Diabetes and COVID-19

The COVID-19 pandemic reshaped our world in unimaginable ways. From lockdowns to lost lives, no one was untouched by the global ripple effect of the virus. But amidst the chaos, an important medical insight emerged: People living with diabetes were disproportionately affected by COVID-19. As scientists scrambled to understand the virus, research began to reveal a dangerous synergy between these two health conditions. Diabetes doesn’t just complicate COVID-19 outcomes; it magnifies them.

Why Are People with Diabetes at Higher Risk?

Diabetes, particularly Type 2 diabetes, is characterised by chronic high blood sugar levels and systemic inflammation. This can lead to compromised immune function, which makes it more difficult for the body to fight infections like COVID-19. When COVID-19 enters the body, it targets the respiratory system, but in diabetic patients, its reach extends further and deeper.

Research published in The Lancet Diabetes & Endocrinology confirms that people with diabetes are up to three times more likely to experience severe COVID-19 complications or death compared to non-diabetics (Apicella et al., 2020).

The Data: What the Numbers Say

• A 2021 global meta-analysis showed that the mortality rate for COVID-19 patients with diabetes was between 21–31%, depending on age and comorbidities (Kumar et al., 2021).
• In Nigeria, a study at the Lagos University Teaching Hospital (LUTH) revealed that 60% of diabetic COVID-19 patients required intensive care, compared to just 30% of non-diabetic patients (Olayinka et al., 2021).
• According to the CDC, diabetes is among the top comorbidities linked to COVID-19 deaths in the U.S., contributing to nearly 40% of COVID-related hospitalisations (CDC, 2022).

How COVID-19 Worsens Diabetes

It’s not a one-way street, COVID-19 doesn’t just impact diabetic patients; it can also trigger new diabetes cases. The virus has been found to damage pancreatic beta cells, the very cells responsible for insulin production.

In a study published by Nature Metabolism, researchers observed that some COVID-19 patients without prior diabetes developed high blood sugar and insulin resistance post-infection, a phenomenon now being studied as COVID-induced diabetes (Montefusco et al., 2021).

Double Burden in Africa

In regions like sub-Saharan Africa, where healthcare systems are often overburdened and under-resourced, the convergence of diabetes and COVID-19 creates a public health nightmare. According to the International Diabetes Federation, Africa saw a 24% increase in diabetes cases during the pandemic years, partly attributed to lifestyle shifts and pandemic-related stress (IDF Diabetes Atlas, 2021).

Coupled with the poor availability of insulin and lack of public awareness, diabetic COVID-19 patients in Africa faced significantly worse outcomes.

Lessons Learned and Next Steps

This dangerous duo taught us many things. Most importantly:

1. Prevention is power. Managing diabetes through healthy diets, exercise, and medication adherence is critical, not just for daily health but also for resilience against pandemics.
2. Vaccination matters. Diabetic patients were, and still are, strongly advised to receive COVID-19 vaccinations due to their heightened risk.
3. Health systems must adapt. Telemedicine, better diabetes screening, and chronic disease management must be part of our pandemic preparedness playbook.

A Call to Action

The intersection of diabetes and COVID-19 is not just a medical issue, it’s a wake-up call. It underscores the importance of chronic disease management as a pillar of infectious disease response. For countries like Nigeria and others across Africa, the time to strengthen healthcare systems, improve diabetes education, and build inclusive public health policies is now.

As we move forward in a post-pandemic world, let’s not forget this powerful lesson: The strength of a society’s health lies in its ability to care for the most vulnerable, especially those living with chronic conditions like diabetes.

Sources:

1. Apicella M, et al. (2020). COVID-19 in people with diabetes: understanding the reasons for worse outcomes. The Lancet Diabetes & Endocrinology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839031/
2. Kumar A, et al. (2021). Is diabetes mellitus associated with mortality and severity of COVID-19? Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 15(1): 211-218. https://pubmed.ncbi.nlm.nih.gov/33381298/
3. Olayinka S, et al. (2021). Clinical outcomes of COVID-19 patients with diabetes at a tertiary hospital in Lagos, Nigeria. Nigerian Medical Journal. https://pubmed.ncbi.nlm.nih.gov/33813755/
4. (2022). COVID-19: People with Certain Medical Conditions. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html
5. Montefusco L, et al. (2021). Acute and long-term disruption of glycometabolic control after SARS-CoV-2 infection. Nature Metabolism. https://www.nature.com/articles/s42255-020-00336-7
6. IDF Diabetes Atlas (10th edition). International Diabetes Federation. https://diabetesatlas.org/
7. Zhu L, et al. (2020). Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes. Cell Metabolism, 31(6), 1068–1077.e3.

WHO. (2021). COVID-19 vaccines and diabetes. https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-(covid-19)-vaccines