COVID-19 has affected nearly every aspect of human life, including diabetes care. While everyone is at some degree of risk for infection with the SARS-CoV-2 virus, people with diabetes have a three-fold increased risk of severe infection.

“The COVID epidemic has been a significant factor in all of our lives in the past year,” said Matthew C. Riddle, MD, Editor-in-Chief of Diabetes Care and Professor of Medicine at Oregon Health & Science University. “We have all devoted a lot of time and energy to the epidemic. For Diabetes Care, submissions have been coming in at a 20% increase compared to the prior year.”

Early indications suggested an interplay between diabetes and COVID-19, which fueled a concern for patient care and a surge in diabetes-focused research, said Dr. Riddle, one of four scheduled presenters for the 2021 Diabetes Care Symposium—Learning to Minimize Risks for People with Diabetes in the COVID-19 Pandemic. The two-hour symposium, which will focus on diabetes-related findings during this first year of the pandemic, will begin at 8:00 a.m. ET Saturday, June 26.

Edward W. Gregg, PhD, Chair in Diabetes and Cardiovascular Disease Epidemiology and Professor of Epidemiology and Biostatistics at Imperial College, London, United Kingdom, will examine the epidemiologic relationships between type 2 diabetes and COVID-19.

It’s not a simple relationship, Dr. Riddle said. There are physiological and behavioral components as well as environmental links between type 2 diabetes and COVID-19. Some populations are better able to access care, some less so. And some diabetes patients are able to stay home and reduce their risk of SARS-CoV-2 infection, while some cannot.

Linda A. DiMeglio, MD, MPH, Associate Editor of Diabetes Care and Professor of Pediatrics at Indiana University School of Medicine, will discuss the emerging relationships between type 1 diabetes and COVID-19 in pediatric and adult populations.

“The relationship is partly physiological,” Dr. Riddle said. “We think the stress of the infection disrupts metabolic control in people who have type 1 diabetes, which is resulting in increased rates of ketoacidosis hospital admissions.”

In other ways, the pandemic has made life easier for diabetes patients, he added. Social distancing, stay-at-home orders, and other measures to limit infection have added a degree of discipline to daily life. People are less likely to stay out late, overindulge in food or drink, exercise too vigorously, and otherwise stray as far from appropriate lifestyle and medication regimens.

Paresh Dandona, MD, PhD, SUNY Distinguished Professor of Medicine at the University of Buffalo Jacobs School of Medicine & Biomedical Sciences, will examine the emerging physiologic interplay between SARS-CoV-2 infection and diabetes and the common role that inflammation plays in both.

“Obesity and diabetes are both pro-inflammatory states and major risk factors for COVID,” Dr. Dandona said. “It has also been shown that in inflammation, immunological response to vaccination is reduced. We know that people who are taking statins for atherosclerosis or heart disease tend to have a milder intensity of COVID illness.”

Steroids have become standard treatment for more severe COVID illness, Dr. Dandona continued. Observational studies suggest that insulin, one of the most potent anti-inflammatory agents in common use, can dramatically reduce mortality in hospitalized COVID-19 patients.

“People don’t pay sufficient attention to glycemic control in the context of infection,” Dr. Dandona said. “Your ability to generate an immune response is diminished with chronic inflammation, and uncontrolled blood sugars make it much more convenient for infections of all sorts to set in. What we are learning about inflammation and glycemic control in the context of COVID is vital knowledge that is applicable to other infections as well.”