COVID-19 has torn a particularly lethal path through the 1 in 10 Americans with diabetes, including many who never caught the virus. That's because when the pandemic hit, people with the chronic disease were already in worse shape than in years.

1. How the pandemic laid bare
America' s diabetes crisis
COVID-19 has torn a particularly lethal path through the 1 in 10 Americans
with diabetes, including many who never caug_ht the virus. That's because
when the pandemic hit, people with the chronic disease were already in worse
shape than in years.
WEST ALEXANDRIA, OHIO
It took the deadly disruption of the COVID-19 pandemic to expose a deeper,
more intractable U.S. public-health crisis: For more than a decade, the
world's richest nation has been losing the battle against diabetes.
Long before the pandemic, Kate Herrin was among the millions of Americans
struggling to control their diabetes.
Her problems often stemmed from her government-subsidized medical
insurance. Doctors routinely rejected her Medicaid plan, and she repeatedly
ran out of the test strips she needed to manage her daily insulin injections.
She cycled in and out of emergency rooms with dangerously high blood­
sugar levels, or hyperglycemia.
Then COVID-19 hit. Herrin - poor and living alone - rarely left her apartment,
ordering fast-food delivery instead of risking the grocery store. She stopped
going in for regular lab tests. She had a harder time than ever securing
medical supplies. Her health deteriorated further.
On Dec. 15, Herrin and Elicia Heaston, her best friend, were swapping
messages on Facebook midday when Herrin abruptly dropped off the
conversation. Heaston called Herrin's phone and got no answer. When a few
more hours passed without any word, Heaston and her husband drove from
their home in rural West Alexandria, Ohio, to Herrin's apartment nearby and
pounded on the door. No lights were on, but they could hear the television.
Heaston called 911. When firefighters arrived, they found the 42-year-old
dead on the bathroom floor. Herrin's rescue dogs, Honey and Sugar, were
lying quietly next to her.
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4. now a professor at Imperial College in London. "The magnitude of the
increase has set us back 15 to 20 years."
Dr Giuseppina Imperatore, who oversees disease surveillance and other areas
in the CDC's Division of DiabetesTranslation, said that the recent trends on
diabetic complications and deaths are "definitely concerning," and that the
agency is still trying to fully understand what's driving the poor outcomes,
particularly among younger adults. She also told Reuters that "the impact of
the COVID pandemic on people with diabetes cannot be overstated."
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An American problem
The failure to effectively treat diabetes carries enormous consequences for
patients, their families and society at large. Roughly 34 million people, or
about 1 in 10 Americans, have diabetes.Treating them costs more than $230
billion a year - more than the U.S. Navy's annual budget - much of that
borne by taxpayers through government-sponsored Medicare insurance for
the elderly and Medicaid for the poor.
About 1.6 million people have type 1 diabetes, an autoimmune disease of
unknown cause that requires lifelong insulin injections when the pancreas
stops producing the hormone. Without insulin, cells are unable to absorb
glucose, their primary source of energy, and the sugar builds up in the blood.
But the vast majority of patients, accounting for most of the increase in new
cases in recent years, have type 2 diabetes, a chronic condition linked to
genetics, weight gain and inactivity. These patients' bodies don't make
enough insulin or don't use it well. Diet and exercise can help manage the
disease, but many also need medication that helps them use the insulin their
bodies produce. Many eventually require insulin injections.
For all diabetes patients, life revolves around checking their numbers. That
means testing their current blood glucose levels several times a day. And it
means visiting a lab every few months to test their hemoglobin A1c, a
measure of their glucose levels over the preceding three months. The higher
the number, the worse it can be for a patient.
Uncontrolled diabetes wreaks havoc on the body. Acute hyperglycemia can
lead to coma or even death. Over time, the disease degrades blood vessels
and damages major organs, leaving patients prone to heart disease, stroke,
kidney failure, amputations and blindness.
2005
Share of adults age 20+