Diabetes and COVID-19: Fact vs. Fiction

Knowledge is power, especially when it comes to diabetes. In the COVID-19 era, separating fact from fiction can literally be the difference between life and death. But information about the pandemic, including diabetes risk, is often wrapped in both myths and politicization.

This is unfortunate since the Centers for Disease Control and Prevention (CDC) is very clear about the link between Type 2 diabetes and severe COVID-19. (Less is known about COVID-19 risks from Type 1 diabetes.) Just as concerning, those infected with COVID-19 may be at higher risk of developing diabetes.

Let's separate fact from fiction:

Myth: Diabetics are more likely to catch COVID-19
Are you at a higher risk of catching COVID-19 if you have diabetes? The answer seems to be no. Diabetes does not seem to increase the likelihood that you will catch the virus.

Fact: Diabetics are more likely to be severely affected by COVID-19
This is, unfortunately, true. Though you're not any more likely to catch COVID-19 than anyone else, you are more likely to have a more serious case. Type 2 diabetics are known to be at higher risk for severe illness, while the CDC states that people with type 1 diabetes *might* be at increased risk.

Myth: Everyone with diabetes is at equal risk from COVID-19
This does not seem to be true. Your risk is lower if you're managing your diabetes well, according to The American Diabetes Association. This appears to be caused by two main factors: First, both COVID-19 and high blood glucose cause inflammation. When combined, they increase inflammation even further, which can make the disease progression more severe. People with unmanaged diabetes are also more likely to have heart disease complications, which can further increase the risk of severe COVID-19 illness.

Fact: Diabetics are at increased risk for diabetic ketoacidosis if infected with COVID-19
This is true when you're sick with any viral infection, especially if you have Type 1 diabetes. Diabetic ketoacidosis happens when your body burns fat rather than glucose for energy. It can lead to coma or even death and can make it harder to manage sepsis — a potential result of severe COVDI-19 infection. If your blood glucose reading is elevated, speak with your doctor promptly.

Myth: There is nothing people with diabetes can do to protect against COVID-19
This is not true. Protect yourself in the same ways as anyone else. Stay home as much as possible, practice social distancing, wear a mask in public, and wash or sanitize your hands often. Also, work with your doctor on a plan to control your diabetes as tightly as possible. This is the best way to reduce your risk of severe illness.

Fact: The rate of diabetes is on the rise among young people
This was true even before the COVID-19 pandemic. Pre-pandemic, new cases of diabetes were declining in adults. But they were going up in youth ages 10-19. The number of adults with prediabetes was also rising.

The pandemic has reduced the number of people seeking preventive healthcare, and the associated economic crisis has increased food insecurity. Because of these trends, new diabetes cases are likely to continue to rise in youth and may lead to an uptick for adults, too.

Unclear: COVID-19 causes diabetes in some people
Though there isn't enough evidence to declare this a fact, it appears that severe COVID-19 infection could cause acute diabetes in some people. This happened with a related coronavirus known as SARS. Some experts have noted a similar possible correlation with COVID-19. Doctors have observed cases of "new-onset diabetes" in patients with COVID-19, noting that diabetes seems to take on more complex pathophysiology when combined with the coronavirus. There is also some tissue-based evidence that the virus may damage insulin-producing cells, which are often already compromised in diabetics.

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