Concerns about diabetes and COVID-19

1. It’s been almost 2 years since the alarm bells first sounded about COVID-19. While we’ve all been very preoccupied with the pandemic, there are other important health issues that may have taken a back seat, at least in terms of the public’s attention, over the last 24 months. Is it fair to say that diabetes is one of those?
   
   Absolutely. Diabetes was referred to as the silent epidemic even before the coronavirus appeared. It’s a condition that affects over 3 million Canadians, or about 9% of the population. And almost as many Canadian adults (6.1%) are at high risk of developing the disease¹ .
   
   During the pandemic, we’ve all seen how efforts to manage COVID-19 in different jurisdictions have had different results and outcomes. Unlike the coronavirus, when it comes to diabetes, Diabetes Canada says the country has no strategy to address the crisis² . According to Diabetes Canada, that means that every 24 hours:
   
   • more than 20 Canadians die of diabetes-related complications
   • 480 more Canadians are diagnosed with diabetes
   • 14 Canadians have a lower limb amputation, and
   • the health care system spends $75 million treating diabetes³ .
     
     
   I believe the country needs a strategy to confront this disease. As our population ages, the effects and costs of diabetes will continue to grow.
    
2. Have the last 2 years made things more difficult for people living with diabetes?
   
   From my perspective as a pharmacist, I’d have to say “yes.” When access to medical services was restricted to prevent the spread of COVID, many people dealing with chronic illnesses experienced interruptions to their care. There was much less screening taking place, and it was more difficult to manage the complications that arise with the illness.
   
   Exercise and proper nutrition are important ways to manage diabetes. During the pandemic, it’s been more challenging to ensure both those things are happening – especially during the lockdowns.
   
   More recently, research is suggesting a two-direction relationship between diabetes and COVID-19. There’s evidence to suggest that people with diabetes are at risk of worse outcomes if they contract COVID-19. Plus, having the virus might prompt the future development of diabetes. This appears to be because of the effect the virus has on the pancreas, the body’s response to infection, and the effects of some drugs used to treat severe cases of COVID-19³ .
    
3. So, there’s more to watch for as we learn about COVID-19’s relationship to diabetes. We already know that diabetes can place a burden on the people living with it (and their families). How is diabetes affecting the workplace?
   
   Well, it can mean time away from work for people who are trying to manage their condition themselves, or for those who are the spouses, partners, or parents of people who have the disease.
   
   For employers and their benefits plans, we’re seeing diabetes as one of the leading categories for drug spend. Express Scripts Canada finds that in 2020, based on its adjudication of claims, the spend on diabetes is only surpassed by the cost to treat inflammatory conditions. And keep in mind, inflammatory conditions often involve high-cost specialty medication⁵ .
    

4. Is there any good news that you can share? What’s next on the horizon in the fight against diabetes?
   
   There certainly are good things happening. Technology is bringing us new medical devices that help diabetic patients manage their condition better, while also offering less invasive treatment regimes. Medications continue to be developed and improved.
   
   In 2021, the world celebrated the 100^th anniversary of the discovery of insulin by a team of doctors at the University of Toronto⁶ . Before that, diabetes was a fatal illness. And just a year ago, none of us had been vaccinated against COVID-19. Those are both important medical milestones.
   
   So, I think there is a lot to look forward to as we strive to prevent, treat, manage, and perhaps someday cure, diabetes and other chronic conditions.

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