Patients with diabetes are at higher risk for severe illness from COVID-19.

HIGHLIGHTS It is currently uncertain whether people with diabetes are at higher risk of severe illness from coronavirus disease 2019 (COVID-19). We found that diabetes was associated with an approximately 4-fold increased risk of having severe/critical COVID-19 illness. This association was independent of age, sex, obesity, hypertension and smoking. These findings highlight the urgent need for a multidisciplinary team-based approach to management of this patient population.