Diabetes increases the odds that a COVID-19 infection will be severe, and folks with diabetes may be up to four times more likely to develop long-lasting symptoms, new research suggests.
"Though more data is needed, some early studies suggest that diabetes may be a risk factor for long COVID, and thus careful monitoring of people with diabetes for development of long COVID may be advised," said study author Jessica Harding, an assistant professor of epidemiology at Emory University School of Medicine in Atlanta.
Long COVID symptoms run the gamut from fatigue, shortness of breath and cough to brain fog, dizziness and changes in taste or smell. These symptoms may come and go or persist and can last for months after the initial COVID infection, according to the U.S. Centers for Disease Control and Prevention.
Exactly how diabetes can add to the risk for long COVID is not fully understood, but many theories exist.
"Diabetes is a chronic disease with accompanying inflammation," said Dr. Len Horovitz, a pulmonologist at Lenox Hill Hospital in New York City, who wasn't part of the study. "Anything that amplifies that inflammatory state may lead to unremitting inflammation or long COVID."
For the new study, Harding and her colleagues examined studies looking at long COVID symptoms in people with and without diabetes. In all, 43% of seven studies included in the new analysis identified diabetes as a potent risk factor for long COVID.
This isn't the final say on the matter, because the studies included in the new analysis included many different groups of people, clusters of symptoms and had multiple follow-up times, making it difficult to draw a firm conclusion, Harding said.
"Vaccines, boosters and masks are the best prevention for initial COVID-19 infection," she said. "However, if infected, it may be advisable [for someone with diabetes] to regularly monitor glucose levels, and adhere to prescribed glucose-lowering agents where appropriate, to reduce and manage long COVID risk."
The findings were presented Sunday at a meeting of the American Diabetes Association, in New Orleans. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.
Outside experts who reacted to the findings agree that people with diabetes need to double down on their efforts to stay healthy during this ongoing pandemic.
"Having diabetes and COVID-19 may be a risk for experiencing long-term negative consequences of COVID-19," said Marlon Pragnell, vice president of research and science at the American Diabetes Association. "People with diabetes may have more severe disease that could manifest over a longer period of time."
The message is clear: "Get vaccinated," Pragnell said. "You could get breakthrough COVID-19, but there are fewer reports of long COVID in people who are vaccinated."
It's equally important to keep your blood sugar in check if you have diabetes.
"The worse your diabetes is going into COVID-19, the worse your outcomes will be," Pragnell said.
Eating a healthy diet, getting regular exercise and maintaining a normal weight are essential for managing diabetes and staying healthy, he noted.
Dr. Eunice Yu, medical director of COVID-19 Recovery Care at Henry Ford Health in Detroit, agreed.
"We are still learning about the mechanisms underlying long COVID, which will help us better understand why diabetes patients seem to be more susceptible," she said.
If you get COVID and have diabetes, monitor your blood sugar more carefully for a couple of months after infection as diabetes may also be more severe after COVID, Yu suggested.
"Good rest, regular exercise and eating a healthy diet can prevent continued damage and help clear the virus," she said.
If COVID-19 symptoms aren't getting better or new ones are popping up, see your doctor for an evaluation, Yu added.
"People do get better," she said. "We don't have a silver bullet, but we do have ways to help people with long COVID."