Hospitalization and COVID-19: The Difference Between Type 1 and Type 2 Diabetes

Almost all studies that have been published regarding COVID-19 and diabetes have lumped together type 1 diabetes (T1D) and type 2 diabetes (T2D) by associating potential COVID-19 complications with diabetes in general. But the two types are quite distinct.

Main differences between T1D and T2D

T1D is an autoimmune illness characterized by the pancreas’ inability to produce insulin. Without the insulin it needs to enter the cells and metabolize, glucose (the body’s main source of energy) accumulates in the bloodstream, which increases blood glucose levels and leads to hyperglycemia. The treatment requires multiple insulin injections every day, either with an insulin pump, a syringe or a pen. When it’s well controlled, T1D is not usually linked to other comorbidities.

T2D is characterized by an insulin resistance that develops gradually over time. So, there is insulin in the bloodstream, but the glucose cannot effectively enter the cells, which increases blood sugar levels (hyperglycemia). People with T2D don’t necessarily require insulin treatment; oral medication and lifestyle changes (diet or physical activity) are enough for some patients. Type 2 diabetes is often associated with comorbidities, such as obesity and cardiovascular diseases.

However, long-term complications (kidneys, heart, eyes and nervous system) for both T1D and T2D are the same.

A minority of people with T1D among diabetic patients hospitalized due to COVID-19

Last week, a report in France published the following statistics on the profiles of 1,300 diabetic patients who were hospitalized due to COVID-19:

3% had T1D
89% had T2D
5% had another type of diabetes
3% were diagnosed with diabetes upon admission to the hospital

Considering that people with T1D represent between 5% and 10% of people with any type of diabetes, a hospitalization rate of 3% is rather low. In short, people with T1D are under-represented in the number of hospitalized diabetic patients.

The same report also revealed that none of the T1D patients under 65 years of age died while they were hospitalized.

No reason to let down your guard yet

This data confirms what experts were anticipating, i.e., that the risk of hospitalization is higher for people with T2D than for people with T1D.

But a lot of research has yet to be done to help us understand the novel coronavirus and its impact on diabetes. To learn more on this topic, read our article about preventive measures against coronavirus disease (COVID-19) and type 1 diabetes.

Do YOU or YOUR CHILD live with type 1 diabetes? We’d like to hear about the challenges you face every day.

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References

Cariou, B., Hadjadj, S., Wargny, M. et al. (2020). Phenotypic Characteristics and Prognosis of Inpatients with COVID-19 and Diabetes: The CORONADO Study. Diabetologia, doi: 10.1007/s00125-020-05180-x.
Huang, Ian, et al. (2020). Diabetes Mellitus is Associated with Increased Mortality and Severity of Disease in COVID-19 Pneumonia – A Systematic Review, Meta-Analysis, and Meta-Regression. Diabetes & Metabolic Syndrome 14(4), 395–403, doi:10.1016/j.dsx.2020.04.018.