Coronavirus: Doctors tell diabetics why they must stay protected
Disease known to increase severity of complications and risk of mortality
Abu Dhabi: With diabetes clearly linked to coronavirus fatalities, doctors and health officials have urged diabetics to adopt strict precautionary measures, including social distancing and healthy lifestyle habits.
Officials announced on Monday that 40 per cent of the 291 people who have so far succumbed to COVID-19 in the UAE were diabetic.
“Our records show that 40 per cent of COVID-19 deaths have been associated with diabetes. [So] we urge the public to pay more attention to groups at risk, including people with diabetes and other chronic conditions, as well as the elderly,” said Dr Amna Al Shamsi, official spokesperson for the UAE government.
Dr Mohamed Sohil Al Hossni, specialist endocrinologist at Medcare Hospital Sharjah, said that the reported link between diabetes and COVID-19 fatalities is not at all surprising.
Immune system impairment
“It is well known that high blood sugar impairs the immune response, thus increasing the risk and severity of all kinds of infection in patients, whether viral, bacterial or fungal. This is why people with uncontrolled diabetes who contract COVID-19 face a two-fold higher risk of being admitted to the ICU, and their risk of mortality is also three times higher,” Dr Al Hossni said.
Dr Job Simon, diabetes and endocrinology consultant at Burjeel Hospital Abu Dhabi, added that certain symptoms of diabetes, such as nerve damage and reduced blood flow, increase the body’s vulnerability to infection, while comorbidities like obesity and hypertension further exacerbate the condition of patients.
“In case of Type 2 diabetics, the risk is heightened because the majority of them are obese. Severe abdominal obesity is linked with mechanical respiratory issues due to decreased ventilation, as well as greater basal lung secretions that are not eliminated,” Dr Al Hossni added. Both the decreased ventilation and excess secretions make it harder for COVID-19 patients to breathe, thus decreasing oxygen saturation in the blood.
Links to other chronic disease
Other countries have also reported a relation between COVID-19 complications and diabetes, including China and the United States.
In addition, studies have previously reported a link between COVID-19 deaths and hypertension. A paper published in the European Heart Journal said that patients with raised blood pressure had a two-fold risk of dying from coronavirus, based on data from nearly 3,000 patients who were hospitalised in China in March. The risk was also found to be higher for people with hypertension who were not on medication to control the raised blood pressure.
“The exact mechanisms have not been completely elucidated [till now], and we may have to wait a little longer to find out [if hypertension and diabetes work in the same way to increase the severity of COVID-19 complications]. Don’t forget that a significant proportion of diabetics also have hypertension, so there might be a complex interplay of factors involved,” Dr Simon said.
What can diabetics do?
Given these risks, the UAE Ministry of Health and Prevention (MoHAP) has advised people with non-communicable diseases to embrace healthier habits since the start of the COVID-19 outbreak. A social media post today (June 16) added that “the risk of becoming severely ill with the virus appears to increase if you are older than 60 years and have pre-existing non-communicable diseases”.
“Fortunately, the risk of complications is the same as in the general population for people with controlled diabetes, so the [key is to control] blood sugar and live healthy,” Dr Al Hossni added.
According to MoHAP, residents with chronic conditions should take their medications as advised, and secure a one-month or longer supply of medication if possible.
In addition to general measures like social distancing, regular handwashing and wearing a mask and gloves, diabetics and others with chronic diseases should also quit smoking.
“Regular exercise also helps build up the immune response, as does keeping hydrated and sleeping well. In addition, patients can consult their doctors and ensure that their levels of Vitamin D and Vitamin C ae adequate,” Dr Al Hossni recommended.
Tips for diabetics and people with chronic conditions
Wash your hands regularly with soap and water.
Avoid crowds and maintain a two-metre distance from others.
Wear a mask and gloves whenever venturing outside the home.
Stay home as much as possible.
Continue to take prescribed medications and follow your doctor’s advice.
Monitor glucose and blood pressure levels closely and seek help when needed.
Secure a one-month or longer supply of medication is possible.
Quit smoking.
Exercise regularly and stay active.
Safeguard your mental health.
Maintain a healthy diet that includes plenty of fruits and vegetables.
Get enough sleep.
Take Vitamin C and D supplements if advised by your doctor.
Source: MoHAP, Dr Mohamed Sohil Al Hossni