May 16, 2020: Issue #1042

TOP STORIES - Diabetes News & Research

Why CGM?

Metformin Used to Reduce Complications from Glucocorticoid Therapy

Diabetic Foot Self-Inspections and the Variations of Performance in Different Racial Groups

Letter from the Editor

George McConnell, PharmD. Candidate, LECOM, has a special feature on the value of CGM versus HbA1c that points to the value of TIR and the use of TIR to uncover problems in patients with a close to perfect A1c. If you are not sure what TIR is, or how to use it, be sure and read his article.

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We can make a difference!

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Dave Joffe

Editor-in-chief

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Did You Know? How diabetes and prediabetes affect the risk of COVID-19 infection and death

Here’s what we currently know about the risks of having diabetes or prediabetes and the Covid-19 Virus. In the majority of people, the illness will be mild. However, people with diabetes may have a higher risk of developing severe medical complications, such as pneumonia, from COVID-19. The coronavirus may thrive in an environment of elevated blood glucose. People with  underlying medical conditions such as diabetes might be at higher risk of severe illness from COVID-19.

Diabetes is a chronic metabolic condition that causes high blood sugar levels. In general, infectious diseases such as COVID-19 are more severe in people with diabetes. One reason for this is that the immune system does not work as well in people with diabetes when their glucose is not in control at the normal ranges, which makes it harder for their body to fight the virus. The novel coronavirus "may thrive  in an environment of elevated blood glucose." Also, when blood sugars are elevated, it keeps the body in a low-level state of inflammation, which makes its healing response to any infection slower. High blood sugar levels, combined with a persistent state of inflammation, make it much more difficult for people with diabetes to recover from illnesses such as COVID-19.

Just as with other respiratory illnesses, such as influenza A, it appears that diabetes increases the risk for COVID-19 infection, although no studies have been published to support this presumption. Several studies from around the world suggest that diabetes increases risks for severe COVID-19 complications and mortality. In one study , people with diabetes had the second-highest fatality rate (7.3%) after cardiovascular disease (CVD; 10.5%) among those with comorbid conditions. We know the Covid-19 virus is linked to comorbidities like hypertension and obesity, and most patients, especially with Type 2 diabetes and prediabetes, have those comorbidities. So it is important to let patients know that now is the time to take control of their diabetes and get their A1cs down into the normal range. Notably, a recent data analysis  for hospitalized patients with COVID-19 suggested a much higher mortality rate. It increased the length of stay among those who developed hyperglycemia during their hospital stay but had no evidence of diabetes before being admitted. Similarly, a previous publication had found an independent association between fasting glucose at hospital admission and severity of H1N1 .

The question that needs to be explored further in both type 1 and type 2 diabetes, however, is whether acute hyperglycemia is genuinely an independent causal factor or merely a marker for increased severity and mortality from COVID-19.

Now is the time to educate your patients about working harder to control their diabetes and using this information to motivate them to better control.

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletters:

Deonna Andrews, PharmD Candidate 2020 of Florida Agricultural & Mechanical University College of Pharmacy and Pharmaceutical Sciences

Antonio Bess, Pharm D Candidate, Florida Agricultural & Mechanical University School of Pharmacy

Jordan Boyd, PharmD. Candidate Florida Agricultural & Mechanical University School of Pharmacy

George McConnell, PharmD. Candidate, LECOM School of Pharmacy

Mit Suthar, PharmD. Candidate, LECOM School of Pharmacy

Chardae Whitner, PharmD Candidate L|E|C|O|M Bradenton School of Pharmacy

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May 16, 2020: Issue #1042

TOP STORIES - Diabetes News & Research

TOP STORIES - Diabetes News and Research

Did You Know? How diabetes and prediabetes affect the risk of COVID-19 infection and death

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletters: