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How covid and diabetes collide in a public health train wreck

    Diabetes is an insidious disease that significantly increases the risk of premature blindness, stroke, and circulatory and neurological disorders that can lead to infections requiring amputation of gangrenous toes and feet. As with many chronic conditions, the poor and people of color are disproportionately diagnosed with diabetes. Black and Latino Americans are more than twice as likely to receive a diabetes diagnosis as whites, and inadequate access to medical care can make it harder for them to juggle the complex diet, monitoring and treatment regimens that are driving the devastating can prevent complications. While there is much that researchers fail to understand, many believe that uncontrolled diabetes greatly increases the dangers of a Covid diagnosis. That’s because a sedentary lifestyle, extra weight, or not closely monitoring blood sugar levels fuel chronic inflammation in the body, which can increase insulin resistance and weaken the immune system.

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

    People with type 2 diabetes tend to fare worse than people with type 1, in part because people with type 1 tend to be younger.

    In some ways, the pandemic has already had some positive effects on diabetes care by increasing the adoption of technology that enables remote management of the disease. For example, the increased adoption of telemedicine has made it possible for health care providers to notice a worrisome foot wound in a home-bound patient.

    Early in the pandemic, the Food and Drug Administration authorized hospitals and long-term care facilities to distribute continuous glucose monitoring devices to coronavirus patients as a way to reduce risks to health professionals. Doctors have also learned the nuances of caring for hospitalized diabetics with Covid through more intensive monitoring and management of blood sugar levels.

    But many claims are unevenly distributed. The uninsured 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 covered by a health insurance policy. insurance.

    β€œThe progress in recent years has been amazing, but not everyone has access to it and that’s just tragic,” said Dr. Ruth S. Weinstock, board member of the American Diabetes Association.