDC-2021-0021-0035_attachment_1.pdf
JDRF Comments to CDC
This letter covers it all- morbidity and mortality data, hospital burden, and T1D glucose control statistics (and what they mean in context of COVID). https://bit.ly/3pAMwuz
What 19 Health Organizations Have Told the CDC
"The new science leaves little doubt that there should be no distinction between individuals with Type 1 and Type 2 diabetes mellitus, given the common, heightened risk both groups face for the most severe health outcomes of COVID-19"
https://www.diabetes.org/sites/default/files/2021-01/CDC%20Letter%20-%20T1D%20Prioritization.pdf
Local Letter to Governor Baker
Massachusetts Type 1 Diabetes Meet-up co-founder's letter to Governor Baker
JDRF Letter to the Seattle Times Editor
Short letter highlighting the studies, complexity of dual diagnosis of type 1 and COVID, and type 1 diabetes statistics.
A quick note: compared to Washington State, Massachusetts has an estimated 35,000 adults with type 1 diabetes.
https://www.seattletimes.com/opinion/vaccine-rollout-remember-those-with-type-1-diabetes/
CDC Guidance
Studies Used in CDC Risk Assessment of T1D and COVID
Please note, the most recent study included in the CDC Assessment is from August 2020 and concludes there is no distinction between T1D and T2D as to COVID risks.
Also worth noting, CDC does not differentiate between type 1 and type 2 diabetes when tracking diabetes related deaths. https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area (April 2020)Conclusion:
- This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID-19 in the New York City area.
https://jamanetwork.com/journals/jama/fullarticle/2765184
Glycemic Characteristics and Clinical Outcomes of COVID-19 Patients Hospitalized in the United States (June 2020)Conclusion:
- Among hospitalized patients with COVID-19, diabetes and/or uncontrolled hyperglycemia occurred frequently.
- These COVID-19 patients with diabetes and/or uncontrolled hyperglycemia had a longer LOS and markedly higher mortality than patients without diabetes or uncontrolled hyperglycemia.
- Patients with uncontrolled hyperglycemia had a particularly high mortality rate.
https://pubmed.ncbi.nlm.nih.gov/32389027/
Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication (May 2020)Conclusion:
- C-reactive protein may help to identify patients with diabetes who are at greater risk of dying during hospitalization.
- Older patients with diabetes were prone to death related to COVID-19.
- Attention needs to be paid to patients with diabetes and COVID-19 who use insulin.
- ACEI/ARB use showed no significant impact on patients with diabetes and hypertension who have COVID-19.
https://care.diabetesjournals.org/content/early/2020/05/13/dc20-0660
Prevalence and impact of diabetes among people infected with SARS-CoV-2 (March 2020)Conclusion:
- Based on these data, we conclude that diabetes may not increase the risk of SARS-CoV-2 infection but can worsen the outcome of this new coronavirus disease.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103097/
Prevalence and impact of diabetes among people infected with SARS-CoV-2 (August 2020)Conclusion:
- The results of this nationwide analysis in England show that type 1 and type 2 diabetes were both independently associated with a significant increased odds of in-hospital death with COVID-19.
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30272-2/fulltext