WESTERN CAPE NEWS - The extremely high risk that the novel coronavirus holds for people living with diabetes was highlighted during a digicon today, 16 July, when Western Cape Health head of department Dr Keith Cloete said that their data for the province showed that 42% of people living with diabetes who were hospitalised for Covid-19, had died.
A high percentage of diabetics diagnosed with Covid-19, namely 46,2%, needed to be hospitalised.
"Of those patients of whom we already have an outcome, that is out of 2 201 patients, the mortality rate was 42%."
However, diabetics don’t have an increased risk of becoming infected with the novel coronavirus (Sars-CoV-2), according to their data.
Prof Joel Dave, head of endocrinology at Groote Schuur Hospital, said studies in countries hard hit by Covid-19, showed that the outcomes improve where hospitalised diabetics' blood sugar levels were well controlled.
A study in China showed that people whose diabetes was well controlled during their hospital stay, with a glucose reading of between 4 and 10, had a much better outcome than those who had poorly controlled diabetes with blood glucose greater than 10.
'Diabetics with Covid symptoms must report early'
Dave said it is imperative that diabetics are told that they should report earlier for Covid-19 testing and not wait till they have symptoms severe enough to be hospitalised.
Currently, 80% of diabetics who are admitted to hospital are tested for the very first time on the day of their admission. Of all diabetics who die from Covid-19 in hospital, 65% are tested on the day of their admission or during admission.
“If we could encourage these people to present earlier (for testing), when their symptoms are less severe, then perhaps it will give doctors a chance to intervene and change the outcome.”
Extra capacity has been created for this. Once the person has been diagnosed with Covid-19, they will be risk assessed. Those at highest risk will be admitted to one of the intermediate care facilities for an attempt to control their diabetes. Those who are at moderate risk, can be targeted for monitoring and assistance with controlling their diabetes through telemedicine.
He said even with such strategies in place, it is essential to convey the message to the whole community that “prevention is the name of the game” to avoid those with comorbidities becoming infected.
Global registry
A global registry has been started at Groote Schuur and other hospitals to gather information regarding the possibility of Sars-CoV-2 being able to actually cause diabetes.
“There is some preliminary data from the Sars epidemic 20 years ago showing that during that epidemic there was an increased risk of new-onset diabetes because the spike of that virus was toxic to beta cells (cells that make insulin),” said Dave. “What is slowly emerging from the world now is that there are many patients with newly diagnosed diabetes coming in with Covid-19.
"A number of patients are also for the very first time presenting with one of the dreaded complications of diabetes, namely ketoacidocis (when your blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body). The registry is going to help us answer whether Sars-CoV-2 can actually cause diabetes.”
Dave said over 450 million people in the world live with diabetes. In Africa, South Africa has the highest number of diabetics - and at least 52% of the population do not know they have it.
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