{"doi":"10.2337/dc20-2260","title":"COVID-19 Severity Is Tripled in the Diabetes Community: A Prospective Analysis of the Pandemic’s Impact in Type 1 and Type 2 Diabetes","abstract":"OBJECTIVE To quantify and contextualize the risk for coronavirus disease 2019 (COVID-19)–related hospitalization and illness severity in type 1 diabetes. RESEARCH DESIGN AND METHODS We conducted a prospective cohort study to identify case subjects with COVID-19 across a regional health care network of 137 service locations. Using an electronic health record query, chart review, and patient contact, we identified clinical factors influencing illness severity. RESULTS We identified COVID-19 in 6,138, 40, and 273 patients without diabetes and with type 1 and type 2 diabetes, respectively. Compared with not having diabetes, people with type 1 diabetes had adjusted odds ratios of 3.90 (95% CI 1.75–8.69) for hospitalization and 3.35 (95% CI 1.53–7.33) for greater illness severity, which was similar to risk in type 2 diabetes. Among patients with type 1 diabetes, glycosylated hemoglobin (HbA1c), hypertension, race, recent diabetic ketoacidosis, health insurance status, and less diabetes technology use were significantly associated with illness severity. CONCLUSIONS Diabetes status, both type 1 and type 2, independently increases the adverse impacts of COVID-19. Potentially modifiable factors (e.g., HbA1c) had significant but modest impact compared with comparatively static factors (e.g., race and insurance) in type 1 diabetes, indicating an urgent and continued need to mitigate severe acute respiratory syndrome coronavirus 2 infection risk in this community.","journal":"Diabetes Care","year":2020,"id":49372,"datarank":6.607439373805389,"base_score":5.575949103146316,"endowment":5.575949103146316,"self_citation_contribution":0.8363923654719475,"citation_network_contribution":5.771047008333441,"self_endowment_contribution":0.8363923654719475,"citer_contribution":5.771047008333441,"corpus_percentile":null,"corpus_rank":null,"citation_count":263,"citer_count":100,"citers_with_citation_signal":100,"citers_with_endowment":100,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7667,"is_data_producer":true,"deposit_databanks":{"figshare":["10.2337/figshare.13235066"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":237696,"name":"James C. Slaughter","orcid":"0000-0002-8770-980X","position":1,"is_corresponding":false},{"id":237697,"name":"Sara H. Duffus","orcid":"0000-0002-7167-2643","position":2,"is_corresponding":false},{"id":237698,"name":"T. Jordan Smith","orcid":"0009-0001-7706-1739","position":3,"is_corresponding":false},{"id":237699,"name":"Lauren M. LeStourgeon","orcid":"0000-0002-8265-6892","position":4,"is_corresponding":false},{"id":237700,"name":"Sarah S. Jaser","orcid":"0000-0002-7958-7662","position":5,"is_corresponding":false},{"id":237701,"name":"Allison B. McCoy","orcid":"0000-0003-2292-9147","position":6,"is_corresponding":false},{"id":237702,"name":"James M. Luther","orcid":"0000-0001-7225-2897","position":7,"is_corresponding":false},{"id":239203,"name":"Erin R. Giovannetti","orcid":null,"position":8,"is_corresponding":false},{"id":237703,"name":"Schafer Boeder","orcid":"0000-0002-6221-7796","position":9,"is_corresponding":false},{"id":237704,"name":"Jeremy Pettus","orcid":"0000-0002-5999-0091","position":10,"is_corresponding":false},{"id":237705,"name":"Daniel J. Moore","orcid":"0000-0002-6889-9345","position":11,"is_corresponding":false},{"id":237695,"name":"Justin M. Gregory","orcid":"0000-0003-2700-0062","position":0,"is_corresponding":true}],"reference_count":19,"raw_metadata":null,"created_at":"2026-07-18T20:36:25.163232Z","pmid":"33268335","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}