Health experts are urging people living with diabetes, who have been diagnosed with COVID-19, not to delay in getting medical help should they develop even just a mild form of breathing difficulty.

They say while diabetics are not at greater risk of contracting Covid-19, they are more at risk of developing severe disease or even death.

Scientists estimate that over 50% of South Africans who have diabetes are undiagnosed.

Healthcare specialists say one in four adults in South Africa over the age of 45 have diabetes, making it one of the most pressing health issues in the country. People living with diabetes who develop COVID19 are more likely to be admitted to hospital, more likely to need oxygen in intensive care, and are more likely to die from COVID-19.

But just why are diabetics more prone to severe disease?

“The Ace2 receptor that the virus uses to enter cells is more plentiful in people living with diabetes. People living with diabetes often have a more dysregulated immune response, putting them at risk of more severe infections and developing more severe inflammation. Something that is called a cytokine storm and people living with diabetes are often overweight or obese. They have hypertension and cardiovascular disease and are often older, all of which in their own right have been shown to be risk factors for more severe COVID-19,” says the head of the Groote Schuur Hospital’s endocrinology division, Professor Joel Dave.

A recent UCT study published on the association of diabetes and COVID-19 during the first wave of infections in the Western Cape
showed that of 66 000 people diagnosed with COVID-19, at least 9 000 were people living with diabetes.

“45% of all these people living with diabetes required admission to hospital and if you look at the mortality from COVID-19 during this period, almost 50% were people living diabetes. Interestingly, among the just over 9 000 of people living with diabetes that we diagnosed with COVID-19, about 1 000 were also newly-diagnosed with diabetes and it is thought that in most of them they had pre-existing diabetes,” explains Professor Dave.

People living with diabetes are urged to check their blood glucose regularly, stick to their medications and adhere to a healthy diet.

“High blood sugar has been shown to change some of the proteins in the body that protects us against severe infection in the lungs and that usually protects people against things like blood clots and so forth. And if blood glucose is high, you lose that protection and therefore it is postulated that this is part of the reason for people living with diabetes to have more severe COVID and also more severe rates of death compared to the background population,” says Stellenbosch University Endocrinologist and senior lecturer, Dr Ankia Coetzee.

COVID-19 vaccination is also strongly advised.

“The vaccine has been shown to be as effective in patients with diabetes. There’s no increased risk of adverse effects due to the fact that they have diabetes and it is probably one of the best things individuals with diabetes can do to prevent the severity of COVID-19,” adds Dr Coetzee.

Doctors say while it could be asymptomatic, classic signs of diabetes are increased thirst, frequent urination, especially at night, dizziness and blurred vision.

Tygerberg and Groote Schuur Hospitals are urging people with diabetes to seek immediate medical care if COVID-19 is suspected.

Diabetes at risk of severe COVID-19: