ATTD 2021: Lessons About Diabetes During The COVID-19 Pandemic


 

ATTD, a technology conference that provides a platform for clinicians and scientists to present and discuss insights on diabetes technology and treatment took place virtually this year from June 2 – June 5. 


The 14th International Conference on Advanced Technologies and Treatments for Diabetes (ATTD 2021) has just concluded. On the conference’s first day, June 2, researchers and scientists from the world’s leading universities, technology companies, and diabetes organizations presented and discussed their work around treating patients with diabetes and lessons about diabetes during the pandemic. 

The first plenary session included a presentation from Irl Hirsch, MD, professor of medicine at the University of Washington and board certified physician at the Endocrine and Diabetes Care Center at UWMC-Roosevelt, about the impact of the COVID-19 pandemic on diabetes. 

“We know from the National Health Service in the UK, there were almost eleven thousand deaths initially linked to COVID-19, over four thousand of them with diabetes,” Hirsch said at the ATTD conference. According to the American Diabetes Association data, the odds of a COVID-19-related hospitalization and greater illness severity for patients with Type 1 diabetes are three to four times higher than patients without diabetes. 

He added that what was most surprising was the higher mortality rate observed in people with Type 1 diabetes when compared to Type 2 in a nationwide study from England.

Editor’s Note: Beyond Type 1 previously covered some of the limitations with the NHS study. Click Here for a more in-depth review and visit coronavirusdiabetes.org to learn more about the intersection of diabetes and COVID-19.

Irl Hirsch also presented the following lessons about diabetes during the pandemic:

  1. Type 2 diabetes results in a two to three fold increase risk of mortality. 
  2. Diabetes was associated with a 64 percent greater excess risk in women compared with men. In men, an HbA1c was not associated with a greater risk of COVID-19. 
  3. Angiotensin-converting enzyme2 (ACE2) is an entry site for the virus into cells. 
  4. Dipeptidyl peptidase-4 inhibitor (DPP4) has not received as much attention despite there being evidence that COVID-19 may also bind to DPP4. Understanding COVID-19’s binding patterns could lead to treatment, said Hirsch. 
  5. Data about the impact of COVID-19 outcomes for those taking Metformin is mixed and inconclusive. 
  6. SGLT2 inhibitors have pros and cons. Pros include reduced inflammatory endpoints and myocardial oxygen consumption. Cons include concerns of DKA associated with COVID-19 infection. 
  7. Telemedicine has revolutionized health care throughout the pandemic by providing a more efficient way to have a visit and train patients on using pumps and other diabetes technology. 

In regards to Telemedicine, Hirsch lists some potential challenges. Firstly, many people with diabetes are still using finger prick glucose monitoring, making it difficult to collect robust data.“Obtaining glucose data for many people with Type 2 diabetes, still using fingerstick home blood glucose monitoring, we can’t get the data with an upload because the technology is not there,” Hirsch said. 

Secondly, uploading electronic records has posed a challenge for clinical staff. “Getting all the data ready before the visit electronically has been a huge burden for our staff and our medical assistance and overall infrastructure,” explains Hirsch. “I think the jury is still out to see what the full impact of telemedicine is.” 

Despite the challenges, in the era of COVID, Hirsh said that telemedicine will continue to be a vital tool now and onwards. “Telemedicine will continue to be important. This is becoming the standard of care, even for newly diagnosed Type one diabetics,” Hirsch said. 

WRITTEN BY Kayla Hui, MPH, POSTED 06/07/21, UPDATED 06/07/21

Kayla Hui is the health reporter for Beyond Type 1 covering diabetes, chronic illnesses, and health inequities. She received her Masters in Public Health from the Boston University School of Public Health. Kayla won a Pulitzer Center fellowship and Slants Foundation award in 2020 for her project on the mental health of Chinese Immigrant truck drivers. Her published work can be found at Healthline, Verywell Health, Pulitzer Center, and more. Outside of work, Kayla enjoys rock climbing, baking, and buying plants she doesn’t need. You can follow Kayla on Twitter at @kaylanhui.