Mumbai: With one in 11 Indian adults living with diabetes, the country has the largest share (16.6%) of the world’s diabetics after China.

In the ongoing COVID-19 pandemic, studies show that patients with diabetes face an increased risk of a severe form of the disease and resultant death. Reports from national health centres and hospitals in various countries until April 2020 have shown that patients with diabetes have a 50% higher risk of dying than those without.

In India, 73% of the COVID-19 deaths are linked with comorbidities including diabetes, hypertension, cardiovascular and respiratory diseases.

In the United Kingdom, a study of 30,693 patients across 260 hospitals in England, Scotland and Wales found that South Asians in the region are at a greater risk of dying, partly due to a higher prevalence of pre-existing diabetes. This study has not been peer-reviewed and its preprint was published in The Lancet.

Heightening the risk, more than half (57%) of the 77 million diabetes patients in India are unaware that they are diabetic and hence may not monitor their condition or take steps to control it. Of the patients who have been diagnosed, 20% do not seek treatment and among those who do, 40% have not managed to bring it under control.

More than 75% of diabetes patients are “lost to care”, IndiaSpend reported in July 2019. These patients may be at a higher risk of dying if they contract COVID-19 because of the uncontrolled levels of glucose in their blood.

“Diabetics have lower immunity--not just to the coronavirus but to any illness because of the high glucose,” said Shashank Joshi, endocrinologist and the president of Indian Academy of Diabetes, “Better the glucose control, better the immunity and lower the risk factor. A person with controlled diabetes has significantly lower risk than that of a person with uncontrolled diabetes. But, they still have a higher risk than a normal person.”

COVID-19 has also been linked to onset of diabetes as it affects the pancreas, Joshi said. “New-onset diabetes and severe metabolic complications of preexisting diabetes… have been observed in patients with COVID-19,” said a letter to the editor of the New England Journal of Medicine. The letter from doctors at King’s College London cites three studies conducted in China.

However, given that COVID-19 pandemic is still relatively new, it will take 1-2 years to understand how the disease interacts with other diseases, said Joshi, adding, “We have only seen one season of COVID-19. To understand how it interacts with other diseases, we need to study it for 4-8 seasons.”

(Shreya Raman is a data analyst with IndiaSpend.)

Shreya Raman

    Shreya Raman is an independent data journalist based in Mumbai.