Diabetes patients of color face higher COVID-19 risks

Study: Blacks and Hispanics with Type 1 diabetes were three times more likely to be infected and twice as likely to die from the novel coronavirus. 

Black and Hispanic people with COVID-19 and Type 1 diabetes are more likely than Caucasians to die or have serious complications, according to a study recently published in the Journal of Clinical Endocrinology & Metabolism.

The researchers analyzed data from 180 people with Type 1 diabetes and COVID-19 from 52 clinical sites in the United States. The study found Black patients were four times more likely to be hospitalized for diabetic ketoacidosis than Caucasians, even with adjustment for age, sex and insurance status, the report concluded.

Diabetic ketoacidosis is a serious condition in which cells don’t receive enough glucose needed for energy, potentially leading patients to coma or death.  The condition usually occurs when the body does not receive enough insulin.

The study also found that Black and Hispanic patients with diabetes were three times more likely to be infected and twice as likely to die from COVID-19. The same patient population also was less likely to use diabetes technology such as continuous glucose monitors and insulin pumps, and they had worse glycemic control than Caucasian patients.

“When the pandemic started, we had no idea what impact COVID-19 would have on patient with diabetes, and even now there is not a complete understanding,” said Dr. Irl Hirsch, the paper’s senior author and a UW Medicine endocrinologist. “What we did realize is that patients were fighting for their place in line for shots.”

This study is the first systematic examination of racial and ethnic disparities for people with Type 1 diabetes and COVID-19 infection, using a diverse cohort with equal representation among Black and Hispanic groups, Hirsch said.

Blacks comprise 13% of the U.S. population, but represent up to 34% of the U.S. mortality attributed to the novel coronavirus, the report noted. These data underscore the reality that social and health inequities predispose Blacks and Hispanics to adverse outcomes of the pandemic, Hirsch said.

 “It’s the same thing we’ve seen before. It all comes back to access to affordable healthcare and insulin.”

Moreover, severe viral infections such as COVID-19 have been reported to reduce healthy behaviors, which can lead to delays in accessing medical care, the report noted.

These social and structural risks must be identified and mitigated to prevent devastating complications for patients with with Type 1 diabetes and COVID-19, the report states. The evidence of an increased risk of ketoacidosis among Blacks with Type 1 diabetes and COVID-19 supports the case for restructuring healthcare systems to cater to underprivileged communities, and also to develop awareness programs for ketoacidosis recognition and treatment among those patients, the report concluded.

This research received funding from the National Institute of Diabetes and Digestive and Kidney Diseases (K23115896-02, P30DK111022).

– Barbara Clements, 206.221.6706, bac60@uw.edu

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Tags:diabeteshealth equity

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