More than one in five diabetes patients in hospital with COVID-19 die within 28 days – study #covid19rftlks

via Sky News | 17 February 2021| More than one in five diabetes patients in hospital with COVID-19 die within 28 days – study

More than 20 per cent of patients with diabetes admitted to hospital with COVID-19 die within 28 days, according to research. A study by the University of Nantes in France followed 2,796 diabetes patients admitted to hospital with the virus. It found that within 28 days, 577 (21 per cent had died and almost half (1,404) had been discharged after a typical stay of nine days.

12 per cent were still in hospital 28 days after their admission and 17 per cent had been transferred to a different type of facility.

Read the full news story at Sky News

See also:

The Standard One in five Covid patients in hospital with diabetes die within 28 days, study shows

Coronavirus: A quarter of COVID-19 patients who died in England had diabetes

Sky News |May 2020| Coronavirus: A quarter of COVID-19 patients who died in England had diabetes

Figures released by NHS England show that 1 in 4 of COVID-19 patients who have died in England had diabetes. Although the statistics do not distinguish between type 1 and type 2, they show that of the 22,332 people who died since 31 March, 5,873 (26%) of them were people with diabetes.

Full news story from Sky

Diabetes UK have also produced this release:

We know many of you will have seen the news yesterday reporting on the new statistic published that shows that 26% of those who have died from coronavirus in England had diabetes. We wanted to give you as much information as we currently have about this data, as well as update you on what we’re doing to support you.

[Updated 4pm 15 May 2020]

Read the [Diabetes UK] Latest statistic on coronavirus deaths in England

See also ITV News One in four coronavirus patients who died in England’s hospitals had diabetes

The Guardian Quarter of Covid-19 deaths in English hospitals were of diabetics

NHS spends around £3bn a year on ‘avoidable’ treatment for diabetes

ITV | September 2019 | NHS spends around £3bn a year on ‘avoidable’ treatment for diabetes

An analysis of hospital treatment in 2017/18 highlights that approximately £5.5bn each year is spent on treatment of diabetes, of this an estimated £3bn is on ‘potentially avoidable’ treatment. The authors of the research explain that this equates to around one-tenth of the NHS budget; compared to people without diabetes, the average annual cost of planned care was over twice as high for those with Type 2 diabetes and the average cost of emergency care was three times higher, once age was taken into account.

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Study author, Dr Adrian Heald from Salford Royal Hospital, said: “People with diabetes are admitted to hospital more often, especially as emergencies, and stay on average longer as inpatients.

“These increased hospital costs, 40% of which come from non-elective and emergency care, are three times higher than the current costs of diabetes medication.

“Improved management of diabetes by GPs and diabetes specialist care teams could improve the health of people with diabetes and substantially reduce the level of hospital care and costs.” (Source: ITV News)

The team’s finding will be presented this week at the European Association for the study of Diabetes (EASD)  annual meeting in Barcelona.

Read the full story from ITV News

See also:

BT NHS spends around £3bn a year on ‘avoidable’ treatment for diabetes

 

Fish oil pills ‘no benefit’ for type 2 diabetes

Brown, T., Brainard, J., Song, F., Wang, X., Abdelhamid, A. & Hooper, L. | 2019| Omega-3, omega-6, and total dietary polyunsaturated fat for prevention and treatment of type 2 diabetes mellitus: systematic review and meta-analysis of randomised controlled trials | BMJ|  366 | l4697|  doi: https://doi.org/10.1136/bmj.l4697 :

Research that investigated whether omega-3 and other fatty acids were beneficial to people with type 2 diabetes has found that increasing long chain omega-3 intake had little or no effect on diagnosis or glucose metabolism; the study’s authors also report that there may be  negative outcomes at high dose. 

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Abstract

Objective To assess effects of increasing omega-3, omega-6, and total polyunsaturated fatty acids (PUFA) on diabetes diagnosis and glucose metabolism.

Design Systematic review and meta-analyses.

Data sources Medline, Embase, Cochrane CENTRAL, WHO International Clinical Trials Registry Platform, Clinicaltrials.gov, and trials in relevant systematic reviews.

Eligibility criteria Randomised controlled trials of at least 24 weeks’ duration assessing effects of increasing α-linolenic acid, long chain omega-3, omega-6, or total PUFA, which collected data on diabetes diagnoses, fasting glucose or insulin, glycated haemoglobin (HbA1c), and/or homoeostatic model assessment for insulin resistance (HOMA-IR).

Data synthesis Statistical analysis included random effects meta-analyses using relative risk and mean difference, and sensitivity analyses. Funnel plots were examined and subgrouping assessed effects of intervention type, replacement, baseline risk of diabetes and use of antidiabetes drugs, trial duration, and dose. Risk of bias was assessed with the Cochrane tool and quality of evidence with GRADE.

Results 83 randomised controlled trials (mainly assessing effects of supplementary long chain omega-3) were included; 10 were at low summary risk of bias. Long chain omega-3 had little or no effect on likelihood of diagnosis of diabetes or measures of glucose metabolism. A suggestion of negative outcomes was observed when dose of supplemental long chain omega-3 was above 4.4 g/d. Effects of α-linolenic acid, omega-6, and total PUFA on diagnosis of diabetes were unclear (as the evidence was of very low quality), but little or no effect on measures of glucose metabolism was seen, except that increasing α-linolenic acid may increase fasting insulin (by about 7%). No evidence was found that the omega-3/omega-6 ratio is important for diabetes or glucose metabolism.

Conclusions This is the most extensive systematic review of trials to date to assess effects of polyunsaturated fats on newly diagnosed diabetes and glucose metabolism, including previously unpublished data following contact with authors. Evidence suggests that increasing omega-3, omega-6, or total PUFA has little or no effect on prevention and treatment of type 2 diabetes mellitus.

Systematic review registration PROSPERO CRD42017064110.

 

The full article is available from the  BMJ

In the news:

BBC News Fish oil pills ‘no benefit’ for type 2 diabetes

High blood sugar levels and BMI linked to stillbirth in mothers with diabetes 

Mackin, S.T. et al | 2019|Factors associated with stillbirth in women with diabetes| Diabetologica | https://doi.org/10.1007/s00125-019-4943-9

Experts at the University of Glasgow analysed population-level data from Scotland during the period 1 April 1998 to the end of June 2016 to describe timing of stillbirths in women with diabetes and associated risk factors.

 

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They report that babies at extremes of weight centiles are at most risk. The authors of the study conclude that maternal blood glucose level and BMI are the main modifiable risk factors associated with stillbirth in our population of women with diabetes

Many stillbirths occur at term and could potentially be prevented by change in routine care and delivery policies (Source: Mackin, et al. 2019).

Abstract

Aims/hypothesis

Stillbirth risk is increased in pregnancy complicated by diabetes. Fear of stillbirth has major influence on obstetric management, particularly timing of delivery. We analysed population-level data from Scotland to describe timing of stillbirths in women with diabetes and associated risk factors.

 

Methods

A retrospective cohort of singleton deliveries to mothers with type 1 (n = 3778) and type 2 diabetes (n = 1614) from 1 April 1998 to 30 June 2016 was analysed using linked routine care datasets. Maternal and fetal characteristics, HbA1c data and delivery timing were compared between stillborn and liveborn groups.

 

Results

Stillbirth rates were 16.1  and 22.9  per 1000 births in women with type 1 (n = 61) and type 2 diabetes (n = 37), respectively. In women with type 1 diabetes, higher HbA1c before pregnancy and in later pregnancy  were associated with stillbirth, while in women with type 2 diabetes, higher maternal BMI  and pre-pregnancy HbA1c  were associated with stillbirth. Risk was highest in infants with birthweights more than 10th centile (sixfold higher born to women with type 1 diabetes [n = 5 stillbirths, 67 livebirths]; threefold higher for women with type 2 diabetes [n = 4 stillbirths, 78 livebirths]) compared with those in the 10th–90th centile (n = 20 stillbirths, 1685 livebirths). Risk was twofold higher in infants with birthweights more than 95th centile born to women with type 2 diabetes (n = 15 stillbirths, 402 livebirths). A high proportion of stillborn infants were male among mothers with type 2 diabetes (81.1% vs 50.5% livebirths, p = 0.0002). A third of stillbirths occurred at term, with highest rates in the 38th week among mothers with type 1 diabetes and in the 39th week for type 2 diabetes.

 

Conclusions/interpretation

Maternal blood glucose levels and BMI are important modifiable risk factors for stillbirth in diabetes. Babies at extremes of weight centiles are at most risk. Many stillbirths occur at term and could potentially be prevented by change in routine care and delivery policies.

 

Article available in full from Diabetologica 

See also:

University of Glasgow [news release]  High blood sugar levels and BMI linked to stillbirth in mothers with diabetes 

In the news:

Independent Diabetic women need more support after study into stillbirth risk, say experts 

2,000 people referred to Type 2 diabetes prevention programme in Wakefield

Wakefield Express |July 2019 | 2,000 people referred to Type 2 diabetes prevention programme in Wakefield

A news story in the Wakefield Express reports that almost 2000 people in Wakefield at risk of developing type 2 diabetes, have been referred to a diabetes preventionprogramme – delivered by the NHS- since 2017.

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Coun Faith Hepenstall, Wakefield’s portfolio holder for health, said:

“The public health team working for Wakefield Council want to help these residents live healthier lives.

“In 2017 we were successful in attracting significant funding from the NHS to run a diabetes prevention programme across (West Yorkshire and Harrogate). 

“This involves education on healthy eating and lifestyle, help to lose weight, as well as access to physical exercise programmes, all of which together have been proven to reduce the risk of developing the condition.

Of these, 1051 attended their first session, an uptake of a little over 50 per cent.

She added that the participants (n=741) who have completed the programme, have lost an average of 6lb each (Source: Wakefield Express)

Read the full story in the Wakefield Express

#TalkAboutComplications

Scibilia, R. & Aldred, C. | 2019|#TalkAboutComplications| BMJ|364 |k5258

In the latest edition of the  BMJ, Renza Scibilia and Chris Aldred write about how to take the blame out of complications for patients and their determination to reframe the way complications are discussed by changing the language used in these conversations.  They write about their #TalkAboutComplications hashtag on Twitter and how people with diabetes and chronic conditions engaged with and responded to it. 

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“Often the focus and language around complications are on prevention rather than on risk reduction. The understanding is that no matter how well a condition is managed, there is always some risk that a complication could develop. Even if the self management of diabetes is not ideal, there is no value in apportioning blame.” (Renza Scibilia and Chris Aldred)

Read the full piece in the BMJ