Covid and diabetes collide in public health trainwreck

Diabetes is an insidious disease that greatly increases the risk of premature blindness, stroke, and circulatory and neurological problems that can lead to infections that require amputation of gangrened toes and feet. As with many chronic diseases, diabetes is diagnosed in the poor and people of colour disproportionately higher rates. Black and Hispanic Americans are more than twice as likely to be diagnosed with diabetes as whites, and lack of access to medical care can make it difficult for them to juggle the complex diet, monitoring, and treatment regimens that can stave off devastating complications. While there’s much researchers don’t understand, many believe uncontrolled diabetes greatly increases the dangers of a Covid diagnosis. That’s because a sedentary lifestyle, weight gain, or lack of blood sugar control promote chronic inflammation in the body, which can increase insulin resistance and weaken the immune system.

Inflammation triggers the release of cytokines, tiny proteins that regulate the body’s immune response to infection or injury. Cytokines are a critical part of the normal healing process, but in people with diabetes and underlying chronic inflammation, all of these cytokines can damage healthy tissue. It turns out that Covid can provoke an uncontrolled release of cytokines, and the resulting “cytokine storm” can wreak havoc on vital organs like the lungs, leading to dire consequences and death.

People with type 2 diabetes tend to do worse than people with type 1 diabetes, partly because people with type 1 diabetes tend to be younger.

In some ways, the pandemic has come a long way positive Impact on diabetes care through increased adoption of technologies that enable remote management of the disease. The raised embrace of telemedicinefor example, has enabled healthcare providers to identify a worrisome foot sore in a homebound patient.

At the beginning of the pandemic, the Food and Drug Administration made hospitals and long-term care facilities available permission Distribute continuous glucose monitors to coronavirus patients to reduce risks to healthcare workers. Clinicians have also learned the nuances of caring for hospitalized diabetics with Covid through more intensive monitoring and control of blood sugar levels.

But many advances are unevenly distributed. Those who don’t have insurance can’t afford the latest glucose monitoring or insulin delivery devices, and in economically disadvantaged communities with low digital literacy, experts say doctors are less likely to offer new technologies and treatments to Black and Hispanic patients, even if they’re through one insurance are covered.

“The advances in recent years have been amazing, but not everyone has access to them and that’s just tragic,” said Dr. Ruth S. Weinstock, board member of the American Diabetes Association.

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