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

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

COVID-19 Vaccine for People with Diabetes: What’s Going On?

The COVID-19 vaccine is here, and like most things dealing with the pandemic, the rollout of both the Pfizer-BioNtech and the Moderna vaccines has been a nightmare. The Trump administration’s Centers for Disease Control and Prevention (CDC) Advisory Committee for Immunization Practices (ACIP) released loose guidelines for states to follow in determining how to disseminate the vaccine but has largely left most of the decisions up to the states. Most people don’t yet know when they’ll receive the vaccine, and on the whole, most states are still in phase 1a, disseminating shots to frontline healthcare workers and those living in long-term care facilities.

In their initial recommendations, people with type 1 diabetes would receive the vaccine further down on the priority list, along with healthy individuals under 65 years old. People with type 2 diabetes are classified as, “at increased risk for severe COVID-19–associated illness”, and are thus to be given priority access in phase 1c, along with people who suffer from other conditions, such as cancer, heart failure, sickle cell disease, chronic obstructive pulmonary disease (COPD), and smoking. Type 1 diabetes is classified as, “might be at increased risk for severe COVID-19-associated illness”, to be given access in phase 2, with other conditions such as being overweight (BMI >25), and suffering from neurologic conditions.

This would put people with type 1 diabetes in the general population rollout, months after not only people with type 2 diabetes have gotten their shots, but behind many other chronic conditions, too. This is a harsh slap in the face for a community that could face so many negative consequences should they contract the virus (not to mention people with diabetes make up 40% of all COVID-19 deaths).

But recent data has come out that people with type 1 diabetes suffer from mortality from COVID-19 at similar rates as people with type 2 diabetes, and a study conducted by Vanderbilt University said people with either type 1 or type 2 diabetes who have COVID-19 have three to four times higher risk of severe complications and hospitalization as compared to people without diabetes.

Several more studies show that having type 1 diabetes is potentially even more dangerous if you contract COVID-19  than having type 2: A Lancet Diabetes & Endocrinology study published last year looked at medical records from the National Health Service in England to conclude that the risk of dying from Covid-19 was almost three times higher for people with type 1 diabetes and almost twice as high for type 2 than for those without diabetes.

In Scotland, another Lancet study said being admitted to an ICU or dying was more than twice as likely for type 1 diabetes patients and nearly 1.5 times more likely for type 2 diabetes patients than for people without diabetes.

People with type 1 diabetes have been told that they live with a disability the entire time they’ve lived with this incurable illness. We’ve sat on the sidelines while going low, been discriminated against in the school and workplace, shut out from certain industries and employers, and know the unique and awful feeling of our skin tightening from a hyperglycemic event after our pump failed for the umpteenth time in our sleep. We require special accommodations, a militant watch on our medication, exercise, insulin, and food intake, and are never offered a break, a day off, or even a hint of affordable insulin.

We live in the unique situation of a dual-reality: having a chronic condition, yet feeling its invisibility every day. We’re never quite “sick enough”; we never “look” diabetic; sometimes, we feel like we don’t even “deserve” the meager accommodations that we get (always pre-board flights, because you’re allowed to!). We live every day with the knowledge that our life expectancy is likely shorter, our days are harder, and especially during this pandemic, many of us have lived in fear of a serious complication should we contract COVID-19 and the bleak consequences we could face. Many of us have stayed home, shut-in, and waited this out, while watching some of our able-bodied peers continue to ignore public health protocols and guidelines.

The end result of the CDC’s recommendations burns and is tangible: states, including Iowa, Illinois, and Virginia, are prioritizing dissemination of the vaccination to people living with type 2 diabetes before people living with type 1 diabetes. Simply put: we’ve been told to stay in, shut up, and wait it out for the vaccine, due to our fragile health condition, and now that the vaccine is here, our disability is yet again being ignored.

Yes, type 2 diabetes is being prioritized and that is right, good, and important, but type 1 diabetes needs to be prioritized, too. They’re not mutually exclusive. Currently, the United Kingdom is not differentiating between type 1 and type 2 diabetes; they are prioritizing people who have either type. Other countries are following suit.

On Tuesday, the Trump administration reversed course, adopting part of president-elect Joe Biden’s distribution plan, advising states to prioritize everyone over the age of 65 and any person with a chronic condition to get the vaccine as soon as possible; states have yet to officially adopt these plans on a wide scale.

Recently, several letters were sent from various diabetes advocacy organizations to the CDC urging them to reconsider their guidelines. Organizations such as T1International, Mutual Aid Diabetes, The American Diabetes Association, JDRF, Beyond Type 1, Children with Diabetes, The diaTribe Foundation, DiabetesSisters, and T1D Exchange have lent their voices to make the needs of the 1.6 million people living with type 1 diabetes in America known.

The bottom line is that we need to curb the tide of this pandemic. Almost 400,000 Americans are dead, with a holiday-related surge in cases, hospitalizations, and death on the way. We need to get shots into as many arms as quickly as possible and stop telling some of our most vulnerable populations that, yet again, they aren’t sick enough to qualify, and that they can wait. We can’t.

Source: diabetesdaily.com

Type 1 Nuclear Pharmacist on Getting a COVID Vaccine

Ann is a nuclear pharmacist who also lives with type 1 diabetes. We chatted with her about her recent experience with the Pfizer COVID-19 vaccine.

Hi Ann! Thank you so much for taking the time to speak to me. I know many people living with diabetes have had a challenging year whether trying to avoid COVID-19 or dealing with the virus itself. Now that a vaccine is available, I know many are wondering if it is right for them.

How long have you been living with type one diabetes?

I was diagnosed in March 1992, a few days before my 7th birthday.

Did having type 1 diabetes impact your decision on what you wanted to do career-wise?

Kind of. I would have loved to try to go to medical school, but I was worried about the difficulty of managing my diabetes throughout such a demanding program.

I understand you are a pharmacist, congrats! I know that takes many years of education and hard work and dedication! At what point did you know that was what you wanted to do?

I started working as a pharmacy cashier when I was in high school. That got me interested in the field of pharmacy.

Where do you work?

I’m a nuclear pharmacist for the University of Oklahoma.

I understand you have a very important role now that the vaccines have arrived at your University. What is your role? And why is it so important that you are all vaccinated?

My pharmacy is preparing all of the vaccine doses for the health sciences campus that we’re a part of. We prepared about 3,700 doses for this initial round. Besides preparing the vaccine, my pharmacy also delivers nuclear medicine doses to hospitals and clinics all around central Oklahoma. Our staff is potentially exposed to COVID during every delivery we make. It would be a devastating loss if multiple staff became infected and we were unable to operate at full capacity.

When you found out you were going to receive the vaccine, what were your initial thoughts?

I was thrilled! I had already made the decision that I would get vaccinated as soon as I had the opportunity.

Ann Kirkpatrick

Photo credit: Ann Kirkpatrick

Did you find most of your colleagues were willing to take it without hesitation? If they were reluctant, what was their reason?

So far, nearly all of our staff has received the vaccine. There are a couple who have had COVID recently, so they will not be getting vaccinated yet.

I understand the vaccine comes in two doses. When will you receive the next one?

I got the Pfizer vaccine. My next dose will be 21 days after my first dose. The Moderna vaccine doses are given 28 days apart.

Have you ever had COVID before?

I’ve never had COVID. People who have had it can still receive the vaccine. One of the current thoughts is that if you still have antibodies, you should wait to get the vaccine, so that others without antibodies may be vaccinated first.

What happens if you are exposed to COVID-19 in the interim before you receive your second dose?

The CDC recommends deferring vaccination until after the quarantine period following a known exposure. It’s best to receive the second dose as close as possible to the 21-day mark (or 28 days for the Moderna vaccine). However, there is no maximum time period between doses.

Did you notice any side effects after receiving the shot? Many are concerned that the shot will elevate their blood sugars. Did you notice any impact on your numbers?

The only effect I noticed was some soreness around the injection site. For me, it was mild and only lasted a couple of days. I did not notice any effect on my blood sugar!

Thank you so much Ann, for answering my questions. I will be sure to check back in with you but thank you so much for doing your part to rid this world of this devastating virus!

Source: diabetesdaily.com

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