Diabetes + COVID Vaccines: What You Need to Know

This content originally appeared on Beyond Type 1. Republished with permission.

By Lala Jackson

COVID-19 vaccines are here. If you have diabetes and/or other underlying health concerns, you may have questions about timing, safety, and what to expect.

It’s important to remember that having well-controlled diabetes alone does not seem to put anyone more at risk for contracting the novel coronavirus, but other factors like older age, high-exposure employment, consistently elevated blood glucose levels, or other non-diabetes related health factors like obesity and hypertension may increase your risk of infection.

We also know that diabetes care itself is made far more complicated after contracting COVID-19 and protecting anyone with diabetes from getting COVID-19 is our ultimate goal. That’s why we encourage everyone with diabetes to get vaccinated as soon as possible.

Immediate side effects from the vaccines are similar to many people’s experience with the flu shot – soreness at the injection site, general muscle aches, some nausea, and tiredness. Some – but not all – people with diabetes are experiencing slightly elevated blood glucose levels. These side effects are typical, indicate the immune system is learning how to fight the virus, and go away within 24 to 48 hours.

Once you are able to get your vaccine, keep practicing safety measures. A vaccine protects you from severe outcomes from COVID-19, but it may still be possible to spread the virus to others. Keep wearing a mask and keep social distancing to help keep us safe until we’re all safe.

Want a deeper dive? Here’s everything you may want to know:

What Vaccines Are These?

In November 2020, Pfizer and BioNTech announced positive results from the conclusion of their COVID-19 vaccine clinical trials, quickly followed by Moderna. In February 2021, Johnson & Johnson’s announced the same.

Each has now been approved for use in multiple countries across the globe, with a few other vaccines rolling out on a country by country basis. Worldwide, more than 60 other vaccines are in various stages of clinical trials.

Each vaccine went through the standard three phases of clinical trials – Phase 1, where it is administered to a small number of people to show initial safety, Phase 2 to hundreds of people split into groups by things like age, ethnicity, and background to show how different types of people react to the vaccine, then Phase 3, in which it is given to tens of thousands of people, tested against a placebo. Because of the speed needed for development, both vaccines were approved to go through animal clinical trials at the same time as human Phase 1 clinical trials.

To be approved, the FDA requires the vaccine work in at least half of those who receive it. Early analysis from the National Institutes of Health independent data review board (DSMB) saw that 94-95% of those who received the Pfizer/BioNTech and Moderna vaccines in the trials became immune to the coronavirus. Johnson & Johnson’s vaccine showed 66% effectiveness against the virusMost importantly, all three vaccines provide significant protection against severe outcomes from the virus.

The Pfizer/BioNTech and Moderna vaccines are mRNA vaccines, a type of immunization that does not use the real virus in the vaccine, but instead employs a piece of genetic material to create antibodies against the novel coronavirus. Each of the mRNA vaccines requires two doses, given three to four weeks apart. The Johnson & Johnson vaccine is slightly different, which makes it easier to store and only requires one dose.

Other vaccines – different types of immunizations made by multiple companies – are currently in clinical trials with results expected early (and throughout) 2021. More than 50 vaccines are currently going through human clinical trials; in any trial where participants exhibit worrisome symptoms, the trial is paused and cannot proceed until any issues are corrected.

  1. More than 60 vaccines are under development worldwide. In the US, the three currently being distributed are from Pfizer/BioNTech, Moderna, and Johnson & Johnson, with some others being rolled out in certain countries.
  2. All three vaccines approved for emergency use in the US provide protection against severe complications or death from COVID-19. Each vaccine has a slightly different rate of protection against getting the virus at all, but each guarantees protection against the worst outcomes of the disease.
  3. The Moderna vaccine trials had a slightly more diverse participant group but both leading vaccine trials included participants from across races and ethnicities, age ranges, health conditions including type 1 and type 2 diabetes, etc. No specific populations experienced any major issues with the vaccines.

Do COVID Vaccines and Diabetes Mix Well?

People with diabetes in each of the vaccine’s trials have not reported major side effects (read this T1Ds experience in the Moderna COVID-19 vaccine trial). Overall, some clinical trial participants have reported mild side effects of the vaccines, much like how some people experience injection-site soreness, mild lethargy, a low-grade fever after other vaccines. These mild reactions some people experience after vaccines are typical and not cause for alarm – they are a result of the immune system going into action as purposely triggered by the vaccine, creating the ability to fight against the actual virus were a person to be exposed to it.

In the UK, two healthcare workers who received the Pfizer/BioNTech vaccine during initial general population rollout experienced severe allergic reactions for which they administered adrenaline autoinjectors. Both individuals had a history of severe anaphylactoid reactions for which they carry adrenaline autoinjectors anyway, so if you are a person who does tend to experience severe allergic reactions, it is recommended that you not receive the Pfizer/BioNTech vaccine at this time. Other vaccines may be better indicated for your use. If you do not have a history of severe allergic reactions, there is no reason to expect you will experience one from a vaccine.

Because of the mild symptoms experienced by some, it is important to stay vigilant about blood sugar levels for the first 24 to 48 hours after receiving the vaccine. The symptoms may impact your BG, so check your levels frequently, stay hydrated, and be familiar with your sick day routine. The mild symptoms you may experience after the vaccine are significantly safer and more easily managed than potentially getting COVID-19 itself.

As we currently understand, you are not more at risk to catch the novel coronavirus if you have diabetes, but if you do catch the virus, you may be more at risk for more severe complications from COVID-19, particularly if you have been experiencing consistently elevated blood sugar levels.

If you have specific concerns or worries, make sure you speak to a healthcare provider you trust (or keep tuning into Beyond Type 1 coverage of COVID-19 to hear from the healthcare providers we trust, like Dr. Anne Peters).

Read this T1Ds experience in the Moderna COVID-19 vaccine trial

Great, When Can I Get Mine?

While the vaccines rollout in the US started as a bit of a logistical mess, the process is finally starting to get more clear! As of March 31, the CDC classified all people with diabetes as part of priority vaccination groups, updating their previous guidance that only included type 2 diabetes. And as of April 19, the Biden administration has announced that all people aged 16 and above in the US are eligible for the COVID-19 vaccines.

The COVID vaccine rollout is being handled on a state by state basis, which has made finding vaccination appointments a bit tricky. Additionally, many states are falling short in equity – many vaccine appointments are only available online, and some states have limited and hard-to-get-to vaccine locations. If you’re trying to find a vaccine appointment, here are some recommendations:

  • VaccineFinder.org is a medical-professional vetted place to find a convenient vaccination appointment.
  • You can also look up your state health department’s guidelines. Each state generally has a special COVID-19 page where they then list out COVID-19 vaccine eligibility guidelines and locations. Many states have started working with local drug stores and pharmacies; if so, they are often linked to from the state health department website.
  • If it is unclear or you are unsatisfied with what you’ve found, go ahead and reach out to your healthcare provider. Particularly if you have a healthcare provider like an endocrinologist who helps you take care of your diabetes, they may have some insider information on how their hospital or practice is planning to distribute the vaccine. Remember to be kind and patient – healthcare providers are carrying an immense amount and they may not have an answer for you immediately.

What About Kids With Type 1 Diabetes (T1D)?

The Pfizer/BioNTech vaccine is currently approved for ages 16+; they also just requested clearance from the FDA to expand eligibility to ages 12 – 15. Initial COVID-19 vaccine trials were focused on the adult population – both because adults seem more susceptible to severe outcomes from COVID-19, and because trials for those under the age of 18 require a stricter review and approval process.

Starting in 2021 and beyond, more trials are including children so that they may be safely vaccinated against COVID-19 as well. Important to note is that children do not seem to be likely to contract coronavirus or have severe outcomes from the disease. However, as we’ve seen throughout the pandemic, disparities are abundant. Native Hawaiian, Pacific Islander, American Indian, Alaskan Natives, and Hispanic children have experienced significantly higher rates of infection than their peers. Non-Hispanic Black children with T1D who contract COVID-19 are four times more likely to also experience DKA.

So while generally children are less likely to contract the coronavirus, it is important to remain vigilant and continue practicing measures to protect everyone – like wearing a mask and social distancing – to keep everyone safe until we’re all safe.

Still Have Concerns?

Individuals have expressed some hesitation to personal vaccination for COVID-19. This is an understandable feeling – vaccines do not typically make it through development and approval this quickly.

Here’s what we know:

  1. The speed with which the vaccines were developed was unprecedented. However, the clinical trials these vaccines had to go through were strict and the reporting of their safety and efficacy had to be unequivocally proven and replicated. Three phases of clinical trials, including a Phase 3 with tens of thousands of participants, had to prove safety and effectiveness of the vaccines. Phase 3 of the clinical trials were also double-blind, meaning neither the trial participants nor the company that created the vaccine knew if participants were receiving the vaccine or a placebo. Data was reviewed by the National Institutes of Health independent data review board, and final approval for the vaccines must be provided by the FDA’s Vaccines and Related Biological Products Advisory Committee, composed of scientists who have no ties to the companies by which the vaccines were produced.
  2. The Moderna COVID-19 vaccine trial focused on creating a diverse trial participant group, knowing that this is vital to ensuring the vaccine works as intended across populations. 37% of the trial’s participants were from communities of color, which is similar to the US population. The Pfizer and BioNTech trial had less representation, and many of the ongoing trials are not reporting diversity numbers at all. It is vital that each and every trial not only focus on recruiting diverse – across age, race, ethnicity, health background, and more – trial participants to prove safety and effectiveness, but also proactively communicate the effects of their vaccines across groups.
  3. Black, Native (including Pacific Islander), and Latinx communities have been hit hardest by COVID-19 because of systemic and medical racism, with Black Americans dying from COVID-19 at twice the rate of white Americans. Ensuring equitable distribution of the COVID-19 vaccines is vital to work against the deep impact of systemic and medical racism, but this must be coupled with understanding distrust due to violent medical racism throughout the US’s history.
  4. We don’t know for sure what percentage of the population needs to be vaccinated in order to achieve herd immunity, but we do know that the more people who are immune to carrying or spreading the virus, the better. Those who are willing and able to take the vaccine are helping to protect everyone in their community.
  5. If, after doing research from reputable, science-based sources (we recommend science communicators like Jessica Malaty Rivera for easy-to-digest and accurate information), you are still not comfortable taking the vaccine as it becomes available to you, continue to practice safe health measures to protect yourself and others from the novel coronavirus. Until the majority of the population is vaccinated, we cannot rely on herd immunity. We must keep those most vulnerable among us safe until we’re all safe, practicing simple actions like wearing a mask and social distancing to do so.

2020 has been hard; at many times, scary and filled with grief. Working toward getting our communities safe and healthy is important for a multitude of reasons, and will take a united effort. Ensuring you have a plan for when you will get vaccinated once you can is vital to keep yourself and those most vulnerable among us safe until we’re all safe.

Source: diabetesdaily.com

Mental Health Check In: Identifying and Processing Trauma

This content originally appeared on Beyond Type 1. Republished with permission.

By Beyond Type 1 Editorial Team

Over the past year, we’ve collectively faced an intense and stress-inducing time due to COVID-19. Even with some light at the end of the tunnel approaching due to vaccines, we will each be dealing with and processing the ramifications of this past year for some time, and nowhere is that more true than the year’s impact on our mental health. So we spoke with diabetes psychologist Dr. Mark Heyman about how to identify stress versus trauma, when and how to get help, and how often similar issues come up when we’re dealing with diabetes, from diagnosis to low blood sugars and more.

For more mental health + diabetes content, check out Dr. Heyman’s podcast at thediabetespsychologist.com

Watch the Entire Roundtable Discussion in Full:



The following transcript has been edited for content and clarity.

Lala: Today, we’re going to be talking about trauma – how to identify it, some of the tools and resources to help us through it. Dr. Heyman, can you start to give us a little bit of an overview of what trauma is?

Dr. Heyman: The definition of trauma is real or perceived danger and threat of death or serious injury. So if you are in a car accident, if you experience a sexual assault, if you have been diagnosed with diabetes, that is the definition of a trauma. Also, if you have a close friend or family member who has experienced that and you have a belief or an actuality that you’re going to lose them and they’re going to be seriously injured or die in a situation, that’s considered a trauma.

I think that often times trauma is thrown around as a buzzword and as a substitute for stressful situations. And not that stressful situations are not challenging for all of us to deal with, and also I think that there’s a lot of similarities in ongoing stress like COVID, and in quarantine and being in this situation for a long time. But that is not the definition of trauma. The definition of trauma is having an event or sometimes a series of events where you are in danger of dying, or you perceive that you are in danger of serious injury or death.

Lala: What are some of the ways that someone might be able to recognize that they did in fact go through something that their minds and body are processing as a trauma?

When somebody experiences trauma, and I’ll use the example of a car accident as an example here, generally speaking, what happens is your anxiety level increases and that’s a natural thing. We would hope that would happen because it’s your body’s way and your mind’s way of keeping you safe. And what happens is you have a couple of symptoms, oftentimes you have what we call re-experiencing, and so you have either intrusive thoughts, or you have nightmares around that event.

You also have what’s called hypervigilance, which means that for example, the car accident, you may be nervous to see a car or nervous that’s the first time you drive after a car after your car accident. So you’re going to be vigilant and kind of be on guard.

And then the third symptom that we see is what’s called avoidance. And that’s exactly what it sounds like – you avoid situations, people, things that remind you of that trauma. But when those happen, those aren’t problematic in and of themselves, those are actually a really natural response.

What the challenge with trauma is, is when those symptoms of re-experiencing, avoidance, and hypervigilance stay with you and they don’t resolve—because naturally they should resolve—but when you get stuck in those symptoms and you stay there in that hypervigilance, avoiding, re-experiencing state, that’s where it becomes really problematic for us, because the context is different in your life, because you’re not in danger anymore, but your body and your mind is telling you that you are still in danger. And that can cause all kinds of challenges in our functioning and our ability to live in the world in a really effective way.

Lala: I want to go through some of the things that I’ve heard on the internet to debunk and maybe verify some things. One of the phrases that I’ve heard is that you can’t process trauma while you’re in it. Can you clarify that statement?

I think that’s probably a fairly accurate way of putting it, because when you’re in a traumatic event or you’re experiencing a traumatic event, or you’re experiencing ongoing stress, your goal is to keep yourself safe.

And so if you’re on guard because there is a danger coming at you, either perceived or real, and you want to stay alive and your mind is telling you to stay alive, your mind doesn’t have the capacity to process that. Your goal is to stay alive.

It’s kind of like having a low blood sugar – when you’re low, all you want to do is eat and get your blood sugar up, because your body knows that if you don’t do that, you can get yourself into some really big danger and really big trouble there.

And so, not that trauma and low blood sugar are in any way equated, but it’s the same concept your body is telling you, “I need food.” Your body’s telling you, or your mind’s telling you, “I need to get out of this situation.”

And you cannot process something while you are in it, because those symptoms that we just talked about are actually really helpful for you. They’re keeping you safe in that place.

When you’re outside of that situation and those symptoms continue in the long-term, that’s where things get challenging, that’s where the processing really needs to happen.

Lala: If I think I may have been through something, what are some tools I can use to just kind of assess where I’m at? I think in this day and age, we’re often taught to just kind of push through it, and if you just keep going, the bad stuff will go away. But how can someone really look at themselves and figure out if this is something that they might need some help processing?

The simple answer is looking at your behavior and how you are right now and how that’s impacting your ability to live in the world.

Is it impacting your work? Is it impacting your relationships? Is it impacting your sleep? And if you’re having trouble in your relationships because of a diagnosis with diabetes, or because of some other trauma, that’s really making you stay away from relationships or be overdependent on relationships, if you’re having trouble sleeping and you’re having nightmares on a regular basis, and that’s impacting your ability to work, because you’re so tired, if you’re not able to focus on your work, those are some really good signs that you might need help because the trauma is not resolving on its own.

Again, I look back to using the example of a car accident. So imagine that you get in a car accident today, God forbid. And so you get your car towed, you get it fixed, and it comes back to you, and so you go and you get in your car and you drive it for the first time, maybe next week after it’s all fixed up. You’re probably going to be a little bit nervous and that’s normal. You’ve just experienced something pretty traumatic and now you are trying to kind of process that and move through it and show yourself that driving is generally a safe thing, although the thing that happened to you that one time is a one-off, but you’re going to be nervous.

And so you do it, but the more you’re able to drive and see that you’re a safe driving, then the easier it gets. But if the same situation happens and you go to get in the car and you cannot get yourself to open the door, or you can’t get in the car without taking three Xanax. And so you’re avoiding that anxiety in that way, that shows you that you’re not able to function at a high level like you want to. And the trauma is the reason why, and that’s a good sign that you may need some help.

T’ara: While you were talking, I was thinking, this is probably the best example of collective trauma that we’ve been through in our lifetimes with COVID. And I feel like we’re still in that state of hypervigilance and sensing danger, and I think as people with diabetes, we know that our risks of severe complications or even death from COVID are very real. But we are starting to see that sort of light at the end of the tunnel, people are getting vaccinated, but I don’t think that means that the trauma is going to just go away. So what are some ways that we can start to process our traumatic experiences, especially as people with diabetes going forward? What are some tools that we can use?

I think, community is really number one, both using the resource of the community that we have, but also talking about it and just being open about how this experience has impacted all of us, and it impacted us individually and impacted us as a society. I think that’s number one.

I think that the number two thing is really using the data to drive our behavior. I’ve talked to a lot of my patients recently about this, many people who have been very, very isolated because of COVID, both because there’s nothing to do, but also because they have fears about it. And talking about what’s going to happen next, once they get vaccinated or once the world opens up, and there’s a lot of people who are really saying, “I’m not sure I’m going to be going out until 2023.”

And that’s a really kind of scary and a really kind of a hopeless place to be. And my response to that is, up until now and even right now, not going to restaurants, wearing a mask, all of those things, those are really important things. Those are really functional. And those things are keeping us safe.

But there’s going to be a time in the future, hopefully sooner rather than later, when those things are not going to be necessary anymore. And they’re not going to be helpful anymore. And not socializing is not going to be helpful anymore. But if we continue in the belief that we are in danger there, and that goes against what the evidence is showing us, the case rates are down, you’re vaccinated, then you get stuck in this traumatic cycle of not being able to process, not being able to move forward.

And so what I would suggest that people do is of course follow the public health guidelines, do not disregard them. But when the public health guidelines say, “It’s okay to go to the grocery store and not wear a mask,” or, “It’s okay to go to a restaurant and eat inside.” And you may feel a little bit uncomfortable doing that, I would really encourage you to push yourself to do that, because that continued avoidance is going to keep you stuck.

Trauma and traumatic events are very contextual. And when you’re experiencing the trauma, or when you’re in danger, those types of behaviors are keeping you alive. But when the context is different those types of behaviors are keeping you stuck, and it’s important to recognize that context.

And if you’re having trouble recognizing that or having trouble taking those steps when it’s safe, and when it’s objectively safe, that may be a time where you need some professional help, because trauma and PTSD—post traumatic stress, which is that stuck place after a trauma—those things generally don’t resolve on their own. Those are things that really require some help in getting you to a place where you can be more flexible in the world.

T’ara: I’ll even say there is no shame in getting extra help or professional help. I know for me, I started therapy in COVID just because of how scary it is… But even then, we know that this isolation that we’ve been in for a year can definitely take a toll, especially how we interact with one another. How do we make sure that our personal traumas are not impacting others? How do we make sure that we’re not lashing out and taking out our anger and fear on other people?

Each one of us has to do some introspection in, and really make sure that that’s not happening. I think that the first piece of advice is to do that introspection and say, “I’m angry right now, or I’m feeling stressed right now. And I’m lashing out at my friends and family, what’s causing that? Is it them or is it me?”

And maybe it’s them, but most likely, or more likely than not, it may be you, especially kind of given the stress you’ve gone through. And so if you’re able to see that and you’re able to use that introspection and be able to look at yourself from the outside and make change, then that’s really helpful. Also, it can be really helpful when you notice yourself getting that anger or that lashing out, that impulse to lash out is to take a deep breath and just give yourself a beat and see if you can make a choice not to.

If you’re having trouble making that choice, if you’re having trouble being able to choose whether or not you lash out or not, you may need some professional help. But if you’re able to do that on your own, and you’re able to calm yourself down and be intentional about how you respond, you have the ability to do this on your own.

But again as you said, there’s no shame in getting help, because staying in that stuck place, it generally becomes even more stuck and more stuck the longer it happens.

T’ara: Someone close to me went on vacation. They got on a plane travel because they were like, “I am tired. I need a break.” And instead of asking them, “Well, what’s going on? How can I help?” I went straight to, “you shouldn’t be doing this. You shouldn’t be doing that. You’re going to kill yourself. You’re going to kill someone else.” Like just completely lashing out and not recognizing that I was projecting my fear onto that person. 

I think that COVID – I think that in some instances it’s this trauma, but in some instances it’s ongoing stress. And in some ways that can be actually even more challenging to deal with because it’s day-to-day, every day is Groundhog day, same thing over and over again.

And that’s stressful for all of us. And so we feel very boxed in and have a difficulty just being in the world because it’s hard to right now. And so, that sort of stress builds up and then we take it out on other people. I certainly been guilty of that as well.

T’ara: I think what you said about introspection is right. I think, especially as the world kind of starts to open up more people are getting vaccinated. So more people are itching just to get out there. If you’re feeling super strong feelings I would probably say to journal it out, write it down and really analyze where those deep feelings are coming from.

I want to say, when we’re talking about trauma, and if you are looking for professional help around trauma, I would really encourage you to make sure that you find a therapist who knows what they’re doing with trauma. And there’s a couple of reasons I say this.

One is that trauma therapy is hard. It’s hard for the therapist. It’s hard for the person getting the therapy, but it’s also hard for the therapist because the therapist’s job here is really to push the person out of their comfort zone. It’s certainly with compassion. But if someone comes to me who’s experienced trauma and they say, “I’m really worried about leaving my house, because I’m worried that I’m going to have a low blood sugar when I leave my house.” Okay. Fair enough.

If I said, “Well, then, I think what you should do is just stay home. I think we should, in order to keep you calm in order to keep you not stressed, I want you to stay home. And that’s probably a good thing for you.” That’s actually doing the exact opposite of what needs to happen.

What needs to happen is for us to assess the risk. And then if the risk is at an acceptable level, objectively push the person to become uncomfortable. And that’s hard to do. And if you’re not trained to do that well, it’s easy to get trapped in this way of like, “Oh, it’s going to be okay, stay home.” And so finding a therapist who is trained in trauma therapy is important.

T’ara: Can you give some tips on how people can find or at least interview with therapists and make sure that that therapist is actually trained in that? Or if that therapist will be for them? What are some common things that you should ask a potential therapist?

There are a couple of evidence-based treatments for PTSD and for people who’ve experienced trauma. I would say that there are three big ones. One is called prolonged exposure. It’s a therapy where the person is asked to recount the trauma out loud, as a way of processing it, as a way of kind of making sense of it. So making the list of things that are scaring you that you’re not doing, and going and doing them on a greater level.

The other one’s called cognitive processing therapy, which is a cognitive therapy, which really focuses on a couple of different areas, including safety, trust, intimacy, and seeing how the trauma has impacted those areas and really finding ways to reframe your thoughts and then moving your behavior forward in those areas.

And the other one is called EMDR, which is a therapy where it includes bilateral stimulation. So, you know, tapping – it’s evidence-based because it helps the brain to process it, as well as to have those exposures.

So asking a therapist how they treat trauma, and what evidence is in place to support the treatments that they use. If they’re unable to answer that question, they’re not the right therapist for the person who’s experienced trauma. Because therapists who are going to help you dealing with stress with your relationships may not be the right therapist to help you if you’ve experienced a traumatic event like a diabetes diagnosis, like a car accident, a sexual assault or having COVID or having a family member who’s had COVID.

Just like you wouldn’t go see your dermatologist for your diabetes, you don’t want to go see a relationship therapist for a trauma-related issue.

T’ara: Thank you for answering, Dr. Heyman. Those are really good tips. 

Lala: I think my last question, Dr. Heyman – if you have a loved one, that you can see has clearly gone through, or is going through a trauma, but is maybe reticent to recognize that or reticent to get help, what’s the best way that we can lend support to those loved ones who are going through something?

I think the best way is really being transparent about what your observations are about what’s happened to that person, how it has impacted them, and also how that’s impacting you. For example, let’s say that your mom is this person that you’re seeing is having a lot of trouble because of a trauma because of COVID. And that’s impacting her ability to come over to your house for dinner, or to talk to you on the phone for that matter.

So saying, “Mom, I’m really concerned about you because it used to be, we talked on the phone every three days, and now I talk to you on the phone once a month – you seem like you’re having a really hard time. And I really want to regain that relationship. And I want to do whatever I can to do that as well, but I want to let you know that what’s happening for you, seems to be impacting you a lot, but it’s also impacting me. And so what can I do to support you in helping us to get back what we had before?”

And so I think that kind of, that sort of transparency – letting somebody see how what’s happening is impacting them, which they may not be aware of, but also how it’s impacting you. You can give them both sides and hopefully give them the courage and motivation they need to get help if they do need that.

Thank you so much, Dr. Heyman, any closing thoughts on trauma and what we’re all going through?

We’ve all experienced stress over the past year, and it’s been significant. And I think it’s going to be a little bit of a road getting out of this situation. When things get back to ‘normal’ I think it’s going to be hard for all of us to do that, because we’re just so used to being in this place of not doing things and it’s going to be really weird to have people in your house again, or go to a restaurant again.

Be patient with yourself and just give yourself some grace, but also when it’s safe and when the public health officials are letting us know that it’s safe, push yourself to be uncomfortable in those situations. Because the last thing we want to do is continue to get stuck and kind of have this collective trauma impacting our lives in the future.

The more we can push ourselves to get back into a routine that may not feel comfortable right away, just like things didn’t feel comfortable when we started this whole process, we didn’t know what was going on, the same thing is going to be the process for getting out of it.

Because now we’re so used to it. And we’re used to, even though it’s not comfortable at all, we’re used to the discomfort. And so we’re going to have to kind of get back into that. And it’s clearly a process.

So patience and grace, a willingness to seek out support, if you need it, whether it’s friends and family, the diabetes community, or a professional.

Source: diabetesdaily.com

What You Should Know About COVID-19 Vaccines and Diabetes

This content originally appeared on diaTribe. Republished with permission.

By Eliza Skoler and Dr. Francine Kaufman

Last updated: March 22, 2021

COVID-19 vaccines have been authorized for use in the United States and in many parts of the world. We’re here to answer questions for people with diabetes. Are the vaccines safe? How do the vaccines work and does it matter which one I get? What are the side effects, and how will the vaccine affect my blood sugar? What can I do after I am vaccinated?

Now that three COVID-19 vaccines have been authorized for use in the United States, and ten more around the world, many questions are circulating about the vaccines, their safety, and when to get vaccinated. While timing may differ by state and even between sites, people with type 2 diabetes or obesity will be eligible for early vaccination in the US in the coming months, though this may not be the case for millions of others – including those with type 1 diabetes and loved ones who are not currently recommended by CDC to receive the vaccine early. As states begin to distribute the vaccines, we’re here to answer your questions about COVID vaccination in the US; we’ll update this article as more information becomes available.

Click to jump down to a group of questions:

Why get the vaccine?
Why should I get the COVID vaccine?
How does the COVID-19 vaccine work?
How do mRNA vaccines work?​
How do viral vector vaccines work?

Vaccine Safety
Is the vaccine safe for people with diabetes?
Does it matter which vaccine you get?
Which vaccine is best for people with diabetes?​
What are the side effects? Can the vaccine be dangerous?
How will the vaccine affect my blood sugar levels?
Do diabetes medications affect the vaccine?
Should I get vaccinated if I have diabetes and other health conditions?
What is the AstraZeneca vaccine?

Getting the Vaccine
When will people with diabetes get the vaccine?
How will I know when it’s my turn to get the vaccine?
How much does the vaccine cost?
What should I expect at my vaccine appointment?
I had COVID-19 – should I still get vaccinated?
If I have symptoms of COVID-19 now should I get the vaccine?

After Receiving the Vaccine
What happens after I get the vaccine – can I still infect people with COVID?
Can I see people now that I am vaccinated?
Is one dose of the COVID vaccine effective?
Does the vaccine protect against the new variant of COVID?
Can I get COVID from the vaccine?
Are other vaccines coming?
When can I stop wearing a mask?

Why get the vaccine?

Why should I get the COVID vaccine?

The vaccine has the ability to protect you, your loved ones, and your community. It will help your body’s immune system fight off a COVID-19 infection – this means that if you are exposed to COVID, your body can protect you and significantly reduce your chances of getting sick or experiencing severe complications from the virus. Two of the vaccines that are currently authorized in the US (from Pfizer-BioNTech and Moderna) are almost 95% effective at preventing symptoms of COVID in adults who have been exposed, and the third vaccine (Johnson & Johnson) is 85% effective at preventing severe COVID infection. In other words, if you are vaccinated with any of the three and then come into contact with someone who has COVID, you probably won’t get sick.

To stop the global spread of COVID-19, the majority of people around the world will have to become immune to the virus. The COVID vaccine – like the many vaccines that protect us from small pox, measles, the flu, and other illnesses – will play a major role in improving the health and wellbeing of people across the globe.

How does the COVID-19 vaccine work?

There are currently three vaccines that have received emergency use authorization in the US: the Pfizer-BioNTechModerna, and Johnson & Johnson vaccines. The Pfizer-BioNTech and Moderna vaccines are similar – both use messenger RNA (mRNA) to target the “spike proteins” on COVID-19 virus molecules. The Johnson & Johnson vaccine is a viral vector vaccine that also targets the spike proteins.

How do COVID mRNA vaccines work?

mRNA contains genetic instructions (like a blueprint) for making specific proteins in cells. The mRNA in COVID vaccines was developed by scientists to trigger human cells to make harmless COVID spike proteins, and after the proteins are built the vaccine mRNA is destroyed. The body’s immune system then recognizes these foreign proteins and builds antibodies against them. This means that if you are later infected with COVID-19, you’ll have antibodies that recognize the spikes on the viral molecule and can destroy it. To learn more about this process view this detailed, interactive piece from the New York Times.

mRNA vaccines are not “live” vaccines – the live virus is not injected into a person’s body. This means that you cannot get COVID from the vaccine. Similarly, the vaccine will not alter your own genes.

How do COVID viral vector vaccines work?

Similar to an mRNA vaccine, a viral vector vaccine causes the body’s cells to make harmless COVID-19 spike proteins so that it can learn to recognize the foreign proteins and build antibodies against them. Later, if you are infected with COVID-19, your body will have antibodies ready to fight off the virus.

Instead of using mRNA, a viral vector vaccine contains the DNA for a different, harmless virus. In the case of the Johnson & Johnson vaccine, it’s an adenovirus – the type of virus that normally causes a cold or a flu – that has been engineered so that it does not make you sick. Once you get the injection and the virus is inside your body, its DNA can be read by your cellular machinery to produce spike proteins. As your immune system works to fight these foreign proteins, it will learn to protect you from COVID-19. To learn more about this process view a detailed, interactive piece from the New York Times.

Vaccine Safety

Is the vaccine safe for people with diabetes?

All three currently authorized vaccines – Pfizer-BioNTechModerna, and Johnson & Johnson – appear to be safe and effective for adults with diabetes. Rigorous clinical trials tested the safety of these vaccines in adults of all ages, races, and ethnicities, as well as chronic health conditions.

  • The Pfizer-BioNtech trial included 3,150 people with diabetes (8.4% of trial participants).
  • The Moderna trial included 2,858 people with type 1, type 2, and gestational diabetes (9.4% of trial participants).
  • The Johnson & Johnson trial included 3,389 people with type 1 and type 2 diabetes (7.7% of trial participants).
  • In terms of racial and ethnic diversity, the trials each included more than 20% Hispanic or Latino participants, almost 10% African American participants, and almost 5% Asian participants.

These vaccines were advanced quickly thanks to the immense resources provided for COVID vaccine development – even with a speedy process, the vaccine manufacturers had to follow the typical safety steps and thorough checks. Read more from the CDC about how the vaccines work, potential side effects, and details from the human clinical trials.

Does it matter which vaccine you get?

No – all three of the vaccines will protect you and those around you. However, there are some differences between the vaccines that may be important to people with diabetes.

Clinical trials found both mRNA vaccines to be extremely effective in adults – with almost 95% efficacy overall, only one in 20 people that receives the vaccine would get sick from COVID. Among the trial participants with diabetes, the Pfizer-BioNtech was 95% effective and the Moderna vaccine was 100% effective, while the Johnson & Johnson vaccine was 53% effective. Participants were only followed for a few months, so we don’t yet know the long-term effectiveness of these vaccines. As more vaccines are administered there will be more data collected, and hopefully children will be enrolled in clinical trials soon.

What does it mean for these vaccines to be “effective?” If a vaccine is 50% effective it successfully protects half of the people who receive it from getting infected by COVID-19 if they are exposed. If a vaccine is 75% effective, it protects three out of four people from COVID-19 infection. More importantly, all three vaccines are highly effective at preventing severe COVID-19 infection. All three clinical trials found that in people who did get infected after vaccination, the infection was much milder – among people who had received one of the three authorized vaccines, there were almost no deaths or hospitalizations resulting from COVID-19. To learn more about how the three vaccines compare, watch this video.

During early vaccine distribution, you likely won’t have any choice in which vaccine is available to you because there will be a limited supply and the goal is to vaccinate people as quickly as possible. Both mRNA vaccines require two shots, meaning that they are not considered fully effective until you have received both doses, and your immune system has developed protection against the virus (after the second shot). You should receive two shots of the same vaccine (either Pfizer-BioNtech or Moderna). The Johnson & Johnson vaccine only requires one shot.

Which vaccine is best for people with diabetes?Which vaccine is best for people with diabetes?

Due to the distinct design of each clinical trial, it can be hard to directly compare the three vaccines that are currently authorized in the US. However, based on trial data and information from the vaccine manufacturers, here’s the best information we have on how the vaccines compare.

Vaccine data table

Image source: diaTribe

The data show that no matter which of the currently authorized vaccines you get, getting a COVID-19 vaccine is safe and important for people with diabetes. All three vaccines are highly protective against severe COVID illness and death. Click here to watch an in-depth video explaining how the vaccines compare.

What are the side effects? Can the vaccine be dangerous?

When you receive a vaccine for a particular virus, your immune system builds protection against it. Because your body is creating antibodies and learning how to fight the virus or bacteria targeted by the vaccine, you may experience normal side effects for a day or two – this is similar to getting a flu shot, and people with diabetes should monitor their blood sugar levels and have a sick day management plan ready.

According to the CDC, these are the common side effects of the COVID vaccines – they are similar for people with and without diabetes:

  • Pain, swelling, or redness in the vaccinated arm
  • Fever
  • Chills
  • Fatigue
  • Headache
  • Nausea
  • Muscle pain

These side effects are a result of your immune system preparing to combat a future viral infection – they do not mean that you have gotten sick from the vaccine itself. If your side effects don’t go away, contact your healthcare team.

Severe allergic reactions to the COVID vaccine are rare – you can learn more from the CDC here. If you have ever had an allergic reaction to any vaccine, ask your healthcare professional if you should get the COVID vaccine. If you experience a severe allergic reaction to the first dose of the COVID vaccine, do not get the second dose.

How will the vaccine affect my blood sugar levels?

Because the vaccine can cause symptoms of illness that can lead to high glucose levels, it’s important to carefully monitor your blood sugar levels for 48 hours after you receive your vaccination. Stay hydrated, and make sure to have your sick day plan ready in case you feel ill. So far, people with diabetes seem to be experiencing few side effects and minimal effect on blood sugar levels.

Do diabetes medications affect the vaccine?

At this time there is no information available on drug interactions between the authorized COVID vaccines and other medications – this has not yet been studied. However, it is not anticipated that the vaccine itself would interact with insulin or other standard diabetes medications. Note: it may be helpful to avoid injecting insulin or placing a glucose sensor or pump infusion set in your vaccine injection site for several days after vaccination.

Should I get vaccinated if I have diabetes and other health conditions?

People with complications of diabetes (including heart disease and kidney disease) are at much higher risk of severe illness from COVID-19. If you have other health conditions in addition to diabetes, getting the vaccine is especially important.

What is the AstraZeneca vaccine?

New results from the US clinical trial of the AstraZeneca viral vector vaccine show that the vaccine was 79% effective at preventing symptoms of COVID-19 infection, and fully prevented severe illness and hospitalization in more than 32,000 participants. The two-dose AstraZeneca vaccine is currently authorized in Europe and in other countries, but has not yet been authorized for use in the US. The latest clinical trial results show the vaccine to be both safe and effective.

In early March, several countries briefly paused giving people the AstraZeneca COVID vaccine due to concerns about possible rare side effects, including severe blood clots. However, since the data does not show that the vaccine increases the risk of blood clots, the World Health Organization determined that it is safe and that the benefits of the vaccine outweigh any risks. We look forward to updating this article if the AstraZeneca vaccine receives FDA authorized in the US.

Getting the Vaccine

When will people with diabetes get the vaccine?

In most places across the US, people with type 2 diabetes and obesity will be prioritized in the third group of early vaccination (Phase 1c) – this has already begun in some parts of the country. Type 1 diabetes is not currently considered a high-risk medical condition for this phase. Some diabetes experts believe that if you have type 1 diabetes and any evidence of kidney damageheart disease, or obesity with high insulin doses, it’s a good idea to seek vaccination as soon as possible because you may be at high risk for severe illness if you are infected with COVID-19. To learn about the CDC’s recommended stages of vaccination and where you fall in the vaccine line, read Dr. Francine Kaufman’s “When Can I Get the COVID Vaccine if I Have Diabetes?

How will I know when it’s my turn to get the vaccine?

The distribution of vaccines is the responsibility of each state, and states have different plans for vaccinating people. Most states will use networks within hospitals, healthcare offices, and pharmacies to distribute vaccines to residents. Depending on where you live, you may be asked to get on a vaccine waiting list. Click here to see the state by state report from the Kaiser Family Foundation, including who is currently eligible for vaccination in your state. To learn more about your place in the vaccination line, read Dr. Kaufman’s “When Can I Get the COVID Vaccine if I Have Diabetes?” If you have type 2 diabetes or obesity (a body mass index above 30 – check here), contact your healthcare office to ask when and how you can get vaccinated.

How much does the vaccine cost?

You will not have to pay for the COVID vaccine in the US; it will be given to all US residents for free. That said, some vaccination providers may charge an administration fee for delivering the injection. Ask your healthcare office if there will be any costs associated with your vaccination.

What should I expect at my vaccine appointment?

When you get your COVID vaccine, you’ll receive a paper card that says which vaccine you received, and when and where you received it. You’ll also get a fact sheet (paper or electronic) with more information about the vaccine, its benefits, and its side effects. After you get your injection, you’ll be asked to stay on-site for a short period of time so that healthcare professionals can monitor your body’s reaction.

I had COVID-19 – should I still get vaccinated?

Yes – though you can wait up to 90 days after initial onset of your COVID-19 infection. Researchers don’t know how long immunity against the virus can last after natural infection, though evidence suggests that you’re not likely to get sick with COVID again for the first 90 days. You should still get vaccinated for longer-term protection, and the CDC says that you can wait 90 days after the infection before getting your vaccine.

If I have symptoms of COVID-19 now, should I get the vaccine?

If you recently tested positive for COVID-19, are currently experiencing symptoms, or were exposed to someone with COVID, please stay away from other people.

  • If you test positive for COVID, wait until you’ve recovered (as early as 14 days from infection) and up to 90 days before getting the vaccine.
  • If you are experiencing symptoms of COVID, self-isolate and get tested.
  • If you were exposed to someone with COVID, quarantine for 14 days and monitor yourself for symptoms. Get a COVID test. If you do not get sick and your test is negative, get vaccinated once your quarantine period is over.

After Receiving the Vaccine

What happens after I get the vaccine – can I still infect people with COVID?

Once you have received both doses of the vaccine, it should protect you from getting sick with COVID. However, researchers don’t know whether you may be able to carry the virus (without symptoms) and pass it on to others. That’s why it’s still important to maintain safety measures even after receiving the vaccine: wear a face mask that fits you well if you’re in public, avoid contact with people not in your household, social distance from others, wash your hands, and monitor your health. Continuing to follow these measures will help you protect others and your community.

Can I see people now that I am vaccinated?

Two weeks after your final vaccine dose (one dose for Johnson & Johnson, two doses for Pfizer-BioNTech or Moderna) you are considered to be fully vaccinated and protected against severe COVID-19 infection. According to new CDC guidelines, people who are fully vaccinated:

  • Can gather indoors with others who are fully vaccinated, with no need to wear a mask.
  • Do not need to quarantine, stay away from others, or get tested if exposed to someone with COVID – unless you begin to show symptoms of illness.

The CDC also says that people who are fully vaccinated can “visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing.” However, people with diabetes have a higher risk of getting severely ill from COVID-19 (though there’s no greater chance of being infected). For this reason, even if you are vaccinated, please continue to be cautious.

Is one dose of the COVID vaccine effective?

For the Johnson and Johnson vaccine, yes.

For the Pfizer-BioNTech and Moderna vaccines, not entirely. Results from the clinical trials (Pfizer-BioNTechModerna) show that one dose of the vaccine can offer some protection, but two doses of both authorized vaccines are required for full efficacy.

Does the vaccine protect against the new variant of COVID?

Probably, but not certainly. Researchers are still studying the newest variants of COVID-19 to determine how effective current vaccines are at protecting against them. So far, much of the virus structure is unchanged in the variants and the currently-authorized vaccines seem to produce antibodies that recognize variants of COVID-19. Other strains of COVID will likely develop with time (similarly to the flu), and the vaccines can then be tweaked to match the changed threat. Click here to learn more about COVID variants, how they work, and what you can do to protect yourself.

Can I get COVID from the vaccine?

No. The vaccines do not contain the live virus, so they cannot infect you with COVID-19. Side effects that appear after you receive the vaccine occur because your immune system is activating and building antibodies – they are not signs of infection.

After vaccination it takes time for your body to develop full immunity to the virus, so it is still possible to get infected with COVID in the days before or after your vaccination. This does not mean the vaccine did not work; rather, it means that your immune system did not have enough time to build full immunity from the vaccine before coming into contact with the virus.

Are other vaccines coming?

To date, 13 vaccines have been approved for full or limited use around the world. Seventy-eight vaccines are currently in different stages of human clinical trials: 55 are in the early stages and 23 are in the final stages of testing. Hopefully, some of these vaccines will be found to effectively protect against COVID, opening up more vaccination options for people around the world. To track global vaccine development, view the New York Times Coronavirus Vaccine Tracker.

When can I stop wearing a mask?

Even after you get the vaccine you should still wear a face mask whenever you are in public places. Masks will continue helping to shield you from the virus and new variants of COVID (since no vaccine is perfect), and will reduce your chances of spreading COVID-19 to people around you (if you are carrying the virus and don’t have symptoms). As more people get vaccinated, the number of people carrying the virus in your community will decrease, bringing the risk of infection down. Public health authorities will make announcements about this, which may vary from place to place and even with the season.

If you are fully vaccinated, you can begin spending time with others who are fully vaccinated without wearing face masks.

While we await further information and research on COVID vaccines, protect yourself and those around you. For more information, read “Staying Safe – And Staying Well – During a Pandemic Winter” and “COVID Variants, Double Masks, Diabetes, Oh My!

Editor’s note: This article was first published on January 8, 2021, and last updated on March 22.

Dr. Francine Kaufman is Chief Medical Officer at Senseonics, a diabetes device company and Distinguished Professor Emerita of Pediatrics and Communications at the Keck School of Medicine, University of Southern California.

Source: diabetesdaily.com

New Study Shows Greater Risk for Severe COVID-19 Among People with Diabetes

This content originally appeared on diaTribe. Republished with permission.

By Eliza Skoler

New results from the CORONADO study reveal that one in five people with COVID-19 and diabetes die within 28 days of hospital admission. The main predictors of severe illness are older age and diabetes complications. 

In May, the CORONADO study revealed that one in ten people with COVID-19 and diabetes died within seven days of hospital admission. Read our early article on the study here.  New findings from the same study show that one in five people with COVID-19 and diabetes died within 28 days of hospital admission.

In the spring of 2020, the study followed 2,796 people with diabetes in France for 28 days after being admitted to the hospital for COVID-19. The analysis looked at rates of death and rates of discharge from the hospital during the 28-day period. The results revealed that after 28 days, 50% of individuals had been discharged and 21% of individuals had died (29% were still hospitalized). The analysis also looked at other factors in the study population:

  • Average age was 70 years old
  • About 40% had long-term microvascular (such as eye or kidney) or macrovascular (such as heart or leg) complications; 11% had heart failure
  • 78% had high blood pressure
  • Almost two thirds were men
  • 88% had type 2 diabetes, and 12% had type 1 diabetes

Older age, diabetes complications (especially heart disease and high blood pressure), difficulty breathing, use of anticoagulant (blood thinning) medication, and biological markers of inflammation were associated with a lower chance of hospital discharge. Similarly, older age, longer duration of diabetes, and a history of microvascular complications were associated with severe illness and poor outcomes from COVID-19 infection. On the other hand, younger age and metformin use were associated with leaving the hospital by the end of 28 days. As discussed in a previous article, while metformin use was associated with a more favorable health outcome, it was not shown to cause better health. Overall, the factors associated with death were the mirror-opposite of those associated with hospital discharge.

Long-term blood sugar management (measured by A1C) was not found to affect COVID-19 outcomes, though high plasma glucose levels at the time of hospitalization were strongly associated with death. Because glucose levels may be tied to COVID-19 outcomes, careful diabetes management remains important for preventing severe illness.

People with diabetes do not have a higher risk of getting COVID; rather, they are more likely to experience severe illness and worse outcomes if infected with COVID-19. It remains important for people with diabetes, as well as their contacts and loved ones, to do everything possible to stay healthy and safe: get vaccinated as soon as you can, continue to social distance, and wear one (or two!) masks in public. To learn more, read “What You Should Know About COVID-19 Vaccines and Diabetes” and “COVID Variants, Double Masks, Diabetes, Oh My!

Source: diabetesdaily.com

When You Can Expect to Get Your COVID-19 Vaccine

This content originally appeared on Beyond Type 1. Republished with permission.

By Lala Jackson

We now have two FDA-approved and safe COVID-19 vaccines in the US! So as a person with type 1 diabetes, you may be wondering when you can get yours.

The answer? Unclear. It’s all a bit of a logistical mess right now, but here’s what we do know – when you are able to receive your COVID-19 vaccine is dependent on your age, your specific health history (not necessarily whether or not you can check the ‘type 1 diabetes’ box on a form), the state and county in which you live, your employment type, and your healthcare provider’s recommendations.

Overall, having type 1 diabetes does not seem to put anyone more at risk for contracting the novel coronavirus, but other factors like older age, high-exposure employment, consistently elevated blood glucose levels, or other non-diabetes related health factors like obesity and hypertension may increase your risk of infection.

However, we also know that diabetes care itself is made far more complicated after contracting COVID-19 and protecting anyone with diabetes from COVID-19 is our ultimate goal. That’s why Beyond Type 1 has signed onto calls to action urging equal prioritization and is working closely with JDRF, the ADA, and other diabetes patient organizations to advocate for all people with diabetes to be included in Phase 1c of the CDC’s immunization recommendations.

Additionally, because vaccine rollout is happening on a state level, individual advocacy at a state level may be more efficient than federal action. In your community, reach out to your state representatives to let them know that people with any type of diabetes should be included in Phase 1c. Utilize JDRF’s COVID-19 Vaccine Access Toolkit for more resources.

The COVID-19 Vaccine Phased Us Rollout

In the US, the vaccine is being rolled out in phases in *most* states. Already, there are inconsistencies that make it difficult to estimate when you might get a vaccine.

Following approval of the vaccines, the CDC’s Advisory Committee on Immunization Practices created a set of rollout guidelines they recommend for states to follow. These guidelines include phased recommendations for which groups of people should be prioritized to receive the COVID-19 vaccines based on risk factors like older age, underlying health conditions, and lines of work that expose them to COVID-19.

Phase 1a is in process, having begun in December 2020 immediately following the approval of the COVID-19 vaccines in the US. It includes frontline healthcare providers and residents of nursing homes, where COVID-19 cases and deaths have been dramatically highest.

Phase 1b is happening in some states already, includes people over the age of 74, and expands to more frontline workers, including first responders, food and agricultural workers, U.S. Postal Service workers, manufacturing workers, grocery store workers, public transit workers, teachers, and child care workers.

Phase 1c is also happening in some states already, while still several months out others. This phase includes people over the age of 64, anyone else aged 16 or above with medical conditions that increase the risk for severe COVID-19*, and all other essential workers, like those in transportation and logistics, water and wastewater, food service, construction, finance, information technology and communications, energy, legal, media, public safety, and public health workers.

Note that Phase 1c is a BROAD group of people, and this is where things get a bit fuzzy. It is up to each state to control rollout. Many states are following the CDC’s recommendations quite closely, some are following them but not precisely (grouping some phases together, accelerating others), and some have created their own systems, often down to a county-by-county basis.

*What Does This Mean for People With Diabetes?

For people living with diabetes who are not otherwise prioritized because of age or employment type, Phase 1c is the one to look at carefully. As defined by the CDC, people aged 16 or over with medical conditions that increase the risk for severe COVID-19 are included in this phase. But what medical conditions are included?

Short answer – it’s in flux and it depends entirely on your state. Important to remember is that the CDC’s recommendations are just that – recommendations. They have very purposely created guidelines to inform rollout based on most recently available data on high-risk medical conditions, but their guidelines are not meant to be absolute law.

Currently included in Phase 1c recommendations are people with the following conditions: cancer, chronic kidney disease, sickle cell disease, COPD, Down Syndrome, heart conditions, weakened immune systems, obesity, pregnancy, smoking, or Type 2 diabetes.

This means that for those with type 1 or any type of diabetes other than Type 2, you are possibly, depending on your state, not included in the initial rollout and may need to wait to receive your vaccine with the general population, which is likely to be in April 2021 or later.

But don’t panic – as we’ll explain further below, you may still be able to receive the vaccine earlier, based on state or based on your specific health history.

Type 1 Diabetes + COVID-19

Type 1 diabetes itself is not likely to make you more at risk of catching coronavirus. While some have pointed toward the callout of people with immunocompromised systems being in Phase 1c, it is important to remember that having an autoimmune disease (where the immune system attacks itself) is not the same thing as being immunocompromised (where the immune system is susceptible to outside illnesses).

However, other factors associated with T1D may increase your risk of more intense symptoms and severe complications, and if you have to get hospitalized for COVID-19, diabetes care becomes dicey.

This is a piece that has been very confusing and not communicated as clearly as it could be throughout the pandemic – the factors that make a person with any type of diabetes most at risk catching coronavirus and for experiencing severe symptoms and complications of COVID-19 are systemic racism (like being denied or not believed when care is needed), healthcare access issues (like not being able to see a doctor for non-COVID care when needed, or not being able to afford medications and supplies because of job or healthcare loss), consistently elevated blood glucose levels, recent diabetes ketoacidosisjobs that increase exposure to COVID-19, etc.

Type 1 diabetes combined with these factors does create elevated risk. But well-controlled type 1 diabetes on its own does not seem to make someone more at risk of severe illness from COVID-19.

A few studies have raised concerns that outcomes for people with type 1 diabetes who get COVID-19 are far more severe than a person without diabetes, but digging into those studies provides clarity on what’s actually being shown.

  • In May 2020, the UK’s health system released numbers showing severe hospitalization and death rates for people with diabetes. It sounded scary, but what it did not clarify was that additional risk factors like heart disease were of great impact to outcomes, and that the study actually showed that people with type 1 diabetes and no other underlying risk factors like older age or other health history actually did quite well – they were not frequently hospitalized for COVID-19 and those who were had low frequencies of severe outcomes.
  • In December 2020, a similar study was released in Diabetes Care, with a headline saying that COVID-19 severity is tripled in the diabetes community. But again, what it did not immediately clarify was how much the severity was dependent on additional factors, like race (due to long-standing systemic racism), elevated HbA1c, hypertension, lack of diabetes technology, lack of health insurance, less diabetes technology use, etc.

Another study that shows these risk factors well was published in July 2020, outlining the fact that older age and other health-related risk factors were more impactful on severe outcomes than diabetes itself, particularly type 1 diabetes.

Overall, yes – anyone living with diabetes of any type needs to pay careful attention to their health amidst this pandemic. The safest thing anyone can do is practice safety measures to avoid getting COVID-19. For those who cannot – essential workers or people who otherwise have to be exposed to the virus – or those with other underlying health factors, those are the most important factors that must be taken into consideration for priority vaccination.

But just having type 1 diabetes alone, if you are otherwise healthy and not significantly exposed to the virus, should not give you reason to panic. Perhaps more important is ensuring everyone in the general public gets vaccinated as quickly as possible so that diabetes care can be safely accessed, and so hospitals and ICUs are not overwhelmed by COVID-19 patients in the event of emergency diabetes care needs.

How You Get Your Vaccine

Look up your state health department’s guidelines. If it is unclear or you are unsatisfied with what you’ve found, go ahead and reach out to your healthcare provider. Particularly if you have a healthcare provider like an endocrinologist who helps you take care of your diabetes, they may have some insider information on how their hospital or practice is planning to distribute the vaccine.

Remember to be kind and patient – healthcare providers are carrying an immense amount and they may not have an answer for you immediately.

Every vaccine taken decreases the risk and prevents the spread of COVID-19. While it is frustrating to watch the logistical mess, the more people who get vaccinated quickly the better, and in the meantime, continue to practice safe measures that protect you and your loved ones from COVID-19, including doing your best to keep tight control of your blood sugar levels, wearing a mask and physical distancing from anyone outside of your household, and avoiding indoor gatherings.

Source: diabetesdaily.com

Metformin May Reduce Your Risk of Death from COVID-19 Infection

This content originally appeared on diaTribe. Republished with permission.

By Eliza Skoler

The use of metformin – the most common initial medication for people with type 2 diabetes – was associated with a lower rate of mortality from COVID-19 among people with diabetes in a study in Alabama, confirming five previous studies.

Do you take metformin? It’s the first-line therapy used to lower glucose levels in people with type 2 diabetes. A recent study found that metformin use was associated with a lower rate of COVID-related death among people with type 2 diabetes. Since people with diabetes are at increased risk for severe illness from COVID-19, including hospitalization and death, the relationship between metformin and COVID outcomes in this report may be of interest to many people around the world who take the medication.

Want more information like this?

The study looked at the electronic health data from 25,326 people tested for COVID at Birmingham Hospital in Alabama, including healthcare workers, between February and June of 2020. Of those tested, 604 people were positive for COVID-19 – and 239 of those who were positive had diabetes. These results showed that the odds of testing positive for COVID were significantly higher for people, particularly Black people, with certain pre-existing conditions, including diabetes. This does not mean people with diabetes are more likely to get COVID-19, only that people with diabetes were more likely to test positive at this hospital.

Importantly, the study found an association between metformin use and risk of death – the study reported that people who were on metformin before being diagnosed with COVID-19 had a significantly lower chance of dying:

  • People taking metformin had an 11% mortality (or death) rate, compared to 24% for those with type 2 diabetes not on metformin when admitted to the hospital.
  • This benefit of metformin remained even when people with type 2 diabetes and kidney disease or chronic heart failure were excluded from the calculations. This is important because people with kidney or heart disease are often advised against taking metformin. By removing this population, it helps to support the notion that metformin may be involved in this difference.
  • Body weight and A1C were not associated with mortality among people with diabetes taking metformin. This suggests that the association of metformin use with reduced COVID-related deaths was not due to the effects of the medication on weight or glucose management.

The data suggest that being a person with diabetes who takes metformin may provide some level of protection against severe COVID-19 infection among people with diabetes. Other studies have shown similar results, though it is not known whether metformin may itself reduce COVID-related deaths among people with type 2 diabetes. The authors discussed some previously reported effects of metformin beyond lowering glucose levels, such as reducing high levels of inflammation (the body’s natural way of fighting infection), which has been described as a risk factor in severe COVID infection. Severe infection with COVID-19, resulting in hospital admission, can lead to damage to the kidneys and decreased oxygen supply to the body’s tissues – and in these circumstances, serious side effects of metformin can occur.

“Given that COVID leads to higher mortality rates and more complicated hospital courses in people with diabetes, it is important to consider whether specific diabetes medications can provide some relative degree of protection against poor COVID outcomes,” said Dr. Tim Garvey, an endocrinologist at the University of Alabama at Birmingham. “This study adds to growing evidence that people with type 2 diabetes treated with metformin have better outcomes than those not receiving metformin.”

Dr. Garvey also cautioned: “Of course, these case-control studies show associations and do not rise to the level of evidence that might be found by a randomized clinical trial. For example, people with diabetes not treated with the first-line drug, metformin, may have a larger number of diabetes complications or longer duration of disease compared with people not on metformin – which could explain the more severe outcomes. In any event, we advocate for early administration of COVID-19 vaccines and other protective measures for people with diabetes.”

Professor Philip Home, a professor of diabetes medicine at Newcastle University in the UK, agreed, saying, “Multiple studies have now addressed the issue of whether metformin and insulin use are associated with better or worse outcomes in people with diabetes who contract COVID-19. In line with previous literature on other diseases, it was expected that people on metformin would do better, and people on insulin worse, than people with diabetes not using these medications. This is confirmed.”

Home continued: “It is believed to happen because people using metformin are younger and have better kidney function than those not taking the medication, while those on insulin tend to have other medical conditions. The good news is that if you have type 2 diabetes and are taking metformin, you are likely to be fitter than if you have type 2 diabetes and do not take the medication – but there is no evidence that metformin itself will make a difference to your outcome if you do get COVID-19. So, get vaccinated as soon as possible!”

To learn more about metformin, read “Everything You Always Wanted to Know About Metformin, But Were Afraid to Ask.”

Source: diabetesdaily.com

Getting the Most Out of Your Remote Healthcare Visits

This content originally appeared on Integrated Diabetes Services. Republished with permission.

By Gary Scheiner MS, CDCES

A long, long time ago, before the days of coronavirus, there was a little diabetes care practice called Integrated Diabetes Services (we’ll just call it IDS for short). IDS taught people with diabetes all the wonderful things they can do to manage their diabetes. Word got out, and people who lived far from IDS’s local hamlet (better known as Philadelphia) wanted to work with IDS. Even people IN the hamlet wanted to work with IDS but were often too busy to make the trip to the office. So IDS had an idea: “Let’s offer our services via phone and the internet so that everybody who wants to work with us can work with us!” The idea took off, and IDS grew and grew.

And virtual diabetes care was born.

Today, in response to the COVID-19 pandemic, virtual healthcare has become a virtual norm. Often referred to as “telehealth” or “telemedicine,” people with diabetes are connecting with their healthcare providers for everything from medical appointments to self-management education to coaching sessions. Some consults are conducted via phone calls, while others utilize web-based video programs (like Zoom) or simple email or text messages. Regardless of the form, virtual care can be highly effective. But it can also have its limitations. Whether you’ve been receiving virtual healthcare for months or have yet to give it a try, it pays to learn how to use it effectively. Because virtual care will certainly outlive the pandemic.

What Can… and Can’t… Be Accomplished Virtually

Most diabetes care services, including medical treatment and self-management education, can be provided effectively on a remote basis. We have managed to teach our clients everything from advanced carb counting techniques to strength training routines to self-analysis of glucose monitoring data, all while helping them fine-tune their insulin program, on a 100% virtual basis.

Some clinics and private healthcare providers have gone 100% virtual since the pandemic began, while others are using a “hybrid” approach – periodic in-person appointments with virtual care in-between. Depending on the reason you’re seeking care, a hybrid approach makes a lot of sense. While virtual visits are generally more efficient and economical (and in many cases safer) than in-person appointments, there are some things that are challenging to accomplish on a remote basis. From a diabetes standpoint, this includes:

  • Checking the skin for overused injection sites
  • Learning how to use medical devices (especially for the first time)
  • Examining the thyroid gland and lymph nodes
  • Evaluating glucose data (unless you can download and transmit data to your provider)
  • Performing a professional foot exam
  • Listening to the heart rhythm and feeling peripheral pulses
  • Checking for signs of neuropathy and retinopathy
  • Measuring vital signs (unless you have equipment for doing so at home)

The Logistics

Virtual care can be provided in a variety of ways, ranging from a phone call to an email, text message or video conference. Video can add a great deal to the quality of a consultation, as it allows you and your healthcare provider to pick up on body language and other visual cues. It also permits demonstrations (such as how to estimate a 1-cup portion of food), evaluation of your techniques (such as how to insert a pump infusion set), and use of a marker board for demonstrating complex subjects (such as injection site rotation or how certain medications work).

When using video, it is important to have access to high-speed internet. A computer is almost always better than a phone for video appointments, as the screen is larger and has better resolution. If you have the ability to download your diabetes data, do so and share access with your healthcare provider a day or two prior to the appointment. It may also be helpful to share some of your “vital” signs at the time of the appointment – a thermometer, scale, and blood pressure cuff are good to have at home.

In many cases, care provided on a remote/virtual basis is covered by health insurance at the same level as an in-person appointment. This applies to public as well as private health insurance. However, some plans require your provider to perform specific functions during the consultation (such as reviewing glucose data) in order for the appointment to qualify for coverage. Best to check with your healthcare provider when scheduling the appointment to make sure the virtual service will be covered. At our practice (which is 100% private-pay), virtual and in-person services are charged at the same rates.

If security is of the utmost importance to you, virtual care may not be your best option. Although there are web-based programs and apps that meet HIPPA guidelines, there really is no way to guarantee who has access to your information at the other end. My advice is to weigh the many benefits of virtual care against the (minuscule) security risk that virtual care poses.

Optimizing the Virtual Experience

Just like in-person appointments, virtual care can be HIGHLY productive if you do a little bit of preparation.

  • Do yourself and your healthcare provider a favor and download your devices, including meters, pumps, CGMs, and any logging apps you may be using, prior to the appointment. If you don’t know how to download, ask your healthcare provider for instructions, or contact our office… we can set up a virtual consultation and show you how. If you have not downloaded your information before, don’t be intimidated. It is easier than you think. People in their 80s and 90s can do it. Oh, and look over the data yourself before the appointment so that you can have a productive discussion with your healthcare provider.
  • Be prepared with a list of your current medications, including doses and when you take them. Check before the appointment to see if you need refills on any of your medications or supplies. If you take insulin, have all the details available: basal doses (and timing), bolus/mealtime doses (and dosing formulas if you use insulin:carb ratios), correction formulas (for fixing highs/lows), and adjustments for physical activity.
  • Try to get your labwork done prior to virtual appointments. This will give your healthcare provider important information about how your current program is working.
  • To enhance the quality of the virtual meeting, do your best to cut down the background noise (TV off, pets in another room, etc…) and distractions (get someone to watch the kids). Use of a headset may be preferable to using the speakers/microphone on your phone or computer, especially if there is background noise or you have limited hearing.
  • Use a large screen/monitor so that it will be easy to see details and do screen-sharing. And use front lighting rather than rear lighting. When the lights or window are behind you, you may look more like a black shadow than your beautiful self. “Ring” lights are popular for providing front-lighting.
  • Provide some of your own vitals if possible – weight, temperature, blood pressure, current blood sugar. This is important information that your healthcare provider can use to enhance your care.
  • Prepare a list of topics/questions that you want to discuss. Ideally, write them on paper so that you can take notes during the appointment. If there is a great deal of detail covered, ask your healthcare provider to send you an appointment summary by mail or email.
  • Be in a private place that allows you to speak openly and show any body parts that might need to be examined – including your feet and injection/infusion sites.
  • Be a patient patient! Technical issues can sometimes happen. It is perfectly fine to switch to a basic phone call or reschedule for another time.
  • Courtesy. Be on-time for your virtual appointment. If you are delayed, call your healthcare provider’s office to let them know. And if you are not sure how to login or use the video conferencing system, call your provider beforehand for detailed instructions. This will help to avoid delays. Have your calendar handy so that a follow-up can be scheduled right away. Oh, one other thing: Try not to be eating during the appointment… it is distracting and a bit rude. However, treating a low blood sugar is always permissible!

If there is one thing we’ve learned during the pandemic, it’s that virtual care is a win-win for just about everybody. Expect it to grow in use long after the pandemic. In-person care will never go away completely, but for treating/managing a condition like diabetes, virtual care has a lot to offer… especially if you use it wisely.

Note: Gary Scheiner is Owner and Clinical Director of Integrated Diabetes Services, a private practice specializing in advanced education and intensive glucose management for insulin users. Consultations are available in-person and worldwide via phone and internet. For more information, visit Integrated Diabetes.com, email sales@integrateddiabetes.com, or call (877) 735-3648; outside North America, call + 1-610-642-6055.

Source: diabetesdaily.com

Is COVID-19 Causing a Diabetes Epidemic?

As the COVID-19 pandemic rages on into its second year, researchers have discovered a new, disturbing trend: there has been a statistically significant rise in both type 1 and type 2 diabetes diagnoses observed in patients after an experience of severe COVID-19. Even more disturbing is that nearly 14.4% of people who are hospitalized with COVID-19 go on to have either a type 1 or type 2 diabetes diagnosis, according to a November 2020 study that followed nearly 4,000 patients with severe COVID-19 infections.

It’s too early to tell if these forms of diabetes are permanent or temporary, but the correlation between severe COVID-19 cases and the development of diabetes is strong.

It’s well known that viruses can sometimes trigger diabetes. When someone contracts a virus, the immune system starts mounting a defense to fight it, mostly with T-cells. Sometimes the body will overreact, and start destroying its own pancreatic beta cells, the result being type 1 diabetes.

Scientists believe the same thing may be happening in the case of COVID-19 patients. Traditionally, COVID-19 has been an attack on the lungs, but a host of other issues and complications have come to light from sufferers of “long-haul COVID”: neurological disorders, blood clots, kidney failure, heart damage, and now many believe an epidemic of both type 1 and type 2 diabetes diagnoses may soon be added to the list.

The association between other coronaviruses and the development of diabetes has been made in the past during the SARS outbreak as well.

After the 2003 SARS pandemic, Chinese researchers tracked 39 patients who had developed high blood sugar levels characteristic of a diabetes diagnosis, within days of hospitalization with the disease. For all but six, blood sugar levels had returned to normal by their hospital discharge, and only two still had diabetes after two years.

This isn’t entirely new, either. Doctors in Wuhan, China reported a link between COVID-19 and elevated blood sugar levels back in April 2020. Italian scientists also looked into whether higher blood sugar levels could lead to a diagnosis of diabetes. That study, from May 2020, admitted more research needed to be conducted before a conclusion was reached.

Because COVID-19 is a global pandemic and the link to new diabetes cases has been observed in multiple countries, researchers globally are collecting data points about those patients in a registry called CoviDIAB.

Scientists do not know whether COVID-19 might exacerbate already developing issues or actually cause them; some believe it’s both. Many people who have had COVID-19 and have gone on to develop type 2 diabetes already have existing risk factors, such as obesity and a family history of the disease. Perhaps the increased medical attention sought out by people suffering from COVID-19 has detected the disease early, when a diagnosis was inevitable later on down the line anyway. Some medical experts believe that more people are getting medical attention than ever before, being closely monitored by experts in the field, and are unveiling underlying issues that may have been there all along.

Another theory is that elevated blood sugar levels also are common among those taking dexamethasone, a steroid that is a common treatment for COVID-19. Steroid-induced diabetes is rare, but not unheard of, and may trigger diabetes in people who have no known health risks for the disease.

“Researchers are working like crazy to see if COVID attacks the beta cells of the pancreas, which makes insulin,” pediatrician Dr. Dyan Hes said. “Some studies feel that they do, but other studies have been repeatedly saying it is not attracted to the beta-cell.”

How exactly the two conditions are connected isn’t quite clear yet, but a prominent theory is that the COVID-19 virus destroys or alters insulin-producing beta cells in the pancreas possibly by binding to ACE2 receptors, according to a short letter published in the New England Journal of Medicine.

Whatever the association is, researchers from the journal of Diabetes, Obesity, and Metabolism say a direct effect of COVID-19 on the development of diabetes, “should be considered.”

Francesco Rubino, a diabetes surgery professor at King’s College London, is convinced there is a connection between the two conditions and has been tracking and studying the phenomenon since early last year. “We really need to dig deeper, but it sounds like we do have a real problem with COVID and diabetes.”

Additionally, Rubino thinks the type of diabetes being developed as a result of COVID-19 may be a hybrid form, something of a cross between type 1 and type 2. His findings show that the symptoms in these patients have some characteristics of each form of diabetes, which he finds concerning.

Researchers are also now seeing a rise in type 2 diabetes diagnoses in children who have had asymptomatic COVID-19, which is even more troubling, as many schools are back in session, many public places do not require masks on children, and the tipping point of a diabetes epidemic may rest solely on the shoulders of our youngest, most vulnerable citizens.

This can also complicate a few things for people: firstly, that neither the Pfizer-BioNtech nor the Moderna COVID-19 vaccines are approved for children, and secondly, that type 1 diabetes is not being prioritized on the Centers for Disease Control and Prevention’s list for vaccine dissemination. States are able to follow their guidance or dismiss it out of hand, but federally, there is no coordination to prioritize the population.

With nearly 10% (34 million people) of the United States already affected by diabetes, and another 100 million living with prediabetes, the tidal wave of COVID-19 cases could very well send our country into catastrophe fighting two disasters at once: both uncontrolled community spread of COVID-19 along with a (COVID-triggered) explosion of new diabetes diagnoses, especially in children. This would not only send our country into panic mode but could also completely overwhelm our already fragile health care system that everyone is so heavily relying on.

Scientists are rushing to find the exact connection between severe COVID-19 cases and new diagnoses of diabetes, but between diabetes being a major risk factor for death in COVID-19 cases (nearly 40% of COVID-19 deaths have been in patients with diabetes), along with the increased risk of developing diabetes from a severe bout of COVID-19, one thing is for sure: we need to find the connection and fast and get the diabetes community and those at risk for diabetes vaccinated as quickly as possible. We don’t have time to waste.

 

Source: diabetesdaily.com

Survey Reveals the Heavy Burden of the Pandemic on People with Diabetes

The COVID-19 pandemic has now been ongoing for over a year, and even with the light finally visible at the end of the tunnel, it is undoubtable that it will have lasting effects, for years to come.

Late in 2020, we partnered with the American Diabetes Association (ADA) to conduct a survey-based analysis to assess the effects of the COVID-19 pandemic on Americans living with diabetes.

Approximately 2,600 responses were collected from the Thrivable online patient panel. People from all 50 states shared their experiences during the pandemic, describing the impacts on access to healthcare, food, outlook on receiving a COVID-19 vaccine, and more.

Key Findings: Reduced Health Care and Food Access

  • About 4 of 10 Americans with diabetes delayed seeking routine medical care, with more than 50% stating the fear of COVID-19 exposure was the primary reason.
  • About 1 in 5 Americans with diabetes have foregone or delayed getting an insulin pump or continuous glucose monitor (CGM).
  • More than 1 in 4 stated their access to healthy food was reduced, with about 1 in 5 relying on food assistance programs.
  • Almost half who receive assistance report that the food they receive negatively affects their diabetes management.
  • About 1 in 5 people who receive nutritional assistance report not having enough food to eat.

Moreover, about 1 in 5 Americans with diabetes have reported having to choose between buying food vs. affording their diabetes supplies.

The effects of the COVID-19 pandemic are widespread and span across multiple facets of people’s lives. For people with diabetes, many of whom are already struggling to afford their healthcare expenses, the financial effects of the pandemic may be particularly grim.

Perspectives on the COVID-19 Vaccine

When asked about their comfort level of receiving a COVID-19 vaccine as soon as it is made available to them, people with diabetes reported being more likely to want to receive it right away as compared to data collected from the general population.

Less than half as many people with diabetes stated that they would never want to get the vaccine as compared to data on the general population (10% vs. 21%, respectively).

It is perhaps not surprising that people with diabetes feel more strongly about receiving a COVID-19 vaccine than the general population. Currently, the Centers for Disease Control and Prevention (CDC) state that people with type 2 diabetes  “are at increased risk  of severe illness” from COVID-19, while people with type 1 diabetesmight be at an increased risk for severe illness.”

Other Insights: Barriers to Clinical Trials Participation

In addition to exploring the financial burden of the pandemic and assessing readiness to receive a COVID-19 vaccine, we also gathered information regarding previous participation or willingness to participate in a clinical trial. As per the recent press release,

“People with diabetes have participated infrequently in clinical drug trials in the past (only 11% report having done so), but the majority – 60% – say they are likely or very likely to participate in such a study in the future. Yet nearly a quarter of those who responded to the survey said they didn’t know how to participate in a drug trial if they wanted to do so.”

Check out the full press release from the ADA as well as the more data below:

New Data Alert: COVID-19 Brings Crisis of Access for Millions Living with Diabetes

Effects of the COVID-19 Pandemic on People with Diabetes

Methodology and Panel Demographics

These figures are based on Thrivable’s survey of more than 2,500 people with diabetes nationally, between December 7th and December 14th, 2020

  • A multiple-choice survey was distributed online to people with diabetes (U.S. residents) who signed up for the Thrivable Insights panel.
  • Participants were not compensated for their responses.
  • Data was analyzed using Qualtrics and Excel.
  • Details on panel breakdown include:
    • N = 2,595
    • o 47% with type 1 diabetes, 53% type 2
    • o 69% female, 31% male
    • o All 50 U.S. states are represented

Source: diabetesdaily.com

COVID-19 Vaccine: Experience and Thoughts from the Diabetes Community

We are almost one year into the COVID-19 pandemic and while it is still causing devastation, there is light at the end of the tunnel thanks to two companies, Pfizer and Moderna, now offering a vaccine.

It varies by state but healthcare workers and people over 75 years (over 65 in some states) are the first in line. After that, people with high-risk, pre-existing conditions will be next. See here to find out your exact eligibility per state.

Many people have mixed feelings about the vaccine. Some are certain they will get it, not only because they don’t believe the vaccine is at all harmful but because they want life to go back to normal as soon as possible, while also protecting their health. Others are reluctant, possibly questioning the novelty and quick turnaround of the vaccine and wondering if there may be unforeseen side effects.

We thought it would be nice to hear from people like ourselves, who also live with diabetes, and see how they feel about getting vaccinated. We also spoke to some people who have already received the vaccine and heard about their experiences with side effects.

We asked our own Diabetes Daily forum members and the diabetes online community and here is what they had to say:

My wife with type 2 diabetes also suffers from COPD, bronchitis, and asthma. Accordingly, she would have a problem surviving COVID, so we have both registered with the NJ Covid Registry and will take the vaccine as soon as it becomes available. ~ Don1942

As I see it, two of these vaccines (Pfizer and Moderna) use a completely new and untested approach called mRNA. They were tested for only a short term on young, healthy adults. Animal, medium, and long-term testing were bypassed entirely. No testing on those with various health issues, and no testing for drug interactions. They only claim to reduce the number of symptoms. Zero claims are made about keeping you from getting or transmitting the virus. Last statement verified by Fauci saying anti-social distancing, lockdowns, and masking will still apply once you have had the vaccine. Then there are the 3+% of those who are vaccinated who suffer worse side effects than the symptoms the drug is supposed to reduce, keeping in mind that in the age groups tested only 1% would ever show any symptoms at all.

Finally the manufacturers take zero fiscal responsibility for bad outcomes. If they don’t believe their drugs are safe, why should I? ~ BobCan2

I have a nephew that has a doctorate in biochemistry (currently working on gene therapy). Said “I would take any of the vaccines in a second.” His wife also an MD has had the Moderna vaccine. I have a niece that is working on her doctorate in microbiology who has had the vaccine. So yes, I will take it. ~ 1986

I’m a no. Given my recent extended exposure, I’m not concerned. I’ll gladly wait for herd immunity. ~ HaoleBoy

I am a surgeon. I got the first dose of the Moderna vaccine. Just a sore arm. I have reviewed all of the science presented to the FDA and have no concerns. Glad to have access! ~ Dr. Carrie D.

So I voted yes… I’ve stated before that I used to be in the vaccine industry and I trust the science and the process. It’s not new technology being used. ~ Jughed

I’m getting the Moderna vaccine on Monday. I am a special education teacher in WI and we are the first group identified in the school district. Blessing! ~ Melissa R.

I think most people of my age remember friends getting polio, and I also remember giving my father chickenpox, which made him very, very ill; so having seen the miracles these vaccines did for quality of life, and preventing unnecessary deaths, I know I am very much pro-vaccination. My name will go down for a vaccine when it finally arrives here, hopefully, next month. I’m eligible for priority vaccination because of my age and a couple of chronic conditions.

I am 81 years old and a type 1 diabetic for 75 years. I am very high risk if I have the COVID virus. I am scheduled for the vaccine on Wed, Jan 21. My only hesitance is that the vaccine is being given in the gym complex at the local high school. I will probably encounter several individuals in the parking lot, while entering the building, inside the building, etc. In some states, people are receiving the vaccine without getting out of their cars. I wish it was done that way here where I live. ~ Richard `57

I am getting mine next weekend. I am 100% behind the science and haven’t given it a negative thought. Bring it on! ~ Susan K.

I’ll have it as soon as it’s offered. I am just recovering from COVID and it is awful. Sugars were terrible. I never want it again if I can help it. ~ Michelle R.

I will not be getting one. Mostly because I can’t help but think childhood vaccines play a major role in type 1 diabetes in the first place as vaccines are designed to trigger the immune system. ~ Fabian B.

I plan on getting the J&J one once it’s approved. I’m uncomfortable with the speed of the first two on the market, despite all I know everyone is saying. I feel better about the slow poke even if it’s irrational. ~ Caroline L.

Nope, nope and nope again. ~Kristin R.

I won’t be giving it to my son or myself. ~ Julie P.

I plan on getting one. In Nebraska, people living with diabetes are now eligible. ~ Wendy G.

My daughter is type 1 but it is not approved for children yet but she will not receive one and will remain not vaccinated as she always has been. ~ Stefanie R.

Here is what the people who have already received the vaccine had to say:

I had both doses. I’m 10 days out and still feel very run down. I was COVID-tested yesterday because it felt like a mild case but was negative. I received the vaccine 2 weeks ago and no side effects. Type 1 for 55 years. ~ Cindi H.

Tolerated both injections. Side effects were mild, with some deep muscle soreness, at least for me. I did note some insulin resistance post injections. ~ Chris A.

I got my first dose a couple of weeks ago and will get my next one in two weeks. I just had a sore arm and a little fatigued the next day. By the third day, I felt pretty normal. I didn’t notice any changes to my insulin sensitivity or blood sugar levels. ~ Karissa G.

I received both doses. My only issues were headache, fatigue, and chills.

COVID vaccine update #2: 24 hours later, I don’t feel horrible, but definitely off. Some body aches, headache and overall sluggishness. I went to bed at about 8:30 and “slept” till 10:30. (with my saul dog interruptions and the baby kicking my bladder, etc.)” ~ Nicole M.

I had mine because I work for the National Health Service and I had no side effects at all. ~ Kate B.

I was nauseous after my first dose for about 12 hours. I took a Zofran and was fine. ~ Jamie B.

I did have side effects (pain, mild fever) but I won’t hesitate to go for the second shot.

I have completed the series and just had a sore arm for a couple of days each time.

No side effects beyond a sore arm. I like the peace of mind and I did extensive research before getting it to fully understand what I was getting into. ~ Sarah R.

My 82-year old identical twin sisters each received the first dose. One got the Pfizer and the other the Moderna. No adverse reactions thus far. The one that got the Pfizer has allergies so was a bit concerned but had no reaction. ~ Auburn75

It should be mandatory that vaccines like this are taken. It’s not a conspiracy theory. There aren’t robots in the vaccine. This whole virus story isn’t a hoax, and this hasn’t been started because some people are simply trying to make some money. The sheer lunacy I’ve seen out there is beyond description. Some people think the world is flat. I’ve gotten both doses and have had zero side effects. ~ Sheralyn B.

I received my first vaccine on Jan 8 with minimal side effects being a sore arm and mild low blood sugars. On Jan 27 I received my second vaccine. Initially only had a sore arm and headache but after 36 hours, developed mild fever of 99.7, body aches, headache, continued low blood sugars, and a grape side swollen lymph node in my armpit, the arm I received my vaccine in. Fever and swollen lymph node improved with Tylenol and Ibuprofen! ~ Carlie W.

Will you be getting the vaccine once it is available to you? Have you had one or both doses and experienced side effects? Share and comment below!

Source: diabetesdaily.com

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