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How Diabetes Increases the Risk of Severe Illness with COVID-19

While all adults are susceptible to the coronavirus and the disease it causes (COVID-19), the severity of illness they experience can vary greatly. Many adults experience flu-like symptoms and recover, but for others it is much more dire. There are several factors that increase a person’s risk of severe illness with COVID-19, including being over the age of 65, heart disease and diabetes. In fact, a new peer-reviewed study from Glytec, published in the Journal of Diabetes Science and Technology found that people with diabetes and/or hyperglycemia have a COVID-19 mortality rate four times higher (29 percent) than people without (6 percent). If you or someone you love has diabetes, here’s what you need to know.

The Difference Between Type 1 Diabetes and Type 2 Diabetes

The main difference between the two types of diabetes is that type 1 diabetes is a genetic disorder that often shows up early in life, and type 2 is largely diet-related and develops over time. If you have type 1 diabetes, your immune system is attacking and destroying the insulin-producing cells in your pancreas. (The pancreas is the flat organ that looks kind of like an elongated, sideways comma and hangs out behind your stomach.)

Type 2 diabetes is more common in the U.S. than type 1, and it is typically caused by lifestyle. With type 2 diabetes, your body still produces a small amount of insulin, but it isn’t effective enough. The pancreas can’t keep up with the high blood sugar levels resulting from poor diet and lack of exercise. Some people with type 2 diabetes actually have “insulin resistance,” which means the pancreas produces insulin but the body does not recognize it (this is different from type 1, in which the insulin-producing cells are being attacked by the immune system). You can learn more about the differences between these two here.

Why COVID-19 Mortality Rates are Higher for People with Diabetes

While much is still being learned about COVID-19 and its effects on different populations, there are a few possible explanations for why people with diabetes are experiencing such severe illness.

According to a recent article in Touch Endocrinology, one reason might be the blood pressure medication many patients with type 2 diabetes take to prevent diabetic nephropathy (kidney disease): angiotensin-converting enzymes (ACE) inhibitors. Patients being treated with ACE inhibitors express a higher level of ACE2 (angiotensin-converting enzyme 2). The coronavirus binds to target cells via this ACE2 enzyme, so it’s been suggested that higher expressions of it could facilitate infection with COVID-19. The bottom line: people who take ACE inhibitors could have an increased risk of severe illness or even death if they are infected with the virus.

Another reason for the increased severity of illness is that many patients with type 2 diabetes are obese, which can put a strain on the respiratory system and cause difficulty breathing. Coronavirus cells attack the respiratory system by infiltrating the lungs and damaging the small sacs responsible for removing the carbon dioxide from your blood and replenishing them with fresh oxygen. The sacs then start filling with liquid, which reduces their capacity and makes it harder to breathe. In obese patients, the lungs are already working overtime, so a combination of the two can be extremely difficult for the body to manage.

How to Protect Yourself from COVID-19

It’s important for everyone to follow the guidelines recommended by the CDC to slow the spread of the coronavirus, but the increased risk for people with diabetes makes it even more crucial for them.

Protect yourself and others from the spread of coronavirus by following these guidelines as strictly as possible:

  • Stay at least six feet away from others at all times
  • Wear a cloth mask over your nose and mouth when leaving your home
  • Stay home unless absolutely necessary (i.e. picking up groceries and medication)
  • Wash hands frequently, with soap for 20 seconds (use hand sanitizer when necessary)
  • Sanitize frequently-touched surfaces regularly (i.e. doorknobs, light switches, faucets)

Symptoms of COVID-19

Be aware of the common symptoms of COVID-19 and contact your healthcare provider immediately if you exhibit any of the following (note that symptoms may not appear until up to 14 days after exposure to the coronavirus):

  • Cough
  • Shortness of breath/difficulty breathing
  • Fever
  • Chills
  • Muscle pain
  • New loss of taste or smell
  • Sore throat

It’s also important to remember that this is not an all-inclusive list of symptoms. Less common symptoms have included gastrointestinal issues as well, like nausea, diarrhea and vomiting.

Call 9-1-1 immediately if you are experiencing any of these emergency symptoms:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

This is also not an exhaustive list. Contact your medical provider if you are experiencing any symptoms that seem severe or concerning to you.

Understand Your Health

Keeping yourself healthy starts with knowing and understanding any conditions or tendencies your body may have so you can be equipped to make the right choices. If you think you might have increased risk factors for COVID-19 but aren’t totally sure, there are a few valuable ways you can get informed about your health:

  • Health screenings are a simple way to equip yourself with accurate information about your health, including risk of heart disease, diabetes and high cholesterol. Life Line Screening has local screening opportunities available for you to gain these invaluable insights. You can learn more about availability and schedule a screening here.
  • Home health tests are another great way for you to get the vital health information you need while staying home and practicing social distancing. Life Line Screening offers several at-home tests, but a particularly relevant one in light of COVID-19 is theA1C Panel, which measures the level of glucose in your blood over the past three months. Everyone should take an A1C test annually as a preventative measure, but it is particularly important if you exhibit risk factors like obesity, family history or high blood pressure. You can learn more about home health tests here.
  • Telehealth is a medical consultation through any kind of remote communication. While lab tests cannot be facilitated through telehealth, a doctor or nurse practitioner is available to help assess any questions you have. Best of all, it can be done from the privacy of your own home. You can learn more about telehealth here.

The Bottom Line

People with diabetes and hyperglycemia are four times as likely to die from COVID-19 than people without. It’s crucial to understand your health and take the proper preventative measures to stay healthy.

A1C panels can determine whether or not you’re at risk for diabetes or prediabetes. If you’re unsure or feel you may exhibit the risk factors, learn more about Life Line Screening’s A1C home test kits today or schedule a screening and get informed about your health.

Learn more or schedule a screening today at — or give us a call at 888.852.8378. We’d love to help.



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