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Keto and the Wuhan Flu

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    Sepulchrave [2092631] Sepulchrave
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    Thread created on 17:23:13 - 19/03/20 (5 years ago)
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    Last replied 16:12:54 - 20/04/20 (5 years ago)
    My wife (LuluCthulhu [2100706]) is strict keto and I am definitely a fan, although not a practitioner. Yesterday she brought a series of articles to my attention.

    Research is pointing towards glucose utilization as a critical protective response during severe viral infections.
    Our data suggest that glucose utilization is required for the cytoprotective response in neurons in the setting of viral inflammation, as inhibition of glucose utilization led to death
    That's from the article in Cell.

    Here's the easy-to-read version:
    When Medzhitov infected the mice with the influenza (flu) virus, the mice were more likely to survive if they were force fed. Denying them food—especially glucose, either by withholding it or administering the antagonist 2-deoxy-D-glucose—caused the mice to die. As the researchers write in the journal, in influenza infection, “inhibition of glucose utilization is lethal.” Whereas glucose was “required for survival in models of viral inflammation, it was lethal in models of bacterial inflammation.”

    How could that be?

    The mechanism doesn’t seem to have anything to do with starving the infectious agent. Rather, it has to do with modulating our own responses to the infections. Here we are dealing with two very different types of inflammation. In one case, [bacterial infections] glucose exacerbates inflammation. In the other, it is critical to survival.
    In other words, glucose appears to be counter-indicated in bacterial infections, but important for preventing the worst effects of a viral attack. These are mouse studies, but as the Cell paper notes:
    Given the conservation of cellular adaptation and metabolic programs in mouse and human, our findings likely have clinical implications.
    We are, in effect, very similar to mice in much of our basic cellular and metabolic physiology. So it's likely that these findings in mice apply to us too.

    I'm not suggesting that anyone change their diet. I am not a doctor, a nutritionist, or even a scientist. Do with this information what you will. The message I'm taking from this is that if you are experiencing flu-like symptoms, which are likely (especially now) to be caused by a virus, you should be aware of the needs of your body. If you're sick and your body is craving a glass of ginger-ale or a PB&J sandwich, it could be giving you information that you need to survive.

    ADDENDUM: Note also that the mice with influenza who were "force-fed" were more likely to survive. Viral infections are not a good time for a fast.
    Last edited by Sepulchrave on 17:35:50 - 19/03/20 (5 years ago)

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    Lunchtime [128309] Lunchtime
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    Posted on 18:58:14 - 19/03/20 (5 years ago)
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    This is interesting and helpful information. Would you happen to know if there are statistics out there that show how people on low carb diets fare when it comes to viral infections?
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    Sepulchrave [2092631] Sepulchrave
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    Posted on 19:47:31 - 19/03/20 (5 years ago)
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    Lunchtime [128309]

    This is interesting and helpful information. Would you happen to know if there are statistics out there that show how people on low carb diets fare when it comes to viral infections?
    I can't see specific stats for low carb diets. I'm an omnivore with a fairly balanced diet, and I've never paid much attention to food science, but if I were restricting my intake of any particular food group I would take pains to make sure that I was getting enough protein, zinc, vitamin A & E and selenium. Their roles in fighting viruses are documented - here, for example:

    https://sci-hub.se/10.1016/s0955-2863(96)00132-5

    There's probably more - a quick search on "viral infection oxidative stress nutrition" for example, seems at first glance to suggest protection from certain aspects of viral pathogenesis through the consumption of foods rich in antioxidants. Sadly, I don't have to time to follow through at the moment. I can feel the expectations of my employers tickling the extra sense at the nape of my neck. Again - everything I've written here is amateur hour - please do your own research and don't jump to conclusions. Virology and nutrition are ticklish affairs. Intuitively, I have a feeling that people who eat a broad enough spectrum of quality food are likely to be doing just fine. ;)

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    Capgros [2088627] Capgros
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    Posted on 11:45:20 - 22/03/20 (5 years ago)
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    I think a healthy and variated diet helps against everything, basically you have better defenses that way. I'm all Mediterranean diet. I'm not too worried for the rest about food, just eat what feels good for my body, too much worrying makes you stressed which is also bad.
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    Hermaeus-Mora [2136279] Hermaeus-Mora
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    Posted on 14:47:04 - 22/03/20 (5 years ago)
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    Lots of people report flu like symptoms when just starting out on keto. Perhaps there's some link? It's not a diet I will be carrying on with but only because I really cannot live without the sauce XD. There's only so many gin and tonics I can drink until I want beer! It is a fantastic diet if you're fully committed to it but that's probably the case with most diets! I would have thought that if you are deep in ketosis then your ketone production would easily hold up to any of the conventional sugar reliant functions and as a result make you no more susceptible to a virus.
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    Sepulchrave [2092631] Sepulchrave
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    Posted on 00:27:27 - 23/03/20 (5 years ago)
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    Hermaeus-Mora [2136279]

    Lots of people report flu like symptoms when just starting out on keto. Perhaps there's some link? It's not a diet I will be carrying on with but only because I really cannot live without the sauce XD. There's only so many gin and tonics I can drink until I want beer! It is a fantastic diet if you're fully committed to it but that's probably the case with most diets! I would have thought that if you are deep in ketosis then your ketone production would easily hold up to any of the conventional sugar reliant functions and as a result make you no more susceptible to a virus.
    Susceptibility is a different issue.

    What I'm talking about is surviving the sepsis caused by a severe viral infection. Sepsis is the leading cause of death in critically ill patients in intensive care units. It occurs when our immune systems respond to injury and infection. If those responses spiral out of control, say in the infamous cytokine storm, they can end in death. I won't go too deep, because I'm NOT a doctor and I'm just learning this stuff myself and it's pretty complicated at a granular level.

    In a nutshell, ketone bodies help to control the products of oxidative stress, an underlying factor in sepsis caused by bacterial infections.

    When it comes to viral infections, however, glucose prevents a chain of events that can lead to cellular suicide (apoptosis) on a Jonestown scale, and dying/dead cells may release signals which can lead to even more inflammation. In the absence of glucose, a positive feedback loop (or "vicious circle") could be initiated that leads to the destruction of tissues and death. So, best not to starve a viral infection, and if you begin to feel flu-ish, it might be a good time to swallow your pride and also some carbs. (Beer, of course, is always good for you, or so I hope.)

    The key finding I'm bouncing off is this:
    We found that, whereas glucose was necessary for adaptation to and survival from the stress of antiviral inflammation by preventing initiation of endoplasmic reticulum (ER)stress-mediated apoptotic pathways, glucose prevented adaptation to the stress of bacterial inflammation by inhibiting ketogenesis, which was necessary for limiting reactive oxygen species (ROS) induced by anti-bacterial inflammation.
    If you want to read the whole paper it's here. I needed to read about 10 other papers for background, but you'll have to find those by yourself.

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    oldskoolsuzuki [70196] oldskoolsuzuki
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    Posted on 19:28:54 - 23/03/20 (5 years ago)
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    I'm a type 1 diabetic and have been informed that good control of my blood glucose (HBA1c at or below 6%) will be beneficial if i do contract CoViD. Apparently this virus likes high blood glucose, which is why so many diabetics that contract it are dying.

    When a T1D gets sick, blood glucose levels tend to rise and become harder to control, we can be required to take up to 25% more insulin than usual and for diabetics, ketones are our enemy!
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    Sepulchrave [2092631] Sepulchrave
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    Posted on 22:55:20 - 23/03/20 (5 years ago)
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    oldskoolsuzuki [70196]

    I'm a type 1 diabetic and have been informed that good control of my blood glucose (HBA1c at or below 6%) will be beneficial if i do contract CoViD. Apparently this virus likes high blood glucose, which is why so many diabetics that contract it are dying.

    When a T1D gets sick, blood glucose levels tend to rise and become harder to control, we can be required to take up to 25% more insulin than usual and for diabetics, ketones are our enemy!
    Yup - figures from China confirm your concern. This is from an interesting summary of ~72,000 Chinese case reports:
    The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44?672 confirmed cases). No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. No deaths were reported among mild and severe cases. The CFR was 49.0% among critical cases. CFR was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer. Among the 44?672 cases, a total of 1716 were health workers (3.8%), 1080 of whom were in Wuhan (63%). Overall, 14.8% of confirmed cases among health workers were classified as severe or critical and 5 deaths were observed.
    So yes, increased risk of death, 7.3% as opposed to 2.3% for the general population (as far as we can trust these stats). Fortunately (and as you implicitly note) I don't see anything to suggest that diabetics are more likely to be infected than anyone else (let's hope that doesn't change). The correlation with severity makes sense - hyperglycemia induces inflammation, and so does the virus...together, intuitively (I have to say that because I'm a complete amateur) it sounds like a recipe for disaster. I can't find anything to suggest a specific SARS-CoV-2 affinity for glucose, but I'm sure there are hundreds of people pouring over lab results as we speak, and I'm sure we'll know more in the future about the underlying "omic" factors that make some people more susceptible, and some people more at risk.

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    HiccupinJonsey [2261316] HiccupinJonsey
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    Posted on 18:34:39 - 11/04/20 (5 years ago)
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    oldskoolsuzuki [70196]

    I'm a type 1 diabetic and have been informed that good control of my blood glucose (HBA1c at or below 6%) will be beneficial if i do contract CoViD. Apparently this virus likes high blood glucose, which is why so many diabetics that contract it are dying.

    When a T1D gets sick, blood glucose levels tend to rise and become harder to control, we can be required to take up to 25% more insulin than usual and for diabetics, ketones are our enemy!

    Sepulchrave [2092631]

    Yup - figures from China confirm your concern. This is from an interesting summary of ~72,000 Chinese case reports:
    The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44?672 confirmed cases). No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. No deaths were reported among mild and severe cases. The CFR was 49.0% among critical cases. CFR was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer. Among the 44?672 cases, a total of 1716 were health workers (3.8%), 1080 of whom were in Wuhan (63%). Overall, 14.8% of confirmed cases among health workers were classified as severe or critical and 5 deaths were observed.
    So yes, increased risk of death, 7.3% as opposed to 2.3% for the general population (as far as we can trust these stats). Fortunately (and as you implicitly note) I don't see anything to suggest that diabetics are more likely to be infected than anyone else (let's hope that doesn't change). The correlation with severity makes sense - hyperglycemia induces inflammation, and so does the virus...together, intuitively (I have to say that because I'm a complete amateur) it sounds like a recipe for disaster. I can't find anything to suggest a specific SARS-CoV-2 affinity for glucose, but I'm sure there are hundreds of people pouring over lab results as we speak, and I'm sure we'll know more in the future about the underlying "omic" factors that make some people more susceptible, and some people more at risk.
    At 45 years old i suddenly became a T1 diabetic. No type two leading into type one, no genetic inclinations or lifestyle patterns that could instigate diabetes just dramatic weight loss over four months and other symptoms i didn't realize were even symptoms until i started losing 3lbs a day and broke down to see a doctor at which point i was down to 105lbs from a solid 170lbs at 5'11. That was two years and many hospital visits for ketoacidosis ago.
    What I've learned, and the learning curve has been steep and heavily laden, is that a healthy balance of glucose levels is paramount to your body's ability to fight infections etc. Avoiding processed sugars, eating healthy protiens, fibre and fats in a normal diet is adequate for most to keep an expected A1C count. If you're worried about Covid, now is not the time to diet. Also, mortality figures regarding diabetics during the initial outbreak in China may be skewed somewhat as China (and most of Asia for the most part) have lower incidents of diabetes than Occidental races.

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    oldskoolsuzuki [70196] oldskoolsuzuki
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    Posted on 19:09:39 - 15/04/20 (5 years ago)
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    oldskoolsuzuki [70196]

    I'm a type 1 diabetic and have been informed that good control of my blood glucose (HBA1c at or below 6%) will be beneficial if i do contract CoViD. Apparently this virus likes high blood glucose, which is why so many diabetics that contract it are dying.

    When a T1D gets sick, blood glucose levels tend to rise and become harder to control, we can be required to take up to 25% more insulin than usual and for diabetics, ketones are our enemy!

    Sepulchrave [2092631]

    Yup - figures from China confirm your concern. This is from an interesting summary of ~72,000 Chinese case reports:
    The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44?672 confirmed cases). No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. No deaths were reported among mild and severe cases. The CFR was 49.0% among critical cases. CFR was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer. Among the 44?672 cases, a total of 1716 were health workers (3.8%), 1080 of whom were in Wuhan (63%). Overall, 14.8% of confirmed cases among health workers were classified as severe or critical and 5 deaths were observed.
    So yes, increased risk of death, 7.3% as opposed to 2.3% for the general population (as far as we can trust these stats). Fortunately (and as you implicitly note) I don't see anything to suggest that diabetics are more likely to be infected than anyone else (let's hope that doesn't change). The correlation with severity makes sense - hyperglycemia induces inflammation, and so does the virus...together, intuitively (I have to say that because I'm a complete amateur) it sounds like a recipe for disaster. I can't find anything to suggest a specific SARS-CoV-2 affinity for glucose, but I'm sure there are hundreds of people pouring over lab results as we speak, and I'm sure we'll know more in the future about the underlying "omic" factors that make some people more susceptible, and some people more at risk.

    HiccupinJonsey [2261316]

    At 45 years old i suddenly became a T1 diabetic. No type two leading into type one, no genetic inclinations or lifestyle patterns that could instigate diabetes just dramatic weight loss over four months and other symptoms i didn't realize were even symptoms until i started losing 3lbs a day and broke down to see a doctor at which point i was down to 105lbs from a solid 170lbs at 5'11. That was two years and many hospital visits for ketoacidosis ago.
    What I've learned, and the learning curve has been steep and heavily laden, is that a healthy balance of glucose levels is paramount to your body's ability to fight infections etc. Avoiding processed sugars, eating healthy protiens, fibre and fats in a normal diet is adequate for most to keep an expected A1C count. If you're worried about Covid, now is not the time to diet. Also, mortality figures regarding diabetics during the initial outbreak in China may be skewed somewhat as China (and most of Asia for the most part) have lower incidents of diabetes than Occidental races.
    Near exact same circumstance as my onset of T1 4 yrs ago at age 39, although my immune system was already trying to kill me via MS!
    Went from +200lbs to around 160 in 8 weeks.. my control is not great and i use a LOT of fast acting insulin (most was 75 units in one day!) I basically eat whatever i want TBH and just smother it with insulin averaging at least one hypo/day, current A1c is around 7% on the libre app. I know i could do much better but f**k it, i stopped smoking what more do they want!!
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    HiccupinJonsey [2261316] HiccupinJonsey
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    Posted on 09:49:56 - 18/04/20 (5 years ago)
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    oldskoolsuzuki [70196]

    I'm a type 1 diabetic and have been informed that good control of my blood glucose (HBA1c at or below 6%) will be beneficial if i do contract CoViD. Apparently this virus likes high blood glucose, which is why so many diabetics that contract it are dying.

    When a T1D gets sick, blood glucose levels tend to rise and become harder to control, we can be required to take up to 25% more insulin than usual and for diabetics, ketones are our enemy!

    Sepulchrave [2092631]

    Yup - figures from China confirm your concern. This is from an interesting summary of ~72,000 Chinese case reports:
    The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44?672 confirmed cases). No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. No deaths were reported among mild and severe cases. The CFR was 49.0% among critical cases. CFR was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer. Among the 44?672 cases, a total of 1716 were health workers (3.8%), 1080 of whom were in Wuhan (63%). Overall, 14.8% of confirmed cases among health workers were classified as severe or critical and 5 deaths were observed.
    So yes, increased risk of death, 7.3% as opposed to 2.3% for the general population (as far as we can trust these stats). Fortunately (and as you implicitly note) I don't see anything to suggest that diabetics are more likely to be infected than anyone else (let's hope that doesn't change). The correlation with severity makes sense - hyperglycemia induces inflammation, and so does the virus...together, intuitively (I have to say that because I'm a complete amateur) it sounds like a recipe for disaster. I can't find anything to suggest a specific SARS-CoV-2 affinity for glucose, but I'm sure there are hundreds of people pouring over lab results as we speak, and I'm sure we'll know more in the future about the underlying "omic" factors that make some people more susceptible, and some people more at risk.

    HiccupinJonsey [2261316]

    At 45 years old i suddenly became a T1 diabetic. No type two leading into type one, no genetic inclinations or lifestyle patterns that could instigate diabetes just dramatic weight loss over four months and other symptoms i didn't realize were even symptoms until i started losing 3lbs a day and broke down to see a doctor at which point i was down to 105lbs from a solid 170lbs at 5'11. That was two years and many hospital visits for ketoacidosis ago.
    What I've learned, and the learning curve has been steep and heavily laden, is that a healthy balance of glucose levels is paramount to your body's ability to fight infections etc. Avoiding processed sugars, eating healthy protiens, fibre and fats in a normal diet is adequate for most to keep an expected A1C count. If you're worried about Covid, now is not the time to diet. Also, mortality figures regarding diabetics during the initial outbreak in China may be skewed somewhat as China (and most of Asia for the most part) have lower incidents of diabetes than Occidental races.

    oldskoolsuzuki [70196]

    Near exact same circumstance as my onset of T1 4 yrs ago at age 39, although my immune system was already trying to kill me via MS!
    Went from +200lbs to around 160 in 8 weeks.. my control is not great and i use a LOT of fast acting insulin (most was 75 units in one day!) I basically eat whatever i want TBH and just smother it with insulin averaging at least one hypo/day, current A1c is around 7% on the libre app. I know i could do much better but f**k it, i stopped smoking what more do they want!!
    My A1C hovers around 12-14. I rarely use fast acting insulin but hit up my Lantus at 50 units twice a day, more than twice what doctors want me to inject. I'm a horrible diabetic. When i feel my sugars are high, i use insulin, if i have energy and am not peeing constantly i don't bother injecting. I have less than two drinks a week, smoke half of what i was and don't eat the obvious bad choice foods except for the rare occasion. Meh. Life is a science experiment

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    oldskoolsuzuki [70196] oldskoolsuzuki
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    Posted on 17:39:03 - 18/04/20 (5 years ago)
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    oldskoolsuzuki [70196]

    I'm a type 1 diabetic and have been informed that good control of my blood glucose (HBA1c at or below 6%) will be beneficial if i do contract CoViD. Apparently this virus likes high blood glucose, which is why so many diabetics that contract it are dying.

    When a T1D gets sick, blood glucose levels tend to rise and become harder to control, we can be required to take up to 25% more insulin than usual and for diabetics, ketones are our enemy!

    Sepulchrave [2092631]

    Yup - figures from China confirm your concern. This is from an interesting summary of ~72,000 Chinese case reports:
    The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44?672 confirmed cases). No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. No deaths were reported among mild and severe cases. The CFR was 49.0% among critical cases. CFR was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer. Among the 44?672 cases, a total of 1716 were health workers (3.8%), 1080 of whom were in Wuhan (63%). Overall, 14.8% of confirmed cases among health workers were classified as severe or critical and 5 deaths were observed.
    So yes, increased risk of death, 7.3% as opposed to 2.3% for the general population (as far as we can trust these stats). Fortunately (and as you implicitly note) I don't see anything to suggest that diabetics are more likely to be infected than anyone else (let's hope that doesn't change). The correlation with severity makes sense - hyperglycemia induces inflammation, and so does the virus...together, intuitively (I have to say that because I'm a complete amateur) it sounds like a recipe for disaster. I can't find anything to suggest a specific SARS-CoV-2 affinity for glucose, but I'm sure there are hundreds of people pouring over lab results as we speak, and I'm sure we'll know more in the future about the underlying "omic" factors that make some people more susceptible, and some people more at risk.

    HiccupinJonsey [2261316]

    At 45 years old i suddenly became a T1 diabetic. No type two leading into type one, no genetic inclinations or lifestyle patterns that could instigate diabetes just dramatic weight loss over four months and other symptoms i didn't realize were even symptoms until i started losing 3lbs a day and broke down to see a doctor at which point i was down to 105lbs from a solid 170lbs at 5'11. That was two years and many hospital visits for ketoacidosis ago.
    What I've learned, and the learning curve has been steep and heavily laden, is that a healthy balance of glucose levels is paramount to your body's ability to fight infections etc. Avoiding processed sugars, eating healthy protiens, fibre and fats in a normal diet is adequate for most to keep an expected A1C count. If you're worried about Covid, now is not the time to diet. Also, mortality figures regarding diabetics during the initial outbreak in China may be skewed somewhat as China (and most of Asia for the most part) have lower incidents of diabetes than Occidental races.

    oldskoolsuzuki [70196]

    Near exact same circumstance as my onset of T1 4 yrs ago at age 39, although my immune system was already trying to kill me via MS!
    Went from +200lbs to around 160 in 8 weeks.. my control is not great and i use a LOT of fast acting insulin (most was 75 units in one day!) I basically eat whatever i want TBH and just smother it with insulin averaging at least one hypo/day, current A1c is around 7% on the libre app. I know i could do much better but f**k it, i stopped smoking what more do they want!!

    HiccupinJonsey [2261316]

    My A1C hovers around 12-14. I rarely use fast acting insulin but hit up my Lantus at 50 units twice a day, more than twice what doctors want me to inject. I'm a horrible diabetic. When i feel my sugars are high, i use insulin, if i have energy and am not peeing constantly i don't bother injecting. I have less than two drinks a week, smoke half of what i was and don't eat the obvious bad choice foods except for the rare occasion. Meh. Life is a science experiment
    Yeah being diabetic is certainly a daily experiment lol.. a lot of times i just play insulin roulette, dial up a number on the pen and hit it... either its not enough or its too much either way i can fix it with more insulin or more food..

    I moved from Lantus to Tresiba due to having too many night hypos (always take my basal before bed) apparently if you hit a blood vessel with lantus it doesnt crystallize and acts as a fast acting insulin. Fortunately the adrenalin would wake me up, most times i would manage to get downstairs to the kitchen but my wife has found me passed out on the kitchen floor with a mouthful of dextrose tablets. Plus Lantus never lasts 24hrs, more like 12-18 where tresiba lasts over 24hrs.
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    HiccupinJonsey [2261316] HiccupinJonsey
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    Posted on 16:12:54 - 20/04/20 (5 years ago)
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    oldskoolsuzuki [70196]

    I'm a type 1 diabetic and have been informed that good control of my blood glucose (HBA1c at or below 6%) will be beneficial if i do contract CoViD. Apparently this virus likes high blood glucose, which is why so many diabetics that contract it are dying.

    When a T1D gets sick, blood glucose levels tend to rise and become harder to control, we can be required to take up to 25% more insulin than usual and for diabetics, ketones are our enemy!
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    Sepulchrave [2092631]

    Yup - figures from China confirm your concern. This is from an interesting summary of ~72,000 Chinese case reports:
    The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44?672 confirmed cases). No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. No deaths were reported among mild and severe cases. The CFR was 49.0% among critical cases. CFR was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer. Among the 44?672 cases, a total of 1716 were health workers (3.8%), 1080 of whom were in Wuhan (63%). Overall, 14.8% of confirmed cases among health workers were classified as severe or critical and 5 deaths were observed.
    So yes, increased risk of death, 7.3% as opposed to 2.3% for the general population (as far as we can trust these stats). Fortunately (and as you implicitly note) I don't see anything to suggest that diabetics are more likely to be infected than anyone else (let's hope that doesn't change). The correlation with severity makes sense - hyperglycemia induces inflammation, and so does the virus...together, intuitively (I have to say that because I'm a complete amateur) it sounds like a recipe for disaster. I can't find anything to suggest a specific SARS-CoV-2 affinity for glucose, but I'm sure there are hundreds of people pouring over lab results as we speak, and I'm sure we'll know more in the future about the underlying "omic" factors that make some people more susceptible, and some people more at risk.

    HiccupinJonsey [2261316]

    At 45 years old i suddenly became a T1 diabetic. No type two leading into type one, no genetic inclinations or lifestyle patterns that could instigate diabetes just dramatic weight loss over four months and other symptoms i didn't realize were even symptoms until i started losing 3lbs a day and broke down to see a doctor at which point i was down to 105lbs from a solid 170lbs at 5'11. That was two years and many hospital visits for ketoacidosis ago.
    What I've learned, and the learning curve has been steep and heavily laden, is that a healthy balance of glucose levels is paramount to your body's ability to fight infections etc. Avoiding processed sugars, eating healthy protiens, fibre and fats in a normal diet is adequate for most to keep an expected A1C count. If you're worried about Covid, now is not the time to diet. Also, mortality figures regarding diabetics during the initial outbreak in China may be skewed somewhat as China (and most of Asia for the most part) have lower incidents of diabetes than Occidental races.

    oldskoolsuzuki [70196]

    Near exact same circumstance as my onset of T1 4 yrs ago at age 39, although my immune system was already trying to kill me via MS!
    Went from +200lbs to around 160 in 8 weeks.. my control is not great and i use a LOT of fast acting insulin (most was 75 units in one day!) I basically eat whatever i want TBH and just smother it with insulin averaging at least one hypo/day, current A1c is around 7% on the libre app. I know i could do much better but f**k it, i stopped smoking what more do they want!!

    HiccupinJonsey [2261316]

    My A1C hovers around 12-14. I rarely use fast acting insulin but hit up my Lantus at 50 units twice a day, more than twice what doctors want me to inject. I'm a horrible diabetic. When i feel my sugars are high, i use insulin, if i have energy and am not peeing constantly i don't bother injecting. I have less than two drinks a week, smoke half of what i was and don't eat the obvious bad choice foods except for the rare occasion. Meh. Life is a science experiment

    oldskoolsuzuki [70196]

    Yeah being diabetic is certainly a daily experiment lol.. a lot of times i just play insulin roulette, dial up a number on the pen and hit it... either its not enough or its too much either way i can fix it with more insulin or more food..

    I moved from Lantus to Tresiba due to having too many night hypos (always take my basal before bed) apparently if you hit a blood vessel with lantus it doesnt crystallize and acts as a fast acting insulin. Fortunately the adrenalin would wake me up, most times i would manage to get downstairs to the kitchen but my wife has found me passed out on the kitchen floor with a mouthful of dextrose tablets. Plus Lantus never lasts 24hrs, more like 12-18 where tresiba lasts over 24hrs.
    Thanks for sharing. I thought i may be the only one who plays roll the dice with insulin dosage! Low sugar is never an issue in my life, i eat constantly and even with four or five apidra shots at 6-9 units per shot plus the two 50 unit lantus, on the rare occasions i do prick my finger, I'm rarely under 12-14 mm/ml. Last A1C was 14.5 and hasn't ever been below 13.5

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