medwireNews: The risk of severe COVID-19 in people with type 1 diabetes is confined to older people and those with diabetic complications, suggest UK audit data.
“The results from the present study gives reassurance to the younger type 1 diabetes population without diabetes complications with regards to their risk of severe COVID-19,” write the researchers in Diabetologia.
Just five (7%) of the 67 people younger than 55 years died after admission to hospital with or for COVID-19, and 24% had severe disease, defined as death or admission to intensive care.
Three of the younger people who died were admitted to hospital for COVID-19, and two for diabetic ketoacidosis (DKA), and all had microvascular and/or macrovascular complications, notes the team, adding: “There were no deaths in people with type 1 diabetes under the age of 55 years old without diabetic complications.”
By contrast, the mortality rate in older people was 38%, and up to 45% had severe disease.
Rustam Rea (Oxford University Hospitals NHS Foundation Trust, UK) and co-workers used national audit data to identify 194 people with type 1 diabetes who were admitted to hospital with COVID-19 and had outcome data available.
“We recognise that the patient population admitted to hospital are significantly different from the wider type 1 diabetes population and so the conclusions should be restricted to this subgroup of people,” say the researchers.
They found their cohort to have a similar sex and ethnicity distribution to those of the general type 1 diabetes population, but to be older and have worse glycemic control.
After accounting for age, Rea and team found that higher BMI and serum creatinine levels and the presence of microvascular disease were significantly associated with a greater risk for severe disease, with the latter two also associated with mortality risk.
In addition, they found an “unexpected” link between lower blood glucose levels and severe outcomes, which they attribute to the fact that blood glucose was on average lower in people with DKA than those without.
The researchers note that 29% of the 171 people with available data had DKA on admission, whereas this was true for just 7% of people admitted to hospital specifically for the management of type 1 diabetes in 2019.
“Our findings emphasise the importance of supporting people with type 1 diabetes in the community during the pandemic, to minimise the incidence of avoidable admission,” they conclude.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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