Diabetes: A Common Comorbidity of COVID-19: Check Your Risk With 23andMe Raw Data

Diabetes is a chronic disorder wherein the body no longer responds to insulin. The disease could reduce the efficiency of the body’s immune system. As such, diabetes is a common comorbidity of COVID-19, with up to 20% of patients requiring intensive medical care. With lockdowns and social restrictions in place across the globe, here are some ways in which you can protect yourself from the novel coronavirus.

Introduction

The current COVID-19 pandemic has affected all our lives in one way or another. The cases report a range of symptoms from mild or asymptomatic cases to severe forms of pneumonia that could lead to the patient’s death.

With newer evidence released on a daily and monthly basis, researchers worldwide are trying to deduce the infection pattern, characteristic symptoms, potential treatment patterns, and drugs.

COVID-19 is an infection of a new coronavirus called the SARS-CoV-2 that emerged in the Wuhan region in China. This disease was so widely spread, that the World Health Organisation declared a global pandemic in March 2020.

The SARS-CoV-2 is a type of coronavirus, which falls under the same family as SARS and MERS. Some experiments have hypothesized that the virus has some affinity to angiotensin-converting enzyme receptor 2 (ACE2), which acts as the gateway to the human body.

Genetics and COVID-19

As many scientists rush to find the cure for the disease, a pressing question remains- why is there such a disparity between patients of COVID-19? How are there some individuals showing absolutely no symptoms, and on the other hand, why are some patients exhibiting severe pneumonia-like symptoms?

The known factors, like age and previous medical history, makes an individual more susceptible to showing severe symptoms.

However, there are cases of perfectly healthy young people showing severe symptoms as well. Some underlying genetic factors can be responsible for this.

As mentioned above, one hypothesized path that the virus takes to the body is through latching onto the ACE2 receptor.

Scientists have found variants of the gene that codes for ACE2, which could influence how the protein functions or impact the structure. This, in turn, affects how the virus could infect a person. 

Another factor that could influence how the virus infects an individual could be the person’s blood group.

The ABO gene determines the blood type of a person and could shine a light on how susceptible a person is to the virus. 

Both these genes are from preliminary studies, and this needs more validation and a larger group of volunteers to conclude any observation. 

Is diabetes a risk factor for COVID-19?

Diabetes is a condition in which there is an impairment in the body’s ability to produce or respond to insulin.

This results in abnormal levels of carbohydrates and elevated levels of glucose in the blood.

People with diabetes are at an increased risk, as they have an impaired immune response to infection.

This applies to both cytokine profiles and activation of T-cells and macrophages.

The impact of having an impaired response to insulin affects the body’s response to viral infection and potential secondary infection in the lungs. 

A study compared hospitalization rates of COVID-19 patients and the underlying medical conditions.

Of all the volunteers in the study, 7% were hospitalized and admitted in the ICU, and 77% were not hospitalized. While analyzing the patients with diabetes, up to 20% were hospitalized, and only 45% were not hospitalized.

This data shows that patients with diabetes require extra medical attention if diagnosed with COVID-19. 

Patients with type 2 diabetes are also at risk of being obese. This is an additional risk factor for severe infection.

In the case of the 2009 H1N1 epidemic, about twofold more patients diagnosed with the disease, with a history of obesity, ended in ICU, and took longer to recover. 

Finally, the most common co-morbidities to COVID-19 are hypertension and diabetes.

These diseases are both treated with ACE2 inhibitors.

This means that a patient with an ACE inhibitor would have an increased expression of ACE2.

Since the novel coronavirus targets ACE2, it could facilitate COVID-19 infection, and place these patients at a high risk of disease and fatality. 

Genetics and Diabetes

Genetics plays a role in type 2 diabetes; however, factors like lifestyle choices play a larger role in the manifestation of this disease.

A choice for healthy living can heavily lower the chances of developing type 2 diabetes.

This includes staying healthy by maintaining a healthy weight and choosing healthy foods.

It is possible to test for your genetic predisposition towards diabetes using your 23andMe DNA raw data.

Diabetes and COVID: Reducing your risk using 23andMe DNA data

If you have are a diabetic/ have a predisposition to diabetes, it is important to be prepared. Some measures that you can take are:

  • Have emergency contacts ready in case you would need them.
  • If you show any influenza-like symptoms, contact a medical professional immediately. 
  • Regularly check blood glucose levels to avoid complications related to low or high blood pressure.
  • Make sure you have access to a sufficient amount of food and water.
  • If you have to quarantine yourself, make sure you have the required medications for that period.
  • If you need to correct your blood pressure, make sure you have the necessary medications. 
  • Try to follow a regular schedule and get a good night’s sleep. 
  • Make movement and exercise a priority, and try to incorporate small exercises throughout the day. Comply with social distancing.
  • Avoid unnecessary travel, stay at home as much as possible
  • If you do have to step out, wear a face mask, stay 6 feet away, and carry hand sanitizer.

Diet plan for diabetes- COVID-19 version

There are three main pillars of diabetes maintenance, monitoring, exercise, and diet. Measures that you can take with respect to exercise and monitoring are explained above, and the following details a diet plan that you can follow. 

  • Prioritize following a healthy, well-balanced diet to keep glucose levels up, and to enhance immunity
  • In the case of dips in your blood sugar, keep simple carbs like honey, fruit juice or candies 
  • Stock up on foods that have a low glycaemic index (vegetables and whole wheat pasta/noodles)
  • Avoid excess consumption of fast foods or fried foods
  • Limit consumption of refined sugars, carbohydrates, and fats
  • Incorporate fruits and nuts into your diet

Summary

COVID-19 is caused by a novel coronavirus, SARS-CoV-2. The symptoms and the path of infection are still being studied, with new data being released on a daily basis. Individuals with comorbidities, especially like diabetes and hypertension, must strictly follow social distancing practices. If they do step out, measures of wearing a face mask, carrying a sanitizer, and washing hands thoroughly with soap can help prevent infection.

References

Could genetics play a role in the severity of COVID-19?

COVID-19 Information Center

COVID-19 Infection in People with Diabetes

Diabetes and COVID-19

https://www.idf.org/aboutdiabetes/what-is-diabetes/covid-19-and-diabetes/1-covid-19-and-diabetes.html

https://www.idf.org/aboutdiabetes/what-is-diabetes/covid-19-and-diabetes/1-covid-19-and-diabetes.html

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