In China, in the early days of the pandemic it was established that about 21% of (mostly elderly) admissions had a history of diabetes but a further c20% were diagnosed on admission.
Was Coronavirus precipitating diabetes or were these people with it previously but undiagnosed?
“The precise mechanisms for new-onset diabetes in people with COVID-19 are not known, but it is likely that a number of complex interrelated processes are involved”
These include
📌previously undiagnosed diabetes,
📌stress hyperglycemia,
📌steroid-induced hyperglycemia, and
📌direct or indirect effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the b-cell.
A number of studies have also reported that preexisting diabetes as well as newly diagnosed diabetes with a first glucose measurement on hospital admission are both associated with an increased risk of all-cause mortality in hospitalized patients with COVID-19.
Pre existing but undiagnosed and unmanaged diabetes cannot be ruled out as a factor, maybe induced in part to changes in lifestyle due to pandemic restrictions and effect on mental and physical health
But it is very striking that a study from London reported 30 children (aged 23 m to 16.8 years with new onset Type 1 diabetes .
This represented an 80% increase in new onset Type 1 diabetes compared with previous years
Further it see,s severity of presentation is increased
That, alone should be a warning flag with regard to the largely uncontrolled spread of Covid amongst children who could be left with a lifelong and serious condition.
However a German study found no such increase of incidence in Type 1 but DID find significant increases in Diabetic ketoacidosis and severe ketoacidosis at diagnosis.
See also Chinese and London studies re Type 2 diabetes
And this is associated with more severe organ injury
This paper goes on to review a large number of related studies and concludes
📌 There is an urgent need for research to help guide management pathways for these patients.
📌 In view of increased mortality in people with new-onset diabetes, hospital protocols should include efforts to recognize and manage acute hyperglycemia, including diabetic ketoacidosis, in people admitted to the hospital.
📌Whether new-onset diabetes is likely to remain permanent is not known, as the long-term follow-up of these patients is limited. Prospective studies of metabolism in the setting of postacute COVID-19 will be required to understand the etiology, prognosis& treatment opportunities
“The policy says: “Instant messaging is provided to all staff and should be used in preference to email for routine communications where there is no need to retain a record of the communication.”
“Instant messages history in individual and group chats must be switched off and should not be retained once a session is finished.”
“There needs to be really clear and immediate messaging from government around which test [people should] act on. My very clear advice would be that if you have a respiratory infection, stay at home because you’re going to pass it on.”
“But if you’ve got symptoms of a respiratory infection and a lateral flow test that’s positive, I would be working on the assumption that it’s Covid-19 regardless of the PCR result at the moment.”
The rotten decision making preceded the Covid pandemic…and countries like Singapore IMPLEMENTED OUR flu pandemic plan with far FAR greater success…imperfect but FAR better
Because they ACTED on it
And had resourced PH to do so..& gave it clout
But which of us thinks giving the likes of Jenny Harries MORE clout would have made a difference?
It wasn’t more clout she needed but a massive kick up the arse from a political leader who was going to put saving lives and health and well-being at the heart of the response
Yet here we are 18 mnths later, post 3 lockdowns of sorts, Alpha then Delta variants increasing the risks & worsening the odds, 45 mill+ fully vaccinated
163,500 Covid deaths (by date of death): deaths & hospitalisations still piling up.
And a Government even sloppier than at the beginning.
The second and third/ fourth waves are unequivocally on Johnson. His choice against scientific advice.
How very Johnson to absent himself from the country when the Select Committee report is published.