Multi-Center Study Addresses Impact of COVID-19 on People with Type 1 Diabetes

A study recently published in Diabetes Care focuses on individuals with type 1 diabetes who are suspected or confirmed to have contracted COVID-19 — the first U.S. based, multi-center study to examine patient characteristics and adverse outcomes among individuals with confirmed or suspected COVID-19.

“While diabetes has been identified as a risk factor for severe illness with COVID-19, there is very little information about type 1 diabetes specifically,” says Mary Pat Gallagher, MD, director of the Pediatric Diabetes Center at NYU Langone Health’s Hassenfeld Children’s Hospital. “We know that with type 1 diabetes, infections of all types can lead to high blood sugar levels and potentially to diabetic ketoacidosis (DKA), which can be deadly. This study – the first to report what happens when individuals with type 1 diabetes are diagnosed with COVID-19 – is a critical step that will set the stage for the future of care.”

The T1D Exchange Quality Improvement Collaborative (QIC) is conducting the study in collaboration with its 15 clinic members and an additional 49 endocrinology clinics, for a total of 64 U.S. sites. Initial results from 33 COVID-19 confirmed positive cases and 31 COVID-19-presumptive cases found the most prevalent presenting symptom reported was high blood sugar, followed by fever, cough, nausea and fatigue. In addition, results showed:

  • More than 50% of cases reported hyperglycemia
  • Nearly one-third of cases experienced DKA and required hospitalization
  • More than 50% of cases had no adverse COVID-19 or diabetic outcomes
  • There were two reported deaths among adult patients with other underlying co-morbidities

“During these unprecedented times, there are a plethora of unanswered questions on the impact of COVID-19 on the type 1 diabetes community and we realized that a population health surveillance study is imperative to better understand potential outcomes and inform intelligent quality improvement initiatives,” says Osagie Ebekozien, MD, MPH, vice president of Population Health and Quality Improvement at T1D Exchange. “We are buoyed by the initial interest and participation of clinicians and patients in this study and expect to announce additional risk factors, insights and outcomes in pediatric and adult patients in the coming months as more data is collected and analyzed.”

The multi-clinic, first of its kind population health surveillance, with currently more than 200 confirmed and presumptive cases, was made possible by the support of the industry and research community. The five Presenting Sponsors — Abbott Diabetes, Dexcom, JDRF, Lilly, and Medtronic — and the two Contributing Sponsors, Insulet Corporation and Tandem Diabetes Care, supported this critical initiative.

“JDRF is committed to improving the lives of everyone affected by type 1 diabetes,” says Sanjoy Dutta, PhD, JDRF vice president of Research. “That means a need to fully understand the implications of COVID-19 on the type 1 diabetes community. JDRF is proud to support T1D Exchange and their research into COVID-19. We are hopeful this study will arm clinicians with the information they need to make informed decisions into how to best treat COVID-19 in their patients with T1D to achieve better outcomes.”

“The research that T1D Exchange is leading around COVID-19 will yield vital information about the prevalence, presentation and outcomes of COVID-19 on those living with type 1 diabetes,” says Robert Vigersky, MD, chief medical officer for Diabetes Group at Medtronic. “We are proud to support this important research and look forward to rapidly learning from real-world experiences.”