Are you a trial lawyer
Ha! No, not a lawyer, a scientist. So, I follow the facts !
(I hesitate to say, “… follow the science…”)
Immunodeficiency is a lack of ability - a deficiency - of the immune system to protect the body from infection. “Deficiency” is part of the word.
My immune system was so on-guard that it killed off my beta cells. I don’t think it was deficient. It was very efficient. It killed everything.
If diabetes is not well-controlled, then a person can become immune-compromised. But diabetes itself does not do it. It is the lack of control that does it.
And is lack of control a certainty? Nope.
Yes, but this is not a “normal” response, and probably not a response that you wanted. Does this mean that when faced with a virus, your immune system will be very efficient in killing it off? Or will it be very efficient and attack something you don’t want it to? I don’t know.
Having one auto-immune disease increases the risk of having another. That makes me think that with T1D, my immune system probably isn’t working “normally.” Will it work normally when confronted with a virus? Or will it over-respond and attack something else? I don’t know.
Am I immune compromised with T1D? I don’t know. But, I would say that my immune system has responded abnormally in the past, and it might respond abnormally again.
I have a friend who 1st developed Addison’s disease which is autoimmune. She has a couple more autoimmune diseases that developed after viral infections. She would say her immune system is compromised.
Just to add a little more to this question. My wife, who is a health care professional but not a diabetic, believes that diabetes is an autoimmune disease.
Can we go up one level, and ask whether there is enough research now to document that T1 diabetics are at higher risk of complications from Covid 19 to warrant consideration as a group that is eligible for the second round of the bivalent vaccine booster?
I say ‘now’ because we investigated this question a couple of years ago on these boards and found that the CDC was missing one study before it declared T1 Diabetics to be high risk. Has that study been done?
here’s a link to that long-ago thread: https://forum.fudiabetes.org/t/my-concerns-about-covid-vaccine-priority/10631/40
More generally, is there science to support the statement that T1Ds are more at risk from Covid than the general population? (I suspect there is, but I don’t have a cite or a definition from the CDC)
The only thing that T1Ds are deficient of, is insulin. White blood cells (which fight infection) are no different than any non-diabetic ASSUMING decent control and no other motivating factors or conditions brought upon an a result of poor D-management.
Incorrect. They are no more susceptible to illness than any other person without T1D IF they have always had perfect control of their blood sugars. The better a diabetic’s control is, the closer their health is to what it would be without T1D. But without perfection, T1D does compromise the immune system–the definition of immunocompromised. The degree of the compromise will vary based the level of control–those with diabetes may be slightly, moderately or severely immunocompromised. Limiting the degree of compromise to ones immune system is yet another reason to try to maintain good control of ones diabetes. But there will always be some compromise and the goal has to be to manage that, not ignore it.
Bringing us back around to the original topic, getting vaccinated/boosted is a simple way of managing that additional risk and I urge everyone with diabetes to get the booster as soon as it becomes available to you.
Are there studies that we can read that teach us how T1D bodies are impacted at each stage? Say I’ve been good 99% off the time (what is the good standard, even?). I would once again point to the old timers who, many of them had T1D before all of our modern tech, and they (to my knowledge) aren’t sick more than non diabetics. Old timers plz feel free to correct me if that’s wrong.
What you describe may very well be the case but it’s antidotal in my mind unless there are actual studies out there that have quantified this.
Just to re-address the original question and not get into the semantics of it all - I think that most likely a T1 could get an early vaccine if they were to go to a doctor and tell them they have diabetes and request whatever classification they needed to be able to get the vaccine.
It is doubtful that any doctor would get into a debate about it.
Although it is not a vaccine, it is a treatment, on the Paxlovid commercials, they reference diabetes. It’s right here!
If you wanted to get an early vaccine, certainly no doctor would debate you on this.
Moving off the topic of immunocompromised, People with diabetes mellitus regardless of type are more at risk of damage from this virus. A large minority if not majority will have hyperglycemia that does not respond well to insulin. This is worse in the non insulin using type 2 DMs because they don’t have the option of increasing their dosage.
Everytime BG is above 160mg/dl 8.9mmol/L and for sure above 180mg/dl 10.0mmol/L damage to micro blood vessels and to the kidneys is possible. One of the things that came out with the pandemic has to do with the lungs. The lungs are filled with extremely fine blood vessels to make the exchange of CO2 for O2. These vessels can be damaged like those in the eyes to fairly low hyperglycemia.
This caused a lot of death and long covid respiratory issues in both the non-diabetic and people with diabetes. We are at greater risk of severely damaged lungs from a covid infection.
My question is Can you say that your BG levels have never been above 160mg/dl 8.9mmol/L?
BG or A1C? No diabetic ever can answer yes to the first I would wager
HbA1c can have highs and lows while being what is considered a safe percentage. Damage to the very fine blood vessels and nephrons at those levels of hyperglycemia. It’s why I set my range to 70 to 145mg/dl.
180 is not safe.
Well that’s a scary thought
I don’t mean to be fear mongering, but we need to be aware that damage can begin to occur at even moderate hyperglycemia.
After 29 years or so I developed a spot of diabetic retinopathy in my right eye. Since starting MDI and using a pump it has cleared up. The retinologist sees only very slight blood vessel enlargement in that spot. My HbA1c was high 6es to 7. For the last 2 years 5.4 to 6%, never higher.
My concern now is slightly elevated albumin. It runs At high normal to above normal. I’m going to ask about Kerendia, I have a concern because my BP is low normal. Kerendia can lower blood pressure.
While the diseases have different causes hyperglycemia is destructive no matter the type diabetes.
One other thing, as you have a child with type 1, growing children have a higher range than us old folks. Might have to do with growth hormone, I forget.