# Discussion of Covid-19 Pneumonia and Diabetics **URL:** \ **Category:** Share\ **Created:** [March 10, 2020, 2:17pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435 "2020-03-10T14:17:01Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Jan](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jan/32/7539_2.png) [@Jan](https://forum.fudiabetes.org/u/Jan)\ **Post date:** [March 11, 2020, 1:42pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/21 "2020-03-11T13:42:00Z")
Both protect against bacterial pneumonia. Pneumococcal conjugate vaccine (called PCV13) protects against 13 types of pneumococcal bacteria. PPSV23 (pneumococcal polysaccharide vaccine) protects against 23 types of pneumococcal bacteria. This vaccine helps prevent invasive infections like meningitis and bacteremia. ---
**Author:** ![jbowler](https://avatars.discourse-cdn.com/v4/letter/j/e274bd/32.png) [@jbowler](https://forum.fudiabetes.org/u/jbowler)\ **Post date:** [March 11, 2020, 2:52pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/22 "2020-03-11T14:52:53Z")
The “normal” CDC recommendations are vaccinate children under 2 and adults over 65, [but they recommend](https://www.cdc.gov/vaccines/vpd/pneumo/hcp/who-when-to-vaccinate.html) one shot of PPSV23 for people with diabetes mellitus; it’s not clear if that is because of studies on T1 or T2. Sounds like a reasonable precaution. It will be interesting to see if the CDC lower their general age guideline now. ---
**Author:** ![Jan](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jan/32/7539_2.png) [@Jan](https://forum.fudiabetes.org/u/Jan)\ **Post date:** [March 11, 2020, 3:40pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/23 "2020-03-11T15:40:39Z")
I’m not 65 and both pneumonia vaccines were recommended by my PCP. ---
**Author:** ![cardamom](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/cardamom/32/2622_2.png) [@cardamom](https://forum.fudiabetes.org/u/cardamom)\ **Post date:** [March 11, 2020, 7:16pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/24 "2020-03-11T19:16:55Z")
Again, the type of pneumonia with COVID-19 isn’t prevented by any vaccines, until they develop one specifically for COVID-19. Vaccines for bacterial pneumonia will not help prevent this virus from causing damage. Still probably a good idea to get them to prevent bacterial pneumonia too (which in theory could happen as an additional infection), but that’s not what is disabling and killing people in this case. What develops is called bilateral interstitial pneumonia, and with COVID-19, it occurs because once the virus infects lung tissue, the immune system reacts to fight it, and the result inflames and damages the lungs, preventing them from being able to absorb oxygen adequately. It is not bacterial in nature. > [@Preparation for Staying Home for a Bit - Covid-19 related](https://forum.fudiabetes.org/t/preparation-for-staying-home-for-a-bit-covid-19-related/9436/3): > > I was supposed to fly to a conference in May, but have just heard that it’s cancelled (or will be moving to an online format). The next few months will be interesting… I was supposed to fly to a conference in early April, and while the conference has not been canceled yet (word is it will be in the next few days), my university suspended all sponsored travel (like many others), all large meetings/grand rounds/etc, and I am waiting any day now for classes to shift to online-only. I’m bummed because, in addition to giving a talk, I was actually due to receive an award at this conference and was really excited about it. My biggest concerns right now though are for the place I do clinical work in, because if we have to suspend services, it leaves a lot of youth without a safe space and needed access to food/toiletries/other basic needs. Same thing if schools close—lots of homeless kids rely on them for meals, showers etc. ---
**Author:** ![Katers87](https://avatars.discourse-cdn.com/v4/letter/k/a9adbd/32.png) [@Katers87](https://forum.fudiabetes.org/u/Katers87)\ **Post date:** [March 11, 2020, 8:12pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/25 "2020-03-11T20:12:10Z")
> [@cardamom](#): > > immune system reacts to fight it This is what I find most concerning. It seems like people with autoimmune diseases are the most at risk. There’s no evidence that anti-virals will help, and there isn’t even a current treatment recommendation for doctors in hospitals. Doctors may be trying different things to help people, but there is no defined treatment plan for people who have COVID-19. > [@Hurry up and get your alcohol swabs!](https://forum.fudiabetes.org/t/hurry-up-and-get-your-alcohol-swabs/9423/46): > > There are many other ways of doing it - would love to hear recommendations - We bought a bunch of beans, rice, and frozen vegetables. I have plenty of D supplies, but I missed out on the clorox wipes. ---
**Author:** ![TiaG](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/tiag/32/594_2.png) [@TiaG](https://forum.fudiabetes.org/u/TiaG)\ **Post date:** [March 12, 2020, 6:47am UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/26 "2020-03-12T06:47:14Z")
Maybe I’m wrong, but I was under the impression 7.3% was not how much more diabetics are likely to require hospitalization. I thought that number was the case fatality rate for diabetics… my impression was that it elevated risk by a factor of 6, so not that different from elevated complication risk for flu… ---
**Author:** ![TiaG](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/tiag/32/594_2.png) [@TiaG](https://forum.fudiabetes.org/u/TiaG)\ **Post date:** [March 12, 2020, 6:49am UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/27 "2020-03-12T06:49:59Z")
well, if you do get coronavirus, it would certainly be good to not _also_ get the flu at the same time, so in that sense a flu shot might be helpful. The pneumonia vaccine doesn’t protect against that type of viral pneumonia but theoretically it could maybe help if you got a secondary type of pneumonia on top of the one caused by COVID-19? ---
**Author:** ![cardamom](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/cardamom/32/2622_2.png) [@cardamom](https://forum.fudiabetes.org/u/cardamom)\ **Post date:** [March 12, 2020, 3:22pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/28 "2020-03-12T15:22:17Z")
> [@TiaG](#): > > Maybe I’m wrong, but I was under the impression 7.3% was not how much more diabetics are likely to require hospitalization. I thought that number was the case fatality rate for diabetics… my impression was that it elevated risk by a factor of 6, so not that different from elevated complication risk for flu… Yes, that’s the fatality rate. It’s unfortunately not taking into account type of diabetes, age, or other comorbid complications, so hard to interpret re: individual risk, beyond that it’s likely elevated. ---
**Author:** ![jbowler](https://avatars.discourse-cdn.com/v4/letter/j/e274bd/32.png) [@jbowler](https://forum.fudiabetes.org/u/jbowler)\ **Post date:** [March 12, 2020, 4:30pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/29 "2020-03-12T16:30:12Z")
> [@cardamom](#): > > Yes, that’s the fatality rate. It’s unfortunately not taking into account type of diabetes, age The age skew in the COVID-19 statistics matches a similar age skew in diabetes; in 2015 [9.4% of Americans were diabetics](https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html) however 25% of Americans 65 or older were diabetics. The fatality rate with Covid-19 also [goes up massively](https://jamanetwork.com/journals/jama/fullarticle/2762130?guestAccessKey=bdcca6fa-a48c-4028-8406-7f3d04a3e932&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=022420) around the same age. So when diabetics are selected from a study there is a much higher proportion of people over 65 and those people have a much higher Covid-19 fatality rate because they are older. ---
**Author:** ![Chris](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/chris/32/382_2.png) [@Chris](https://forum.fudiabetes.org/u/Chris)\ **Post date:** [March 12, 2020, 4:33pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/30 "2020-03-12T16:33:48Z")
When you look at the Lancet dataset from two centers in China, age was the predominant factor, the younger folks with diabetes survived. I wouldn’t get too worked up unless you are \>65 ![image](https://canada1.discourse-cdn.com/flex030/uploads/fudiabetes/original/2X/0/0028850d19c9907f858fb0751e90413e300a99e0.png) [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext) ---
**Author:** ![Jan](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jan/32/7539_2.png) [@Jan](https://forum.fudiabetes.org/u/Jan)\ **Post date:** [March 12, 2020, 9:56pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/31 "2020-03-12T21:56:47Z")
How about 63? 🙂 ---
**Author:** ![Chris](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/chris/32/382_2.png) [@Chris](https://forum.fudiabetes.org/u/Chris)\ **Post date:** [March 12, 2020, 10:11pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/32 "2020-03-12T22:11:44Z")
Try to not to get the virus. We really need a bigger (Italian??) study to come out soon to get a better idea. ---
**Author:** ![docslotnick](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/docslotnick/32/75_2.png) [@docslotnick](https://forum.fudiabetes.org/u/docslotnick)\ **Post date:** [March 12, 2020, 10:27pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/33 "2020-03-12T22:27:20Z")
> [@Chris](#): > > I wouldn’t get too worked up unless you are \>65 I’m not at all worked up, except that I can’t find any toilet paper and I only have two rolls left. And BTW, I’m 67, and my comorbidity is likely to be constipation. ---
**Author:** ![Jess](https://avatars.discourse-cdn.com/v4/letter/j/2bfe46/32.png) [@Jess](https://forum.fudiabetes.org/u/Jess)\ **Post date:** [March 12, 2020, 11:16pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/34 "2020-03-12T23:16:03Z")
So… I’m using this as an opportunity to get a backup for Dexcom. I just talked to MN Blue Cross and the guy on the phone said they don’t really care as much with refills on the durable medical goods piece so if your dr will write a script you can get one. My son’s dr has recommended we have extra in stock “just in case” so I don’t think I will have a problem getting the script to have a spare in stock- which would be great. I hate not having a spare transmitter- it makes such a difference on how well we are able care for Liam. (Also some Dexcom metals are sourced in China, so even though it’s a US product, there is still the possibility of supply chain issues). Fingers crossed. ---
**Author:** ![Chris](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/chris/32/382_2.png) [@Chris](https://forum.fudiabetes.org/u/Chris)\ **Post date:** [March 12, 2020, 11:21pm UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/35 "2020-03-12T23:21:37Z")
See this thread, at worst you can use @T1Allison 's idea of a hose through the window. > [@Unexpectedly Robust Discussion of Bidets and Toilet Construction](https://forum.fudiabetes.org/t/unexpectedly-robust-discussion-of-bidets-and-toilet-construction/9434): > > I’m also ordering a bidet attachment for the toilet since people are hoarding all the TP for some inexplicable reason. I’m told once you go that route you never go back. ---
**Author:** ![jbowler](https://avatars.discourse-cdn.com/v4/letter/j/e274bd/32.png) [@jbowler](https://forum.fudiabetes.org/u/jbowler)\ **Post date:** [March 13, 2020, 1:31am UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/36 "2020-03-13T01:31:12Z")
> [@Chris](#): > > We really need a bigger (Italian??) The Chinese study probably has the diabetes information; I couldn’t get to the original on [chinacdc.cn](http://chinacdc.cn), so I was working from the very limited information JAMA summary. China has about the same aggregate diabetes rate as the US while, so far as I could determine, the rate in Italy is about half our rate so may be less representative wrt diabetes. The Chinese **study** also has 44,672 confirmed cases of COVID-19 while Italy to date has 15,113 **total** according to [worldometers.info](https://www.worldometers.info/coronavirus/#countries) (there’s lots of apparently good statistics there.) I’ll see if I can get anything from the PDF; it seems to be downloading now but it is very very slow. ---
**Author:** ![John58](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/john58/32/147_2.png) [@John58](https://forum.fudiabetes.org/u/John58)\ **Post date:** [March 13, 2020, 1:33am UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/37 "2020-03-13T01:33:34Z")
> [@Chris](#): > > We really need a bigger (Italian??) study Hoping the stats from Italy come out soon. We 63 year olds don’t like the looks of the Wuhan stats. ---
**Author:** ![jbowler](https://avatars.discourse-cdn.com/v4/letter/j/e274bd/32.png) [@jbowler](https://forum.fudiabetes.org/u/jbowler)\ **Post date:** [March 13, 2020, 1:38am UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/38 "2020-03-13T01:38:22Z")
> [@Jan](#): > > How about 63? 🙂 [This page](https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/) explains the source of the data and has numbers. It also has good explanations of what the numbers mean. The executive summary is that the fatality rate starts going up at age 40. Look for " Age of Coronavirus Deaths", then look at the next paragraph too 😉 ---
**Author:** ![Jan](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jan/32/7539_2.png) [@Jan](https://forum.fudiabetes.org/u/Jan)\ **Post date:** [March 13, 2020, 2:01am UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/39 "2020-03-13T02:01:51Z")
Thanks for the article, now I have a little less anxiety. 🙄 But I’m still going to practice “social isolation” as much as possible. Fortunately I’m retired and our business is cattle, so we’re socially isolated anyway. ---
**Author:** ![jbowler](https://avatars.discourse-cdn.com/v4/letter/j/e274bd/32.png) [@jbowler](https://forum.fudiabetes.org/u/jbowler)\ **Post date:** [March 13, 2020, 3:16am UTC](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435/40 "2020-03-13T03:16:13Z")
> [@jbowler](#): > > I’ll see if I can get anything from the PDF I did manage to download the PDF, eventually. I mirrored it [here](https://drive.google.com/file/d/1EJBhmweTpp8i648v2DAlH22BUsZ-Yaep/view?usp=sharing) in case anyone else wants to see it and has problems downloading. They do give comorbidity data for diabetes in the PDF, but they do not split it out by age range. Realistically I wouldn’t expect any paper we might see to do that; we would need access to the raw data to do that analysis. The data set is also reduced: > The comorbid condition variable, only includes a total of 20,812 patients and 504 deaths and these values were used to calculate > percentages in the confirmed cases and deaths columns My null hypothesis is that diabetes (which, in this context, means T2D) does not significantly alter the death rate associated with COVID-19 because the increased fatality rate reported for diabetics is wholely accounted for by the corresponding increase in diabetes with age. The results for T1D will not come out of any of these studies; we are much too small a population for the scientists involved to be concerned about us given the massive scale of the problem. T1D results won’t come out of China either. China mysteriously has one of the lowest reported rates of T1D in the world; perhaps sometimes if you ignore a problem it really does go away [ironic in general to the point of sarcasm in this specific case.] [Previous page](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435.md?page=1) [Next page](https://forum.fudiabetes.org/t/discussion-of-covid-19-pneumonia-and-diabetics/9435.md?page=3)