From the Frontlines: A Doctor With Type 1 Diabetes Shares Her COVID-19 Story

From the Frontlines: A Doctor With Type 1 Diabetes Shares Her COVID-19 Story

First, it's important to say that I live in a rural area in a state that implemented early social distancing, has good testing access, and isn't projected to peak until late April, at which point we are still expected to be well within our health system capacity.

The coronavirus pandemic impacts us all, but my experiences are not the same as my colleagues in New York, where people are dying en masse and ICUs are overwhelmed.⁣⁣

Am I High Risk for COVID-19?

That said, we still have community spread, active cases, and limited PPE; we are preparing for the worst. As a person with diabetes (specifically, type 1 diabetes), I was asked early on if I felt like I was high-risk and if I wanted to be reassigned to patient care areas with lower risk of exposure. ⁣⁣

I said no. ⁣⁣

We have all heard by now that people with diabetes and those with pre-existing conditions are at highest risk from COVID-19. This is true.

But there's a lot of "us v. them" when it comes to type 1 diabetes versus type 2 diabetes. There is also a lot of overlap between the two, sometimes more than people like or care to admit.

The Truth About High-Risk COVID-19 Conditions

So having type 1 diabetes compared to type 2 diabetes doesn't necessarily make someone low(er) risk. It has a lot to do with the individual’s underlying metabolic profile, including A1C. Basically, we know that A1Cs <6.5-7% are associated with negligible increases in complications, including those from infections. ⁣⁣
I've had an A1C <6.5% for years now, am not on immunosuppressive drugs, and have no other underlying conditions or respiratory disease.

My risk is likely comparable to that of any other 20-something. To be clear: it's not zero. Young, healthy people die of COVID-19 every day. But my situation is not particularly increased, and as a member of our relatively small, local healthcare workforce, I felt that it would be unfair for me to request an accommodation. ⁣⁣

That's my situation, not to be confused with general advice. I've been asked by a lot of other people with diabetes if they should continue to work. I can't make those calls. Medicine is complex and differs for each and every person.

While I am a doctor, I am not your doctor. It’s unethical and unfair of me to give you personal medical advice. ⁣The best thing for all of us, though, is to isolate at home when we can.

So please, stay home. And stay well!

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Jordan Hoese, MD, MPH
Apr 16, 2020

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