Reflecting on type 2 diabetes and COVID-19
An updated version of this analysis was published in the June 11, 2020, edition of the Winnipeg Free Press. Click here.
The term “underlying conditions” has become a convenient catch-all for measuring, understanding, and reporting the worst effects of COVID-19.
The implication is clear. Bluntly speaking, if you have certain health conditions when you contract COVID-19, you are more likely to become ill and you are more likely to die.
Researchers are starting to learn more about these conditions. For example, on April 14, NYC Heath released data that showed of the 6,840 people who had died in New York City of COVID-19 by that date, 5,151 (75 percent) had known underlying conditions. The footnote in their report describes underlying conditions as diabetes, lung disease, cancer, immunodeficiency, heart disease, hypertension, asthma, kidney disease, and gastrointestinal/liver disease.
On March 9, the peer-reviewed science journal The Lancet released data from two hospitals in China showing that 48 percent of hospitalized COVID-19 patients had a comorbidity, mainly hypertension, diabetes, or coronary heart disease.
As a scientist, I look at this with great curiosity. My team and I at Scimar are studying a new paradigm for detecting, preventing, treating, and ultimately reversing type 2 diabetes. We believe that our work, which has been green-lighted for clinical trials by Health Canada, will change how the world understands metabolic health. Through our research, which is based on understanding the influence of a specific hormone produced by the liver, we are also gaining new insights on metabolic syndrome, the cluster of conditions that can lead to diabetes and heart disease.
Why would having diabetes increase one’s risk of getting more ill or dying from COVID-19? Why would a body’s ability to manage glucose have any impact on how that same body responds to a virus? I have some ideas around this, but they are just speculation at this point. The relationship could be related to the diabetic body’s reduced antioxidant capacity, or perhaps it is related to the higher generation of free radicals or to how glucose binds to certain proteins. Again this is just speculation, but plausible.
The linkages, though, suggest that if fewer people were living with type 2 diabetes and other underlying conditions, our COVID-19 story would be different. I do not mean to diminish the impact of the coronavirus. This is a tragic time and even perfectly healthy people are dying. In terms of the big picture, though, if we were healthier as a society our COVID-19 numbers would not be as troubling as they are. Fewer people living with underlying conditions would mean fewer people experiencing the worst impacts of COVID-19.
As I write this, 4.4 million people around the world have been diagnosed with COVID-19. As individuals and as communities, we have responded by physical distancing, changing our personal habits, and abiding by new bylaws and recommendations from our authorities and experts. Scientists have mobilized like never before to develop a vaccine. We have closed our schools and we haven’t stopped washing our hands.
By comparison, about 463 million people live with diabetes right now (up from 400 million in 2015). That’s more than 100 times the number of people who have been diagnosed with COVID-19. Of the 463 million, 90 percent have type 2 diabetes, the type closely related to poor diets and sedentary lifestyles. Again, not to diminish the impacts of COVID-19, but the diabetes data seem far more grim. Where is the rush for solutions? Where are the daily progress reports from our leaders? Where is the ongoing dialogue about how to achieve and sustain optimal health through policy, science, and individual and community action?
I am newly optimistic that we are now in a position to change the conversation. We are flattening the COVID curve; now I believe we can flatten the diabetes curve. We have learned through the response to COVID-19 that scientists, policy-makers, communities, and individuals can mobilize quickly and work together for the sake of human health. We can, as we have learned, focus together on the right things at the right time.
So, let’s take advantage of this realization and work together to conquer type 2 diabetes and metabolic syndrome. Science and policy are vital, but ultimately we need individuals and communities to help flatten this curve, as they are doing for COVID-19.
Dr. W. Wayne Lautt is Professor Emeritus, Department of Pharmacology and Therapeutics, University of Manitoba, and the Chief Scientific Officer at SciMar Ltd., a Manitoba-based life sciences company focusing on developing new treatments and programs to address type 2 diabetes and metabolic syndrome.