StemCell Therapy

Why does diabetes make people particularly vulnerable to COVID-19? There is no persuasive evidence that this is because they are more likely to catch the virus in the first place and we, as yet, have no answers. Research is underway to understand the biological reasons why diabetes might allow the virus to get a firmer hold. A pro-inflammatory state, vascular damage, and upregulation of ACE2 receptors, all of which are associated with diabetes, have been suggested as potential contributors to severe COVID-19 in people with the condition7. The type of basic science needed to explore the virus mechanisms of attack and its interplay with diabetes takes time and is vital for understanding how we might better protect and care for people living with the condition.

Recently emerging is some limited and anecdotal evidence that COVID-19 might be triggering new cases of type 1 diabetes, accelerated progression of type 2 diabetes, or a new type of diabetes altogether. Again, we need to look to science for answers only long-term studies will reveal whats really going on and, crucially, help to inform care. To find answers, a global database of new cases of diabetes in patients with COVID-19, called the CoviDiab Registry Project, has been established8. The Post-HOSPitalisation COVID-19 (PHOSP COVID) study, a national consortium to understand and improve long-term health outcomes in people who have had the virus, will also shed light on the long-term implications of COVID-19 for people with diabetes.

Investment in science has never been more important. Last year, UK charities, including Diabetes UK, invested 1.9 billion into medical research more than half of all public spending nationally. But the sector is facing a dramatic and deeply concerning drop in income due to COVID-19 and research is at risk. The Association of Medical Research Charities (AMRC) has predicted a 310 million shortfall in research spend in 2020/21, with an estimated four-year recovery period.

AMRC and its members, including Diabetes UK, are urging the Government to commit to the Life Sciences Charity Partnership Fund (support at #Researchatrisk) co-investment scheme. This will allow medical research charities to emerge from this pandemic intact and in a strong position to continue to fund research that transforms healthcare and saves lives. Now more than ever, investment is needed in the sector to mitigate the impact of COVID-19 and future pandemics, on the health of the nation.

References

1 International Diabetes Federation, (2019). IDF Diabetes Atlas, 9th edn.Brussels, Belgium: IDF. Available at: https://www.diabetesatlas.org

2 Estimated from NCVIN (2016), Diabetes Prevalence Model for England + estimated growth between 20152020 from APHO (2010) Prevalence Models for Scotland and Wales.

3 Barron, E., Bakhai, C., Kar, P., Weaver, A., Bradley, D., Ismail, H., Knighton, P., Holman, N., Khunti, K., Sattar, N. and Wareham, N.J., (2020). Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. The Lancet Diabetes & Endocrinology.

4 Diabetes Prevalence Model. Quality and Outcomes Framework (QOF) 2017/18. Public Health England. Available at: https://fingertips.phe.org.uk/profile/diabetes-ft/data

5 Holman, N., Knighton, P., Kar, P., OKeefe, J., Curley, M., Weaver, A., Barron, E., Bakhai, C., Khunti, K., Wareham, N.J. and Sattar, N., (2020). Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study. The Lancet Diabetes & Endocrinology.

6 Williamson, E.J., Walker, A.J., Bhaskaran, K., Bacon, S., Bates, C., Morton, C.E., Curtis, H.J., Mehrkar, A., Evans, D., Inglesby, P. and Cockburn, J., (2020). OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Nature.

7 Apicella, M., Campopiano, M. C., Mantuano, M., Mazoni, L., Coppelli, A., & Del Prato, S. (2020). COVID-19 in people with diabetes: understanding the reasons for worse outcomes. The Lancet Diabetes & Endocrinology.

8 Rubino, F., Amiel, S. A., Zimmet, P., Alberti, G., Bornstein, S., Eckel, R. H., & Del Prato, S. (2020). New-Onset Diabetes in Covid-19. New England Journal of Medicine.

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COVID-19 and diabetes: What do we (not) know? - Open Access Government

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