Ruth Groff is terrified of contracting COVID-19 and landing in the hospital — in large part because of her diabetes.
A Type 1 diabetic since she was just 5 years old, Groff, now 57, wears a continuous glucose monitor and takes at least two shots of insulin a day. She’s healthy, but the stress of the pandemic can further mess with her blood sugar levels, requiring extra attention.
If Groff had Type 2 diabetes, she’d qualify for a coronavirus vaccine in Massachusetts ahead of the general public.
But Type 1 diabetes didn’t make the state’s list of eligible medical conditions in Phase 2, despite newer research showing that people with Type 1 face an increased risk of hospitalization and death comparable to those with Type 2.
“It’s just unfathomable. I can’t imagine what the rationale could possibly be,” Groff said. “I’ve tried to stay inside and never encounter anybody and now it turns out I’m actually considered by Massachusetts to be perfectly healthy, no comorbidity?”
Massachusetts bases its list of eligible medical comorbidities on the Centers for Disease Control and Prevention’s list of underlying conditions for which adults “are” at increased risk of severe illness should they contract COVID-19. That group includes Type 2 diabetes, in which the body develops insulin resistance. But Type 1 diabetes, in which the body stops producing insulin entirely, is listed as a condition that only “might” put people at greater risk for severe outcomes, leading to it being left off the list in Massachusetts even as New York and Tennessee prioritized both types.
The exclusion of Type 1 diabetes caught 24-year-old Natalia Mesiti, who was diagnosed with the condition as a college junior, by surprise.
“It’s a little upsetting because Type 1 diabetes is autoimmune and should be taken very seriously — and so should Type 2,” said the East Longmeadow native and current Dorchester resident. “It shouldn’t be a battle between which type of diabetes you have to be getting a vaccine.”
About one in 10 Americans have diabetes. While Type 2 is far more common, the approximately 10% of diabetics with Type 1 account for roughly 1.6 million people.
Dr. Elizabeth Halprin, clinical director of adult diabetes at Joslin Diabetes Center, said she doesn’t believe excluding those with Type 1 diabetes was “a passive act.”
“I don’t think they were forgotten, I think they were actively omitted,” Halprin said. “They should have the same priority as someone with Type 2 diabetes.”
The Boston-based Joslin Diabetes Center is among the local and national groups — including the 5,000-plus people who have signed a change.org petition — pushing both the state and the CDC to reconsider their classification of Type 1 diabetes based on newer research that shows comparable increased risk of hospitalization and death between the two types. The risk of dying from coronavirus is almost three times higher for Type 1 diabetes patients and about twice as high for Type 2 patients compared to people without diabetes, according to recent research published in The Lancet medical journal.
“The clinical evidence clearly indicates people with Type 1 are at increased risk for serious health outcomes and death from COVID-19 and should be prioritized equally to those with Type 2,” Dr. Robert Gabbay, chief scientific and medical officer of the American Diabetes Association, said in an email.
The ADA and 18 other groups sent a letter to the CDC last month urging the agency to update its guidance, writing that it would be “problematic for any state to differentiate” between the two in access to the potentially live-saving shots.
Gabbay said Friday the CDC had not responded to the letter. Advocacy efforts in Massachusetts have also not produced results, even as the state added another initially excluded condition — asthma — to the list as it opened vaccinations to those with two or more eligible medical conditions.
“The numbers are alarming,” Gabbay said. “This pandemic has severely impacted people with diabetes and they must be prioritized as states make plans to protect those most at risk for deadly complications.”
