Insulet Omnipod DASH insulin pump with insulin pods, podders, Omnipod DASH Personal Diabetes Manager

KITLIVING

High blood glucose and a rise in T1 diagnoses in children

linked to Covid-19; ARCADIA trial underway.

CORONAVIRUS UPDATE (5)

Staying safe and well

A

new therapy that

could treat people with

diabetes suffering from

Covid-19 is undergoing

an advanced clinical trial

in the UK.

The Medicines and Healthcare

products Agency (MHRA) has approved

the trial - named ARCADIA - following

preclinical research that suggests a

glucose kinase activator (AZD1656)

could help people with diabetes infected

with coronavirus by dampening the

overactive response of the immune

system typically acute in those patients

with raised blood glucose levels. The

trial will involve hospitalised patients with

mild to moderate Covid-19 symptoms

and, if successful, the compound could

ultimately be prescribed by a GP for

people with diabetes presenting with early

Covid-19 symptoms.

Over half a million people have been

referred into the programme, and those

completing the programme who were

overweight or obese lost on average

3.6kg, greater than initially predicted.

GPs are also now being encouraged

to prescribe cycling as a way for their

patients to lose weight, as part of a new

government strategy to tackle the nation's

obesity crisis.

Early-onset Type 1?

Imperial College London researchers want

to investigate a possible link between

Type 1 diabetes and Covid-19 after a

small study found cases of Type 1 among

children almost doubled during the peak

of Britain's coronavirus epidemic.

The study, published in Diabetes

Care, analysed data from 30 children in

London hospitals diagnosed with newonset Type

1 diabetes during the first

peak of the pandemic - around double

the cases during this period in previous

years. Twenty-one children were tested

for Covid-19 or had antibody tests -

and five tested positive for the infection.

"More research is needed to establish

whether there is a definitive link, ... but in

the meantime, we hope clinicians will be

mindful of this," said Karen Logan, who

co-led the study.

Covid-19 and hypers

New research indicates that nearly

half of hospitalised Covid-19 patients

without a prior diabetes diagnosis have

hyperglycaemia - which is an independent

predictor of mortality at 28 days.

Several previous studies have shown

a link between hyperglycaemia and worse

outcomes in Covid-19, and at least one

diabetes diagnosis, but this is the first to

focus specifically on that group of patients.

The findings, analysed retrospectively

from 605 patients with Covid-19 treated

at two hospitals in Wuhan, China, saw

that a fasting blood glucose of 7mmol/l or

more on admission - present in 45.6% of

those without a prior diabetes diagnosis

- was an independent predictor of 28-

day mortality

Although HbA1c data wasn't

analysed, the population is believed to

include both individuals with pre-existing

but undiagnosed diabetes and those

without diabetes who have acute 'stress

hyperglycaemia'.

"Glycaemic testing and control should

be recommended for all Covid-19 patients

even if they do not have pre-existing

diabetes, as most Covid-19 patients are

prone to glucose metabolic disorders,"

said Sufei Wang, of the Department of

Respiratory and Critical Care Medicine,

Union Hospital, Tongji Medical College,

Huazhong University of Science and

Technology.

"Addressing elevated fasting blood

glucose at an early stage can help

clinicians better manage the condition

and lower the mortality risk of Covid-19

patients."

The study is published in Diabetologia.

Glycaemic testing

and control should be

recommended for all

Covid-19 patients even

if they do not have preexisting diabetes

" continued over

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