Diabetes and Covid-19 risk: Do’s & Don’t

I am sure you must have come across information more frequently than usual about how diabetes can make you much more prone to complications of Covid 19. We believe that this subject is muddied up by a lot of false claims and half baked information provided. Let us try and clear things up so that you can have your peace of mind when dealing with Diabetes in the era of COVID.

In separate sections, we have already covered as to how it’s important to keep a stock of your diabetes (insulin) and other vital medications.

Like we discussed earlier about the two categories, one more prone to the infection, the other one presenting more severe manifestations. Diabetes belong to the second category. About a third of our elderly are diabetic, they have other complications like Hypertension and heart disease or other concomitant infections. They have a reduced immune response and are therefore at increased risk. The ADA puts diabetics ( with controlled Blood Glucose) at a 1.6 times higher risk of complications with the risk increasing as glucose control worsens.

Reliable sources have quoted that about 22 to 27 percent of people admitted in hospitals around the world due to covid 19 had diabetes. Previous studies round the years already stress on the role of elevated glucose levels on complications related to respiratory system. A recent study published in the journal JAMA, china, the death rates in people with diabetes as their pre-existing complications were three times greater than non-diabetics.

With the new facts lining up each day about covid 19 and its manifestations pertaining to pre-existing illness, it is difficult to cover a hundred percent risks here. Let’s give it a shot.

1. According to an assistant professor of public health at Arcadia University in Pennsylvania, there is an enhanced risk to population with both type 1 or type 2 diabetes who consume ACE inhibitors (blood pressure/heart medications) as their prescription medication. This is mostly attributed to covid 19 binding to angiotensin-converting enzyme II. These claims were later refuted and no risk with ACE inhibition is shown.
2. Individuals with Type 1 diabetes when suffering from a viral infection may develop a complicated condition called ketoacidosis. The body starts breaking down fat at a much faster rate. This fat is then processed to ketones making the blood to become acidic. This acidic blood is unable to alleviate sepsis. Most of the deaths in diabetes with an infection case takes place due to the same reason. This was again proven as incorrect. Although Type 1 diabetics often develop ketoacidosis the deaths were usually caused by respiratory compromise over and above the metabolic compromise. Poor healing and recovery in diabetics is usually to blame here.
3. Diabetic Drugs like DPPIV inhibitors may help in COVID. Although certain diabetic drugs were shown to have promise in treating other coronavirus illnesses like MERS, they did not show any effect against COVID-19.

This list is not comprehensive and there can be limitless way yet to be discovered as to how the risk of covid 19 is much higher in diabetics.

Preventive steps

1. Keep all your vital statistics in limit, especially your blood sugar. You can measure it daily or alternate days.
2. Stay in touch with your endocrinologist through telemedicine or video consultations
3. Hand washing benefits all people, all categories, healthy or people with pre-existing illness. 20 seconds, hands and soap, you know the steps.
4. Clean and disinfect handles, doorknobs, all eatables from outside
5. Social Distancing as we know is already being followed everywhere
6. Healthy dietary habits including adequate intake of Vit C, protein and restrictions of other high glycaemic index products.
7. Mild physical activities, cardio, yoga is advisable
8. Contact your clinicians in case

• You have symptoms of flu or breathing distress
• Your blood sugar levels are over 240mg/dl (taken twice a day in four-hour interval)

Everyone is contributing their bit in these difficult times, I hope you appreciate and make good use of my bit…

Dr. Gaurav Jain, Consultant – Internal Medicine, Dharamshila Narayana Superspeciality Hospital, Delhi