After older people and nursing home residents, no other group seems to have been hit harder by Covid than people with diabetes. They account for a staggering 30 to 40 percent of all U.S. Covid deaths, several studies suggest.

Diabetes patients who are hospitalized with Covid spend more time in intensive care, are likelier to be intubated and are less likely to survive, our colleague Andrew Jacobs reports. One study found that 20 percent of such patients died within a month of admission.
Diabetes is a chronic disease that hobbles the ability to regulate blood sugar and inexorably wreaks havoc on circulation, kidney function and vital organs.

Though researchers are still trying to understand the dynamics between diabetes and Covid, most agree on one thing: Uncontrolled diabetes impairs the immune system and decreases a patient’s ability to withstand a coronavirus infection.
Diabetics often struggle with hypertension, obesity and other medical issues, which can fuel chronic inflammation inside the body. That triggers the release of cytokines, tiny proteins that regulate the body’s immune response to infection or injury.

Covid, it turns out, can also provoke an uncontrolled release of cytokines, and the resulting “cytokine storm” can wreak havoc on vital organs.
Like the pandemic, which has had an outsize toll on communities of color, the burden of diabetes falls more heavily on Latino and Black Americans, highlighting systemic failures in health care that have also made the coronavirus far deadlier for the poor.

“It’s not that diabetes itself makes Covid inherently worse but rather uncontrolled diabetes, which is really a proxy for other markers of disadvantage,” said Nadia Islam, a medical sociologist at NYU Langone Health.
About 1.5 million Americans are diagnosed with diabetes each year, according to the C.D.C., and roughly 96 million, about one in three adults, are at high risk for developing the disease. The disease claims 100,000 lives annually but draws less funding or notice than illnesses such as cancer and heart disease.

Experts say addressing the nation’s diabetes crisis will require well-funded public education campaigns that drive home the importance of exercise and healthy eating. That would require seismic changes to a food system geared to cheap, processed food.
“The only way to move the needle is to reform a system that prioritizes cures and new drugs over prevention,” said Dr. Sudip Bajpeyi, a researcher at the University of Texas at El Paso.