Discussion of Covid-19 Pneumonia and Diabetics

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

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext

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How about 63? :slight_smile:

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Try to not to get the virus. We really need a bigger (Italian??) study to come out soon to get a better idea.

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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.

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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.

See this thread, at worst you can use @T1Allison 's idea of a hose through the window.

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The Chinese study probably has the diabetes information; I couldn’t get to the original on 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 (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.

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Hoping the stats from Italy come out soon. We 63 year olds don’t like the looks of the Wuhan stats.

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This page 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 :wink:

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Thanks for the article, now I have a little less anxiety. :roll_eyes: 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.

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I did manage to download the PDF, eventually. I mirrored it here 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.]

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well as of now the stats in Italy are looking so dire we can’t tell what they’re saying. The fatality rate is at 6% because they’re just so overwhelmed. A lot of those people could have maybe survived if they had the best treatment options available. My guess is that it’s really going to depend on when people get this, how they’ll fare in the US.

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On another forum, a mom who used to live in China and was still on some Chinese forums had read about a few cases of T1D in kids and they all came out of it fine. Of course, kids are the ones faring the best in this outbreak so it’s not super surprising.

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Unfortunately the government in Italy had to prioritize their resources and stop treatment for many older patients. Sad, they may end up with the highest fatality rate. Fingers crossed this is the worst outcome that arises out of this pandemic.

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I suspect that it is more the denominator than the numerator. The NYT had this take at the end of February:

Viral infections often set the stage for bacterial pneumonia to occur. The vaccine is recommended for all people with diabetes age 19-64 and all people older than 64

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Sure like I said, it’s worth getting for other reasons and as a broader precaution, because you never know, especially once hospitalized. But it’s not going to prevent or alleviate the pneumonia that is killing people with COVID-19, so for example, if someone needs to go to a pharmacy or dr’s office to get it, it may at present not be worth the increased exposure risk. Depends on all the factors in play.

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The fatality rate is also higher because the Italian population is older, especially in the north. Close to a quarter of the population is over 65. The median age (46) is about 4 years higher than in the rest of the EU and about 10 years higher than in the States. Earlier on a Lombardy doctor was quoted as saying 100% of deaths were in those over 80. Although those stats have since changed, last I saw the average age of those who have died was 81.

They also rolled out testing fairly late, so by the time testing was widely available, a lot of people were already seriously ill or on the verge, and therefore more likely to die. (This is the opinion of several Italian friends. I have not checked whether it’s backed up by data.)

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The data I checked while researching @Chris’s original comment about not treating older patients backs up those assertions. The median population ages agree with the assertions countrywide; i.e. the median across the whole of China and the median across the whole of Italy. I had not seen the point about northern Italy, but I know enough history to treat the concept of an Italian government with a grain of salt. I would hope Americans in general would, Garibaldi is not just a biscuit and he had a significant influence on our thinking after the revolution.

There is an identical geographical point about China, where most of our figures come from; the numbers primarily reflect the Wuhan population, not the population of China as a country.

Every time I have been able to get at relevant figures they have backed up your point.

Here’s a third party that affirms this line of argument:

It quotes its source; it apparently has only one, but that is the New York Times. The article is also from March 10, so it is contemporary with the discussions here. The NYT article is a better reference because it predates the discussions on this list. It’s also very well written. Very.

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Long and sometimes wandering but the best expert info I’ve seen… well worth the time… from an unlikely source

Please watch

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