Why having diabetes may increase the risk for severe COVID-19 illness: LSU doctor explains

Published: Apr. 22, 2020 at 4:04 AM CDT
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One in 10 people in the U.S. have diabetes and 1 in 3 adults are pre-diabetic, according to the Centers for Disease Control and the CDC says having diabetes, including Type 1, Type 2, or gestational diabetes may put people at higher risk of severe illness from COVID-19.

In Louisiana, diabetes is second only to hypertension on the list of underlying conditions among those who have died from the novel coronavirus, according to data released this week by the Louisiana Department of Health.

Dr. Lauren Davis is an LSU Health Internal Medicine physician who detailed the disease and how it works.

"Diabetes is a condition that is very serious in that it could lead to a lot of other complications. Some of those complications are kidney disease and that's the one that's most concerning because that's also a risk factor for COVID-19 and a lot of other complications,” Davis said.

Diabetes happens when blood glucose or blood sugar is too high and that can have serious health consequences.

"High blood sugar can affect your kidneys, in that the body is filtering the sugar through the kidney and that causes scarring and changes in the kidney that cause the kidney to no longer do the job that it’s supposed to do which is deal with toxic waste, deal with electrolyte balances and deal with blood pressure control,” said Davis.

Inflammation in the body is also a concern.

"Just diabetes alone with COVID-19 have higher levels of inflammation in their body,” said Davis.

She added that inflammation which is the body’s response to injury and infection could be worse in people with diabetes that is not well-controlled.

“I want to emphasize poorly controlled diabetes which causes very high levels of blood sugars can lead to inflammation in the body. Inflammation is the body's response to infection, and it causes swelling, redness, it's an irritation inside the body that causes the body to try to fight illness. So that when inflammation levels rise that puts patients at risk for sepsis, sepsis is what is causing many patients with COVID-19 to be in critical care states,” Davis stated.

Blood glucose in and of itself is not bad. The National Institute of Diabetes says blood sugar or glucose is the body’s main source of energy and it comes from food that is eaten. Additionally, it says insulin, the hormone made by the pancreas, helps glucose from food get into the body’s cells for energy purposes.

But being overweight can impede that internal process.

"Fat leads to insulin resistance, so the very way that the body controls blood sugar which is insulin is actually not working well when there's excess fat in the body,” Davis said.

And for those who may not have diabetes, healthcare professionals say there are steps they can take to reduce the odds of becoming a diabetic.

"Lifestyle things like not being active are risk factors for developing diabetes and so during this time when we have a lot of free time on our hands, this is the time to get active, even if one is not obese,” said Davis.

She said Type 1 diabetes is often seen in children and is more linked to auto-immune conditions. Type 2 diabetes affects more adults and gestational diabetes impacts some women during pregnancy.

“So, women in pregnancy are at a higher risk of having what looks like a diabetic state and they can recover from that after their pregnancy,” said Davis.