Diabetes and COVID-19: Moving From News to Knowledge and a Glucose Hypothesis.

Abstract

Science makes civilization possible. New observations provoke theories as to what they mean. Theories (hypotheses) are tested by systematically gathering and analyzing further information. Support for a theory by these methods (experiments) can lead to a plan of action. Other observations from this process (research) may pose further questions, leading to more experiments. In the past, actionable knowledge accumulated slowly, but digital technology has accelerated everything. Novel observations appear as “news” distributed by electronic, broadcast, and print media. Floods of reports, all apparently equal in significance, compete for attention. The media have insatiable appetites—they demand new material daily. Delivery of news is driven by its power to elicit emotional reactions, and we are all somewhat addicted. But news does not teach us what to do. Some items are valid and reproducible, others confusing, some misleading. Each can be placed in context, verified, and converted into useful knowledge using the scientific method, but this takes time. Experience with the coronavirus disease 2019 (COVID-19) pandemic and its implications for people with diabetes illustrates this process. Diabetes Care has welcomed early reports on COVID-19, even when the first data sets were unavoidably limited. Special collections of articles appeared in the July and August issues, but most were available online earlier (1). These and articles published elsewhere confirmed the alarming news that people with diabetes are up to three times more likely than others to become severely ill or die of COVID-19. They showed that older age, obesity, and other medical conditions often associated with diabetes are also associated with increased risk. These reports highlighted the need for people with diabetes to take precautions to avoid infection, but they did not provide much guidance on how to treat these patients if they did fall ill. Articles by expert clinicians, based on the evidence and …