Why African-Americans with diabetes are at a higher risk of developing severe complications from COVID-19

Korin Miller
·Writer

Reporting by Jacquie Cosgrove

As data on COVID-19 continues to pour in, one thing has become incredibly clear: As a whole, African-Americans are impacted more by the coronavirus. Black Americans are infected with the virus and die from it at disproportionately higher rates than any other group in the U.S. 

There are many layers to this, but diabetes plays a role, according to Dr. Jennifer Caudle, family physician and associate professor in the Department of Family Medicine at Rowan University. Black Americans are “80 percent more likely than white people to have diabetes,” she says, adding, “that can put you at higher risk for severe complications from COVID-19.”

The Centers for Disease Control and Prevention (CDC) specifically lists people with diabetes as having a higher risk of severe illness from COVID-19 than the general population. “Diabetes is a condition that can affect your whole body in different ways,” Caudle explains, noting that it can impact your brain, eyes, heart, extremities and kidneys. And, when you add COVID-19 on top of possible complications from diabetes, there is the potential for severe illness from the virus.

“When we talk about African-Americans, what we’ve seen is it’s almost compounded when we talk about COVID-19,” says Caudle. For example, the doctor points to data from Chicago that found that, while black residents make up just 30 percent of the city’s population, nearly 50 percent of those who have died from complications of COVID-19 in Chicago were African-American. That’s true in other areas, as well. “We are often making up a large percentage of those who are becoming severely ill with COVID-19 or dying from complications of COVID-19,” she says.

There are many other reasons for the racial disparity in COVID-19 infections.

“I often think of it as something that is like an iceberg,” says Caudle. “The top of the iceberg is the stuff above the water — African-Americans are 80 percent more likely to have diabetes.” But, she says, underneath the “iceberg” are other factors that can contribute to severe COVID-19 infections in this group:

  • African-Americans are more likely to not be able to work from home during the pandemic.

  • They’re more likely to be essential workers.

  • They’re more likely to need to take public transit.

  • They’re more likely to be underinsured.

  • They’re more likely to live further away from grocery stores and healthcare facilities. 

“COVID-19 is really shining a light on these health disparities,” Caudle says. 

There are some things everyone with diabetes can do to control their disease — and lower their risk of developing serious complications from COVID-19.

Caudle recommends that people with diabetes do the following to help lower their risk of severe COVID-19 complications:

Try to get your diabetes under control. “We certainly know that people with controlled underlying illness may do better [with COVID-19] than those who don’t have controlled illness,” she says. “We want diabetes to be under control.” That can look different for every diabetes patient, so connect with your doctor if you’re not certain of what your target numbers should be.

Have regular check-ins with your doctor. If you’re nervous to visit a doctor’s office right now, Caudle points out that many are offering telemedicine or telehealth visits.

Eat a healthy diet and exercise regularly. “We know that is a mainstay to controlling and helping to control type 2 diabetes,” Caudle says. 

Overall, Caudle advises that everyone — regardless of race or diabetes status — be aware of their individual risk factors for COVID-19. “It’s certainly a reminder to us to look at what risk factors we may have so that we can stay as safe as possible.”