New research is showing an epidemic of diabetes in younger people in Mexico means more of them are getting COVID-19, which could have implications for the US, where 10% of the population has diabetes.
The diabetes crisis in Mexico, which kills more people there each year than interpersonal violence, could be making their COVID-19 pandemic even worse, particularly for young people, according to metabolic health experts.
Casey Means, a medical doctor and Chief Medical Officer of metabolic health company Levels, said reports from the Mexican government show of those dying from COVID, 44% reported having hypertension, 43.2% diabetes and 40% obesity.
Means said early data coming out of Mexico is showing those with early-onset diabetes are much more likely to end up in hospital and/or on a respirator.
There appears to be a reason for this, down at the cellular level in the human body. In a recent article in the scientific journal Metabolism, Means said a protein which helps the COVID-19-causing virus into human cells, is found more often in patients with diabetes.
“These are largely preventable lifestyle mediated diseases that people dying are disproportionately dying of the disease,” Means said.
Carlos Aguilar Salinas, a medical researcher and director of the nutrition division of Mexico’s National Institute of Medical Science and Nutrition. Institute, says there is both a genetic and nutritional component to the high rates of diabetes in Mexico.
“Mexicans have ethnic specific genetic variants that increased our susceptibility for type 2 diabetes ,” Aguilar Salinas said, “The shift from a carbohydrate rich diet to a high-calorie, high-fat diet and a remarkable decrease in physical activity caused the rise of obesity in our region.”
Aguilar Salinas says major changes must occur in the next few years in developing countries to control metabolic disorders.
“Modifications in the food chain production and distribution, major adjustments in supermarkets, changes in built environment to enforce walking and physical activity will have a major impact in the short term,” Aguilar Salinas said.
Means says the lowest hanging fruit in public health measures is clear, strong guidelines from health authorities and government.
“The risk of becoming seriously ill with COVID-19 is likely to be lower if diabetes is well controlled, and glucose levels are rapidly modifiable with dietary and lifestyle changes,” Means said.
Means says that given only 5% of diabetics appear to have their condition well controlled and managed, this could be a big help.
“Another low hanging fruit includes supporting increased access to diabetes monitoring technology like continuous glucose monitors, which are wearable sensors can allow people to forgo fingersticks and have continuous tracking of glucose 24 hours a day,” Means said.
Mexican researcher Omar Yaxmehen Bello-Chavolla said although Mexico is not at excess risk of COVID-19 compared to other countries, there could be more young people dying of COVID-19 because of co-morbidities, that is, pre-existing conditions like diabetes or obesity.
“Despite our population being younger, mortality might not be lower due to the high rates of young adults with metabolic co-morbidities,” Bello-Chavolla said, “But no study on ethnicity and disease severity in Latin Americans or other ethnicities has been conducted in relation to COVID-19 incidence, severity and mortality, and these gaps in knowledge must be addressed to understand the heterogeneity of the pandemic across different regions.”
Diabetes patients in the developing world aren’t the only ones that are facing challenges in the era of COVID-19.
Utibe Effiong, a MidMichigan Health doctor and a senior fellow of global health and development at the Aspen Institute, says lupus and rheumatoid arthritis patients in the US and across the world are currently losing access to hydroxychloroquine, putting them at risk of disease flares and hospitalization – possibly exposing them to COVID-19.
Effiong and other health experts are warning hundreds of thousands of people, mostly women, could be in pain thanks to the hydroxychloroquine shortage.