Professor Alan Sinclair, who has an international reputation in the field of older people, has said the combination of old age, frailty and diabetes is more likely to lead to fatality among those who become infected by coronavirus in a new research paper.

He said: “The epidemiology of COVID-19 incidence, severity of illness and mortality seem to be shifted towards older people particularly those with multiple comorbidities such as diabetes, hypertension and cardiovascular disease.

“However, frailty, which affects more than one in five older people with type 2 diabetes, worsens prognosis in severe acute illness and is a better predictor of intensive care unit outcomes.”

Professor Sinclair, the original founder of IDOP (Institute of Diabetes in Older People, 2008-14) and Diabetes Frail (2014 onwards), an organisation which explores the emerging importance of frailty, has also co-chaired a national multi-stakeholder COVID-19 Response Action Group which drafted a document to support clinical decision-making in care homes as part of a drive to reduce morbidity and mortality among residents with diabetes.

Professor Sinclair said: “Care homes represent a major challenge in ensuring that COVID-19 prevention and control issues are optimal. Residents of care homes, both residential and nursing, are a highly co-morbid population who are particularly vulnerable to COVID-19 infection.”

In the documents, it has been highlighted that older people with both diabetes and frailty must remain as healthy as possible, and many should already be classed as a vulnerable adult and be ‘shielding’.

He added: “Key steps to maintain health in this highly vulnerable group of people include daily exercise (bearing in mind the restrictions in place), which boosts immunity and  improves glycaemic control, which in turn reduces the risk of infection. Keep individuals well hydrated and review the use of SGLT2 inhibitors if unwell and maintain access to medical advice through telemedicine or telephone/video conversation.”

Click here to read A Covid-19 Response Action – Diabetes Management in Care Homes

Click here to read Age, Frailty and Diabetes – triple jeopardy for vulnerability to COVID-19 infection