Which Type of Diabetes Is Worse for COVID?

COVID-19, the disease caused by the SARS-CoV-2 virus, is a mild illness in most people. People with type 1 diabetes have 3.5 times the risk of dying compared to people without diabetes and people with type 2 diabetes have double the mortality risk with this viral infection.

COVID-19, the disease caused by the SARS-CoV-2 virus, is a mild illness in most people. But certain conditions increase your risk of having severe symptoms. Among these conditions, diabetes, hypertension, and obesity are common and often cause life-threatening disease.

Diabetes isn't the same for everyone. There are two main types of diabetes, type 1 and type 2. They differ in their natural history, treatment, and risk for dangerous COVID-19 disease. You may be concerned about which is worse — type 1 or type 2 diabetes.

Diabetes is a disorder of glucose management. Glucose is a type of sugar that your body's cells need to create energy. Insulin, a hormone produced by the pancreas, allows glucose to enter your cells. This hormone is crucial to glucose utilization and control of blood glucose levels. Your glucose levels need tight control. Both too much and too little are harmful.

There are two types of diabetes:

In type 1 diabetes, the body's own immune system destroys the insulin-producing cells in the pancreas. The pancreas can't produce insulin, and blood glucose levels are uncontrolled. About 5% to 10% of people with diabetes have this type. If you have type 1 diabetes, you need insulin injections every day.

In type 2 diabetes, the body is unable to produce enough insulin, or the cells don't respond to it. About 90% or more of people with diabetes have this type. You can control type 2 diabetes with a planned diet, regular exercise, weight loss, and anti-diabetic medications taken by mouth.

Gestational diabetes is a temporary disorder that happens during pregnancy. 

Having diabetes does not increase your risk of getting a COVID infection. But if you do get the disease, it increases your risk of respiratory failure, heart failure, and intensive care unit admission. Severe COVID with diabetes is also associated with high mortality.

In the U.K., about 5% of the population has diabetes — but almost 30% of COVID deaths are among people with diabetes.

Severe COVID with diabetes is related to blood glucose control. Among people with diabetes hospitalized with COVID, those with well-controlled blood sugar have better outcomes. People who have high blood sugar levels when admitted to the hospital with COVID have a higher risk of complications and death. 

People with diabetes have a higher risk of kidney failure during hospitalization with COVID. They are also more likely to need intensive care and ventilator support. That means they have respiratory failure more often than people without diabetes.

Both types of diabetes put you at high risk for severe COVID-19 illness. People with type 1 diabetes have 3.5 times the risk of dying compared to people without diabetes. People with type 2 diabetes have double the mortality risk with this viral infection. 

Scientists have found that people who use insulin have 3.58 times the risk of a bad outcome when they have COVID-19. All people with type 1 diabetes use insulin, but very few with type 2 need it. 

Apart from the type of diabetes you have, a few factors increase your risk for dangerous disease with COVID-19.

• Male sex
• Older age
• Kidney disease
• Socioeconomic deprivation
• Previous stroke 
• Previous heart failure

You'll notice that most of these are unchangeable. You can't do much to reduce your risk if you get COVID. If you have diabetes with one or more of these factors, you should take additional precautions to keep yourself safe from COVID infection.

If your diabetes puts you at risk of severe COVID, you need to safeguard yourself.

• Keep your diabetes under control. See your doctor regularly, and follow testing and treatment diligently. 
• Avoid contact with people, especially crowds. Meet people outdoors if possible. 
• Get vaccinated. You'll have protection 14 days after the second dose. 
• Consider using telehealth services for your medical consultations. 
• Wear a mask in stores, on public transport, and in other enclosed places where you come in contact with people.
• Wash or sanitize your hands frequently.

Type 1 diabetes appears to be more dangerous than type 2 during COVID infection — but diabetes of either type increases your risk of a bad outcome. If you have diabetes, you should take all the recommended precautions to avoid the infection.

Other conditions, like obesity and high blood pressure (hypertension), also increase the risk of severe COVID disease. If you have diabetes with hypertension, make sure to get effective treatments for both. Reducing obesity will also benefit your diabetes control and reduce your risk of severe COVID. 

Regardless of the type of diabetes you have, high blood sugar levels increase your risk. If your blood sugar is high when you get COVID, you're at a higher risk of getting severe symptoms. Regular diabetes treatment and monitoring will keep your glucose at the recommended levels. That will help keep you safe from severe COVID.