Number of non-COVID-19 deaths among people with diabetes soared during pandemic, data shows

Leicester researchers involved in an international study have seen an increase in the number of deaths that were not related to COVID-19 among people with diabetes during the pandemic.

Dr Patrick Highton and a group of experts have identified a higher prevalence of health complications and non-COVID-19-related deaths among those with diabetes who are female, younger, and from ethnic minority groups.

During the review, the researchers examined the impacts of pandemic-related disruptions on people living with diabetes.

Commissioned by the World Health Organization and published in The Lancet Diabetes & Endocrinology, the review looked at 138 global studies to calculate and compare the number of non-COVID-19-related deaths among people with diabetes before and during the pandemic.

One study found that in 2021, there was an 11 per cent rise in non-COVID-related deaths among people with diabetes compared to 2019.

Dr Highton, joint primary author and Research Fellow for the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) East Midlands, said: “The rise in non-COVID-19 deaths among people with diabetes during the pandemic is deeply alarming.

“It is imperative that we address the broader health implications of the pandemic to ensure the wellbeing of those living with chronic conditions like diabetes.”

Co-author Professor Kamlesh Khunti, Director of NIHR ARC East Midlands and the Real World Evidence Unit and Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester, said: “In examining the health landscape during the pandemic, it is disheartening to observe the negative health impacts on individuals with diabetes are disproportionately affecting females, younger populations, and racial and ethnic minority groups.

“Recognising and addressing these disparities is crucial for fostering a more inclusive and resilient healthcare system.”

A startling increase in diabetes-related admissions to paediatric intensive care units (ICU) were identified in the review, as well as a rise in cases of diabetic ketoacidosis (DKA) among children and adolescents.

According to the study, some of the cases were due to new-onset diabetes, meaning DKA – a serious, potentially life-threatening complication of diabetes – coincided with the diabetes diagnosis. There was no rise in the frequency or severity of DKA among adults.

Fellow joint primary author Jamie Hartmann-Boyce, from the University of Massachusetts, said: “What we found overall was a fairly negative impact on diabetes outcomes.”

“The data on paediatric ICU admissions and paediatric DKA is probably the most striking thing that comes out of this review.”

She added: “It was very consistent across countries, and a paediatric ICU admission is a major event for kids and their families.”

Hartmann-Boyce, who herself has lived with type 1 diabetes since she was diagnosed at age 10, had initially conducted another WHO-commissioned study review on the direct impacts of the pandemic on people with diabetes.

She said: “We know that not getting your eyes screened regularly if you have diabetes is a problem and leads to more sight loss. And we saw diabetes-related mortality and all-cause mortality increasing in England during the first wave that wasn’t attributed to COVID but was probably related to reduced access to health care and reduced health care utilisation.”

This work was funded by the NIHR ARC East Midlands, with additional support from the NIHR ARC Oxford and Thames Valley.

NIHR ARC East Midlands funds vital work to tackle the region’s health and care priorities by speeding up the adoption of research onto the frontline of health and social care. The organisation puts in place evidence-based innovations which seek to drive up standards of care and save time and money.

NIHR ARC East Midlands is hosted by Nottinghamshire Healthcare NHS Foundation Trust and works in collaboration with the Health Innovation East Midlands. It has bases at the University of Leicester and the University of Nottingham.

To access the full research study, click here.

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