Latinos are more likely to get COVID-19 and diabetes. What does the combination mean for health?

Medical researchers are still studying exactly how the coronavirus affects people with diabetes. One thing, however, is already clear: both diabetes and COVID-19 are affecting Latinos more than other Californians.

“In the United States, members of racial and ethnic minority groups are disproportionately affected by diabetes,” according to David Kerr, a physician and director of research and innovation at the Sansum Diabetes Research Institute in Santa Barbara.

The trend is reflected in California ethnic communities. About 9.7% of the state’s Hispanic and African-American adults and 7.7% of Asian/Pacific Islander adults have Type 2 diabetes, compared to 6.8% of non-Hispanic white adults, according to an analysis from the state department of public health.

Diabetics face a higher chance of serious complications from COVID-19, according to the American Diabetes Association. But early research shows the risk of becoming seriously ill from COVID-19 is reduced if the diabetes is well-managed.

Type 1 diabetes occurs when an individual’s body is unable to produce its own insulin. Type 2 diabetes, the most common form, occurs when an individual’s body is resistant to its own insulin or when the pancreas doesn’t produce enough of it.

Latinos have long been more likely to develop Type 2 diabetes and to die from that disease.

Nationally, data from the U.S. Department of Health and Human Services Office of Minority Health found Hispanic adults are nearly twice as likely as non-Hispanic white adults to be diagnosed with diabetes by a doctor. About 17% of U.S. Latinos have diabetes, compared to 8% of non-Hispanic whites.

In the U.S., Hispanics also are 1.4 times more likely than non-Hispanic whites to die from diabetes. The risk of diabetes-related complications, including premature death, acute stroke and kidney disease, is also high among Latino adults.

Among Latino subgroups, a study from the Centers of Disease Prevention and Control found diabetes was more prominent among Mexicans, 24% and Puerto Ricans, 21%.

“We do not know whether people with diabetes are specifically at an increased risk of getting COVID-19. However, for those that do get COVID-19, if you have diabetes … the outcomes are dramatically worse for those populations, particularly if they have poor diabetes control,” Kerr said.

In California, Latinos make up 39% of the population, yet make up more than half of known COVID-19 cases and 45% of COVID-19 deaths.

Kerr said it’s too early to know if underlying conditions like diabetes contribute to high COVID-19 death rates among Latinos. But contracting COVID-19 could make a diabetic’s blood sugar more difficult to control, he said.

A letter signed by 17 medical experts, published in The New England Journal of Medicine, said there was a “bidirectional” relationship between COVID-19 and diabetes.

“On the one hand, diabetes is associated with an increased risk of severe COVID-19,” the letter stated. “On the other hand, new-onset diabetes and severe metabolic complications of preexisting diabetes, including diabetic ketoacidosis and (high blood sugar levels) for which exceptionally high doses of insulin are warranted, have been observed in patients with COVID-19.”

Jeffrey Reynoso, executive director of the Latino Coalition for a Healthy California, is concerned with the health disparity. He understands that those with underlying conditions like diabetes are more likely to face worse health outcomes from COVID-19. He also knows it’s especially hard for working-class Latinos who work the types of jobs where social distancing isn’t always possible.

“They have to go to work. They are more likely to be exposed to the virus,” Reynoso said. “How do we create those workplace policies that protect employees from further spreading the virus, ensuring that they have the necessary and personal protective equipment to keep themselves safe and ultimately healthy?”

Why are Latinos and Hispanics at a greater risk for Type 2 diabetes? Health studies have pointed to multiple factors, including Hispanic cuisine, genetics, obesity and the lack of access to health insurance. An estimated 13.7% of California Latinos remain uninsured, according to a UCLA Center for Health Policy Research brief.

Currently, the research institute has a program in the works called “Mil Familias,” or A Thousand Families, which plans to recruit 1,000 Latino families to look at the socio-cultural influences of their diabetes risk, including ethnicity, economic status, educational level and place of residence.

“In terms of participation in clinical trials of new therapies, devices, technologies, Latinos and other minority populations have been under-represented,” Kerr said.

In order to reach Spanish-speaking communities, the research institute launched a website in Spanish to provide information about COVID-19 and diabetes.

Improving access to healthy food could reduce the risk of poorer health outcomes from COVID-19, according to Kerr, and could play a role in reducing the impact of the virus’ second wave.

“Good control of diabetes protects people against having a bad outcome from infection,” he said.

Still, the most important thing for diabetics to do is to prevent infection in the first place, Kerr said.

The American Diabetes Association recommends regular hand-washing, avoiding high-touch surfaces in public places and avoiding crowds, especially in indoor spaces.

Those who feel they have COVID-19 symptoms are advised to call their doctor, with their glucose and ketone readings available. The organization also suggests keeping track of fluid consumption.

This story was originally published July 24, 2020 at 5:00 AM with the headline "Latinos are more likely to get COVID-19 and diabetes. What does the combination mean for health?."