July 24, 2020
Why diabetes must not be forgotten in the global fight against COVID-19
The International Diabetes Federation is highlighting three major concerns for people living with diabetes during the COVID-19 crisis.
By Andrew Boulton
The coronavirus (COVID-19) pandemic has caused shockwaves around the world, with people’s lives suddenly turned upside down. As governments deploy social distancing measures and other restrictions to protect citizens, millions of people living with chronic health problems continue to rely on the care, advice and treatment they need to manage their condition. People living with diabetes are no exception.
The latest figures from the International Diabetes Federation (IDF) show that around 463 million people (10% of the global adult population) live with diabetes. The condition is a leading cause of several life-threatening or debilitating complications, including blindness, heart attack, stroke, lower-limb amputation and kidney failure. IDF is highlighting three major concerns for people living with diabetes during the COVID-19 crisis: vulnerability, access to care, and physical and mental well-being.
People living with diabetes, particularly those with poorly managed blood glucose levels and some of the chronic complications, are more vulnerable to the severe effects of COVID-19. When people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels. Unfortunately, the coronavirus crisis has led to some healthcare systems having to suspend routine clinic appointments for those with underlying health conditions – including people with diabetes.
Studies indicate that, depending on the global region, up to half of those admitted to hospital with COVID-19 live with diabetes. For these people, it is suggested the risk of death from the virus may be 50% higher, particularly older people living with type 2 diabetes. The risk posed by COVID-19 in young people with type 1 appears to be much lower, providing they have access to satisfactory healthcare and good control of their diabetes.
IDF is highlighting three major concerns for people living with diabetes during the COVID-19 crisis: vulnerability, access to care, and physical and mental well-being.
The restrictions put in place to fight the spread of COVID-19 in many countries, such as temporarily closing or limiting access to healthcare facilities and services, reallocating healthcare resources and interrupting screening programmes, have disrupted the delivery of care for the treatment and prevention of non-communicable diseases (NCDs) like diabetes. According to an assessment conducted by the World Health Organization in May, 62% of countries surveyed reported disruptions to services to treat diabetes and its complications.
People living with diabetes require uninterrupted access to medicines, supplies, technologies and care. People with type 1 diabetes, for example, require insulin to survive. Disruption to medical supplies and care resulting from the pandemic can make it more difficult for people with diabetes to manage their condition and can increase the chances of diabetes complications in the longer term if not addressed. Governments must take the necessary steps to ensure that people with diabetes and other NCDs have uninterrupted access to the care and treatment they need.
Regular physical activity and a balanced diet are important in managing diabetes and preventing complications. The introduction of physical distancing measures to tackle COVID-19 has reduced opportunities to exercise and made it more difficult to stick to a healthy diet. For some, the pandemic has been a considerable cause of stress.
Along with the real harm that restrictions to accessing care can create, any uncertainty is likely to cause increased anxiety for people living with diabetes and their families. Many are experiencing financial difficulties as the global economy continues to struggle due to the pandemic.
We have received reports of people with diabetes avoiding healthcare facilities for fear of contracting COVID-19. For example, in the UK, most people who have cancelled appointments have diabetes, cardiovascular problems or respiratory issues. As a result, there is a concern that down the line many countries may see a spike in diabetes complications.
A story we hear repeatedly from IDF’s member associations is that many with diabetes are fearful of catching coronavirus if they leave their homes. They seek reassurance that it is still safe to attend healthcare appointments or decide it would be better to stay away.
Along with the real harm that restrictions to accessing care can create, any uncertainty is likely to cause increased anxiety for people living with diabetes and their families.
It is critical that governments recognise people with diabetes can be more vulnerable to COVID-19 and are at increased risk of the worst possible outcome. Measures to reduce potential exposure to the virus are therefore of great importance. At the same time, people with diabetes need to be able to manage a complicated condition. Access to care and supplies must be maintained to protect them from serious complications.
People living with diabetes are advised to seek urgent medical attention if they feel unwell and are suffering from any coronavirus symptoms, such as a continuous cough and a fever. IDF is offering advice about the precautions those with diabetes should take during the pandemic. Information, including guidance on how to best maintain physical and mental health, can be found at www.idf.org/covid-19.
Prof. Andrew Boulton is President of the International Diabetes Federation, 2020-21