The disruption in diabetes care during the COVID-19 pandemic could be storing up potentially serious health problems for those living with the disease, experts have warned.
Diabetics need to attend routine appointments to check for possible complications. However, there are fears a fall in testing and delayed diagnoses over the past 15 months could have resulted in an increase in health problems.
Researchers at the University of Manchester have estimated, between March and December 2020, Type 2 diabetes diagnoses were missed or delayed for an estimated 60,000 people in the UK.
Prior to that, a study of 3.3 million people with diabetes in England published by the International Journal of Clinical Practice found that the number of routine tests dropped by 88% in April 2020, after the UK went into lockdown on 23 March.
Dan Howarth, head of care at Diabetes UK, told Yahoo News UK that he was still being contacted by diabetics concerned about being able to access routine care.
He said: "What we have found is that, across this past year, people with diabetes have needed us more than ever before. We heard a wide range of concerns from people living with diabetes during the pandemic.
"The main areas of worry were around shielding, the poor outcomes for people living with diabetes if they caught COVID-19 and their emotional wellbeing."
There are 4.8 million people with diabetes in the UK, roughly one in 14 people.
The two main types of diabetes are Type 1, an auto-immune disease where the body’s immune system destroys cells which produce insulin; and Type 2, where the body does not produce enough insulin.
Possible complications that can occur due to uncontrolled sugar levels include nerve damage and problems with vision. Diabetes is also the leading cause of blindness among people of working age in the UK.
Eleanor Noyce, 23, a politics student at University of Leeds was diagnosed with Type 1 diabetes when she was 17.
She said: "I've had both of my vaccines now so the stress relating to COVID has eased somewhat, but my biggest concern during lockdown was not being able to physically go to hospital to have appointments.
"I felt really disconnected from the hospital and my team. I hadn't had any eye checks in 2020 and any appointments I did have were online.
"I did struggle a bit more with high blood sugars, so I took up running to ensure I was getting out as much as possible. These highs affected my emotional wellbeing as having high blood sugar means you're more likely to become emotional and angry."
She added: "I was prescribed new technology during the pandemic and this has allowed me greater control, though I understand that this won't be the case for all type ones."
Last month, the World Health Organization (WHO) warned that this was threatening to become a global problem and highlighted an urgent need to provide extra support for diabetics.
It said: "The COVID-19 pandemic is causing fear and suffering for people with diabetes across the world. An effective response during the pandemic is hampered by a chronic lack of investment in diabetes prevention, early diagnosis, appropriate treatment and care."
In the UK, more than 75% of adults have received their first coronavirus vaccine dose and 50% have had both doses. Those with diabetes were put in priority group six for vaccinations due to an increased risk of becoming seriously ill with coronavirus.
Diabetics are at a higher risk of having high blood sugar levels and therefore developing diabetic ketoacidosis (DKA), a potentially fatal condition caused by dangerously high levels of acid in the blood.
In India, which has the second highest rate of diabetes in the world, the situation is more precarious, with only 12% of adults having had their first jab and 3% being fully vaccinated.
Shivani Vyas, 25, a documentary filmmaker from Bombay, told Yahoo News UK about her experience of having Type 1 diabetes during India’s devastating second wave.
Shivani was diagnosed with Type 1 aged 11, while she was still living in the UK, before moving to India with her family a year later.
Her state of Maharashtra, which has been in lockdown since April, was the first Indian state to report the B.1.617 variant responsible for the country’s second wave.
She said: "The pandemic has been tough, this lockdown we’re currently in has been very difficult.
"The last lockdown it felt like we were all going through it together, worldwide. But the danger of the new variant means I have to be extra careful, firstly because of the diabetes and also the fact I’m not going to get a vaccination for some time."
At the beginning of May, the Indian government began offering vaccines to people aged over 18.
But there is a shortage and no priority has been given to diabetics, despite them being at an increased risk of getting seriously ill and dying from the virus.
"Many people find it hard to accept that a young person who looks healthy could possibly have this autoimmune disease," Shivani said.
"It’s like if you aren’t physically disabled you don’t need help, though I know there are doctors who are really trying to fight this attitude."
One non-government organisation (NGO) in India has warned that the situation for some is helpless.
Nupur Lalvani, director of Blue Circle Diabetes Foundation in Mumbai, said: "India has a unique set of issues for people living with diabetes as we are experiencing a vaccine shortage as well as a huge surge in COVID-19 cases.
"I've had diabetes for the past 26 years and I am not vaccinated yet. I recognise the urgency but I am also helpless.
"I spend a few hours each day, unsuccessfully trying to schedule a slot as the few vaccine slots that do open online get booked in seconds."
Lalvani has started voluntary projects offering psychological support to diabetics during this difficult time, including a support line, buddy scheme and workshops that provide information on how to control glucose levels.
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