Coronavirus UK: A quarter of patients who died had diabetes - Daily Mail

A QUARTER of all COVID-19 patients who died in hospitals in England had diabetes, NHS figures reveal

• NHS England has published a breakdown of deaths by pre-existing conditions 
• Some 26 per cent of people who have died since March 31 had diabetes
• The chronic condition affects some four million Britons and may lower immunity
• Figures show that almost one fifth of COVID-19 hospital victims had dementia
• Here’s how to help people impacted by Covid-19

By Vanessa Chalmers Health Reporter For Mailonline

Published: 16:49 BST, 14 May 2020 | Updated: 19:42 BST, 14 May 2020

A quarter of COVID-19 patients who have died in hospitals in England had diabetes, according to official figures.

For the first time, NHS England has published a breakdown of deaths by pre-existing conditions. Only five per cent of victims didn't have an underlying issue.

Of the 22,332 patients who died since March 31, when pre-existing conditions began to be reported, some 5,873 (26 per cent) of patients had diabetes.

The condition - affecting around 4million Britons - makes people more susceptible to developing infections.

High blood sugar levels can weaken the patient's immune system defense, making it slower to respond to viruses such as SARS-CoV-2. 

It's also closely connected with obesity, which has been recognised as potential risk factors for suffering severe COVID-19 complications. 

Doctors today said diabetics would have better COVID-19 outcomes if they managed their condition properly. 

NHS England figures also revealed almost one fifth of COVID-19 victims in hospitals had dementia and 15 per cent had COPD. 

A quarter of COVID-19 patients who have died in hospitals in England had diabetes, according to official figures from NHS England. Almost one fifth of COVID-19 victims in hospitals had dementia and 15 per cent had COPD

The Government's official death tally shows that 33,614 people have died of COVID-19 in the UK, including 24,100 in hospitals in England.   

From today, the NHS has started to publish rolling information on the conditions of COVID-19 victims. 

Of those that have occurred since March 31 (22,332), 5,873 patients who died were suffering from diabetes.

Diabetes is a common condition affecting an estimated one in 16 people in the UK. That includes both diagnosed and undiagnosed people.

WHY DOES DIABETES RAISE THE RISK OF COVID-19? 

Diabetes puts people at a higher risk of developing severe COVID-19 because it makes the immune system weaker, scientists say.

The illness, which affects more than four million people in the UK, is caused by abnormal levels of sugar in the blood. For most people this takes the form of Type 2 diabetes, in which there is too much sugar in the blood.

This, researchers, say, thickens the blood and reduces its ability to carry substances around the body at speed.

Dr Hajira Dambha-Miller, a GP and specialist in diabetes, said a patient's blood becomes 'like treacle' as a result of high sugar levels.

'Physically, it's harder for the immune system to get to the virus,' she said. 'The virus bugs do a lot of damage before the immune system even realises it's there.'

Therefore, when someone is infected with the coronavirus, it may take longer for their body to respond and fight it off, and the response may be less effective when it does begin.

Their illness doesn't make a diabetic person any more likely to catch the virus itself - that is indiscriminate - just less likely to be able to recover quickly.

Dr Dambha-Miller added: 'When the body does kick in, it won't work as it should do. The immune cells are damaged because they've been saturated in sugar for years and don't work the way they should.'  

The American Diabetes Association says it's not clear if COVID-19 will pose a difference in risk between type 1 and type 2 diabetes.

But the risk of getting very sick from COVID-19 is likely to be lower if diabetes is well-managed no matter whether it is type 1 or type 2.

The Association explains that people who have diabetes often have other health problems, such as obesity, heart disease or high blood pressure, which in turn contribute more to their risk of dying with COVID-19.

The ADA said: 'Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19, like other viral infections, because your body’s ability to fight off an infection is compromised.

'Viral infections can also increase inflammation, or internal swelling, in people with diabetes. This is also caused by above-target blood sugars, and both could contribute to more severe complications.' 

People of black African or Caribbean, or south Asian, backgrounds are more likely to develop diabetes and have also been found to be at more risk of dying if they catch the coronavirus.

Dr Hajira Dambha-Miller, a GP and specialist in diabetes, said she was not surprised by the data.

She told MailOnline: 'People with diabetes are more susceptible to infections, even if we are not in the middle of a pandemic.

'Diabetes leads to greater susceptibility to infection because there is more sugar for bugs to grow on and chronic inflammation means the immune system is slower to clear it.'

Dr Dambha-Miller said when someone has diabetes, their blood becomes 'like treacle' as a result of high sugar levels.

'Physically, it's harder for the immune system to get to the virus,' she said. 'The virus bugs do a lot of damage before the immune system even realises it's there.

'When the body does kick in, it won't work as it should do. The immune cells are damaged because they've been saturated in sugar for years and don't work the way they should.' 

Management of diabetes is notoriously difficult. It involves dealing with short term events, such as high and low blood sugar, as well as understanding how to cope with the condition in the long term.  

NHS England did not specify whether those who died had type 1 and type 2 diabetes. But experts say the risks of adverse outcomes from COVID-19 is likely to be lower if either type are well-managed.

Dr Damnha-Miller said: 'The better the sugar control, the better the outcomes for people with diabetes. If people are really careful about sugar control, over the long term, this will be helpful in improving outcomes. There is tonnes of evidence on this from everyday infections like flu or colds.' 

Diabetes is linked to obesity and ethnicity - both of which have independently been identified as risk factors for COVID-19 disease severity. 

Nine in ten of diabetics are type 2, which is offset by an unhealthy lifestyle. Rising diagnoses of type 2 diabetes parallels soaring obesity levels. 

Ethnicity plays a big role in the prevalence of diabetes - it is four times more prevalent in Bangladeshi and Indian people.  

Pakistani women are five times more likely to develop diabetes, and Indian have an increased risk of 2.5-fold, according to the charity Diabetes.co.uk. 

Generally speaking diabetes prevalence is often six times higher for people of South Asian origin and three times higher for those of African origin.  

Emerging evidence linking obesity and ethnicity with COVID-19 has prompted an investigation by Public Health England. 

A major study in Glasgow last week found obesity may double the risk of needing hospitalisation for COVID-19. 

Dr Hajira Dambha-Miller, a GP and specialist in diabetes, said better management of the disease would improve outcomes. Stock: Glucometer used to manage the condition 

EIGHT MILLION BRITS WITH HEALTH CONDITIONS 'SHOULD BE EXEMPT FROM RETURNING TO WORK' 

Eight million Britons with underlying health conditions should be exempt from going back to work when the coronavirus lockdown eases, scientists say.

Experts at University College London and Cambridge University fear not protecting society's most vulnerable could see UK's death toll rise to 73,000 within a year.

One in five people - more than 8million people in Britain - are at a higher risk of dying if they catch COVID-19 because of their age or poor health.  

But most of this group are not deemed 'extremely clinically vulnerable' people, who were asked to 'shield' for 12 weeks by the Department of Health. 

Britons with long-term conditions such as heart disease and diabetes would make up between 80 and 90 per cent of the fatalities, the researchers calculated.

And they said it means another 30,000 Brits could die unless everyone at high-risk is protected for as long as possible and not forced back to work post lockdown. 

In a separate, worst-case scenario estimate they predicted up to 590,000 deaths if the government did nothing and 80 per cent of the population were infected within a year.  

Office for National Statistics data today suggested more than 40,000 people have already died with COVID-19, confirming Britain's status as the worst-hit nation in Europe. But the researchers said this is set to rise much higher. 

If 10 per cent of people in England are allowed to catch the virus, the scientists said - and four per cent are already thought to have done so - the death toll could double. 

Lead author Dr Amitava Banerjee, of the UCL Institute of Health Informatics, said: 'I don’t think they should be rushing to go back to work until we have made sure that the infection rate is down, that transport is set up and that workplaces are safe.' 

The study, published in The Lancet, looked at the medical records of 3.8million people and predicted what could happen after lockdown.

It said vulnerable people – including all over-70s and those who have high blood pressure or asthma – make up 20 per cent of the British population.

Dr Banerjee said: 'This group is more likely to be admitted to hospital, to go to intensive care and to die.

'Why are we even discussing them going back to work at this stage?'

And Government data shows the risk of dying from the coronavirus is 'significantly' higher among some ethnic groups compared to white people, when age was taken into account.

For example Black people are four times more likely to die from the virus, which only reduced by half when taking health conditions and other factors into account.

Charity Diabetes UK said the figures show an 'urgent' need for more information to ensure the safety of those with diabetes as lockdown measures are eased.  

Diabetics are among the most vulnerable to severe COVID-19, but are not considered 'extremely high risk' by the Government. 

They are able to leave their homes for exercise and to get medication, unlike those with rare cancers or organ recipients who should not leave their home under any condition.  

Bridget Turner, director of policy at Diabetes UK, said: 'The fact that more than a quarter of people who have died with COVID19 have diabetes underlines the urgent need to ensure better protection and extra support is available to those in the clinically vulnerable groups. 

'We still urgently need to understand through research why people with diabetes are affected in such numbers. But until we know more, people living with diabetes should be supported to manage their condition. 

'Government must ensure urgently that employers take all the necessary measures to keep employees with diabetes safe, if they are expected to attend work outside the home as restrictions are eased,' she said.

'This includes ensuring the guidance for employers is clear, consistent, and focused on the safety of employees above all else.' 

Dementia was the second most common condition linked with COVID-19 deaths - 18 per cent of victims had the memory disease. 

Following that was COPD, (chronic obstructive pulmonary disease), which covers a number of lung conditions. Nearly one in seven of COVID-19 victims had COPD.   

Some 14 per cent of victims had kidney disease, 10 per cent had ischaemic heart disease and seven per cent had asthma.   

NHS England said the accuracy of the data is reliant on the availability and transfer of information by healthcare providers, and patients may have had more than one pre-existing condition. 

It comes after a study warned more than 8million people in Britain are at a higher risk of dying if they catch COVID-19 because of their age or poor health. 

But most of this group are not deemed 'extremely clinically vulnerable' people, who were asked to 'shield' for 12 weeks by the Department of Health.

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2020-05-14 19:02:32Z
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