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Type2 diabetes is on the CDCs list of covid comorbidities but Type1 is not.
So I went through all the journal articles the CDC cites, expecting to see covid has worse outcomes for T2Ds than T1Ds. The articles either show the opposite, or dont distinguish between T2/T1
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So I went through all the journal articles the CDC cites, expecting to see covid has worse outcomes for T2Ds than T1Ds. The articles either show the opposite, or dont distinguish between T2/T1
A thread
This matters because most states are using the CDCs list of comorbidities to determine vaccine priority. Right now, since Type 1 Diabetes is not considered a comorbidity, T1 Diabetics are lumped in with the general population. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/evidence-table.html
The CDC cites 5 studies that look at diabetics. In four of these studies, the authors do not distinguish between T1 and T2 diabetes. In all of them, they find significantly more diabetics dying of covid then there are in the population.
"Diabetics have worse outcomes than non-diabetics" is a really solid result across all covid studies. But because there are just so many more type 2 diabetics than type 1 (90% of diabetics in USA have T2), this research is being assumed to only apply to type 2's.
The ONLY study which noted which diabetics are T1 and which are T2 is a study on all covid deaths that took place in England March-May 2020. They find the odds ratio for dying from covid in hospital is were 3.51 (95% CI 3.16–3.90) for T1Ds and 2.03 (1.97–2.09) for T2Ds.
T1Ds had a much higher odds ratio with "dying from covid" than T2 did. EVEN when controlling for things like heart disease, the confidence intervals never overlapped.
And to put an odds ratio of 3.51 into perspective, the OR of being 70-79 is 2.64.
And to put an odds ratio of 3.51 into perspective, the OR of being 70-79 is 2.64.
The point is-- the CDC cites a lot of research showing bad outcomes for diabetics. But they generally cant separate those effects for T1 and T2, and the only study that does finds that T1 is way more correlated with death-from-covid than both T2 diabetes AND "being 79 years old"
TL;DR If you are writing medical papers about covid, PLEASE note which patients are T1 and T2Ds. And if you are the CDC, PLEASE take another look at this scant literature. Diabetes = T2D + T1D in 4/5 studies. And in the 1 study where they are looked at independently, T1D is worse
References:
Among people already hospitilized for covid, mortality rate for diabetics 28.8 compared to 6.2 for non diabetics. "Diabetes" defined as anyone with an A1C greater than or equal to 6.5. https://pubmed.ncbi.nlm.nih.gov/32389027/
Among people already hospitilized for covid, mortality rate for diabetics 28.8 compared to 6.2 for non diabetics. "Diabetes" defined as anyone with an A1C greater than or equal to 6.5. https://pubmed.ncbi.nlm.nih.gov/32389027/
Population wide UK study of all hospitalizations in England between March - May 2020. They use logit model to examine the effect of diabetes BY TYPE on in-hospital death with covid, adjusting for demographics and cardiovascular comorbidities.
https://www.thelancet.com/action/showPdf?pii=S2213-8587%2820%2930272-2
https://www.thelancet.com/action/showPdf?pii=S2213-8587%2820%2930272-2
For 5,700 patients in NYC hospitals the most common comorbidities were hypertension, obesity, and diabetes. (no distinguishing between types) https://jamanetwork.com/journals/jama/fullarticle/2765184
900 patients in Wuhan, 135 with T2 diabetes, 1 with T1 diabetes.
https://care.diabetesjournals.org/content/diacare/early/2020/05/13/dc20-0660.full.pdf
https://care.diabetesjournals.org/content/diacare/early/2020/05/13/dc20-0660.full.pdf
Paper from March 2020 on early outcomes from Wuhan and Italy. Technically a meta-analysis, but small and old https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103097/
