Non-COVID-19 deaths among people with diabetes spiked during pandemic

Non-COVID-19-related deaths among people with diabetes increased during the pandemic, as did the diabetes complication of sight loss, according to a global study review led by a University of Massachusetts Amherst public health researcher that examined the impacts of pandemic-related disruptions on this vulnerable population.

The review, commissioned by the World Health Organization (WHO) and published Jan. 23 in The Lancet Diabetes and Endocrinology, looked at 138 studies comparing pre-pandemic to during pandemic periods in North America (39), Western Europe (39), Asia (17), Eastern Europe (14), South America (four), Egypt (one), Australia (one) and multiple regions (33).

“What we found overall was a fairly negative impact on diabetes outcomes,” says co-lead author Jamie Hartmann-Boyce, an assistant professor of health policy and promotion in the UMass Amherst School of Public Health and Health Sciences.

The review also found a startling increase in diabetes-related admissions to pediatric ICUs, as well as a rise in cases of diabetic ketoacidosis (DKA) among children and adolescents. Some of the cases were due to new-onset diabetes, meaning DKA – a serious, potentially life-threatening complication of diabetes – coincided with the diabetes diagnosis. There was no rise in the frequency or severity of DKA among adults.

In addition to an increase in deaths, “the data on pediatric ICU admissions and pediatric diabetes ketoacidosis is probably the most striking thing that comes out of this review,” Hartmann-Boyce says. “It was very consistent across countries, and a pediatric ICU admission is a major event for kids and their families.”

“We know that not getting your eyes screened regularly if you have diabetes is a problem and leads to more sight loss,” Hartmann-Boyce says. “And we saw diabetes-related mortality and all-cause mortality increasing in England during the first wave that wasn’t attributed to COVID but was probably related to reduced access to health care and reduced health care utilization.”

The researchers note that there were more new cases of Type 1 diabetes than would have been expected, and children newly diagnosed with Type 1 diabetes were much sicker than during non-pandemic periods. Much less common than Type 2 diabetes, Type 1 diabetes is an autoimmune disease that is usually diagnosed in childhood but can occur at any age.

Reference: Non-COVID-19 deaths among people with diabetes jumped during pandemic; The Lancet