Diabetes and COVID-19: Risks, management, and learnings from other national disasters

Evidence relating to the impact of COVID-19 in people with diabetes (PWD) is limited but continuing to emerge. PWDappear to be at increased risk of more severe COVID-19 infection, though evidence quantifying the risk is highly uncertain. The extent to whichclinical and demographic factors moderate this relationshipis unclear, though signals are emerging that link higher BMI and higher HbA1c to worse outcomes in PWD with COVID-19. As well as posing direct immediate risks to PWD, COVID-19 also risks contributing to worse diabetes outcomes due to disruptions caused by the pandemic, including stress and changes to routine care, diet, and physical activity. Countries have used various strategies to support PWD during this pandemic. There is a high potential for COVID-19 to exacerbate existing health disparities, and research and practice guidelines need to take this into account. Evidence on the management of long-term conditions during national emergencies suggests various ways to mitigate the risks presented by these events.