This article is incredibly misleading. Please don't take it seriously.

First, note the dates: this study is pre-vaccine. You are vaccinated. This doesn't apply to you.

Second, note the wording: if you have X,Y and Z and are hospitalized -- that second part is extremely low probability, even if X,Y and Z are true. In other words, they're conditioning the statement on a rare event to make it sound like it's common for people with diabetes to end up with ARDS. It is not common. It's very rare (but maybe 30% less rare for people with 3+ risk factors.)

To be more specific, read this part carefully:

> Researchers from Tulane University, the Society of Critical Care Medicine and Mayo Clinic followed outcomes for patients hospitalized between mid-Feb. 2020 to mid-Feb. 2021...Researchers compared 5,069 patients (17.5%) with metabolic syndrome with 23,971 control patients (82.5%) without metabolic syndrome. They defined metabolic syndrome as having more than three of the following criteria: obesity, pre-diabetes or diabetes, hypertension and high cholesterol.

> Patients with metabolic syndrome were 36% more likely to develop ARDS, almost 20% more likely to die in the hospital, more than 30% more likely to be admitted to an ICU, and 45% more likely to require mechanical ventilation.

In other words, if you restrict yourself to looking only at the sickest of the sick (i.e. people who are hospitalized; a small sub-population of everyone who gets Covid, strongly skewed toward the elderly), then those with 3+ risk factors are slightly more likely to die than those who do not have 3+ risk factors.

That's all that this study says. The MMWR study I cited more relevant to your situation, if only because you are vaccinated. You are very, very well-protected against severe disease. Even with diabetes.