Undiagnosed diabetes contributed substantially to COVID-19 hospitalisations and deaths in many low- and middle-income countries (LMIC), including India, a new study published in the medical journal The Lancet said.
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The study was supported, in part, by the Bill and Melinda Gates Foundation and FIND, a global health non-profit based in Geneva. Eight LMICs were studied — Brazil, China, India, Indonesia, Mexico, Nigeria, Pakistan, and South Africa.
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According to the study, while it is seen that patients with COVID-19 that had diagnosed chronic diseases — including diabetes — may experience higher rates of hospitalisation and mortality relative to the general population, the burden of undiagnosed co-morbidities during the pandemic, however, had not been adequately studied.
The study is titled ‘Estimates of hospitalisations and deaths in patients with COVID-19 associated with undiagnosed diabetes during the first phase of the pandemic in eight low-income and middle-income countries: a modelling study’.
For the study, a model to estimate the hospitalisation and mortality burden of patients with COVID-19 that had undiagnosed Type 1 and Type 2 diabetes was put in place.
The study, as per its modelling estimates, found that across the eight countries, 6.7 million COVID-19 hospitalised patients had undiagnosed diabetes, of which 1.9 million died. They represented 21.1% of all COVID-19 hospitalisations and 30.5% of all COVID-19 deaths in these countries.
“We find that if these populations had been diagnosed for diabetes prior to the COVID-19 pandemic, 1.7% of COVID-19 hospitalisations and 5.0% of COVID-19 deaths could have been prevented, and 1.8 million quality adjusted life years (QALY) gained,’’ it added.
The study notes that an understanding of the risk factors driving severe COVID-19 outcomes could lead to targeted investments in prevention and control efforts to reduce health system burdens during future pandemic waves.
Further explaining the implications of all the available evidence, it noted that the growing burden of non-communicable diseases (NCD) necessitates increased investments in prevention and diagnostics.
“NCDs can severely increase the health burden caused by new and emerging infectious diseases,’’ it further warned. It added that a meta-analysis had found that diabetes was the third most common comorbidity associated with higher COVID-19 severity and mortality after hypertension and obesity. However, accounting of diabetes in patients with COVID-19 has focused on populations with known diabetes, potentially excluding the 45% of individuals with diabetes globally that are not aware of their status,” the study pointed out.
“Non-communicable diseases, specifically diabetes, obesity, and hypertension, are rapidly growing in LMICs, afflicting a serious health and economic burden. Their importance has been magnified during the COVID-19 pandemic. This study highlights the benefits of prevention of diabetes cases, and the importance of timely diagnosis to reduce future disease burdens,’’ the study said.
