Abu Dhabi: Diabetics are known to be more prone to infections, and this link is evident even between diabetes and COVID-19, a top health official has warned.
Speaking at the latest COVID-19 government news briefing, Dr Omar Al Hammadi, official spokesman for the COVID-19 development briefings, urged diabetics to practise extra vigilance to protect themselves from the coronavirus. “Many diabetics are also obese, and the two [metabolic diseases] are some of the main [contributors] to COVID-19 complications. They weaken the patient’s immunity, and leave them prone to infections [and complications] that can harm vital organs,” he said.
In the UAE, about one in every five adults is known to be diabetic. “Some diabetic patients are obese, and have underlying heart or kidney diseases. These factors increase the risk of complications, not just from COVID-19 but also other respiratory infections like H1N1, influenza, etc,” Dr Job Simon, endocrinology and diabetes consultant at Burjeel Hospital Abu Dhabi, told Gulf News.
Dr Abdul Jabbar, consultant endocrinologist and diabetologist at Medcare Hospital, said the risk occurs because infections are harder to treat in diabetics. “When people with diabetes develop a bacterial or viral infection, it can be harder to treat due to fluctuations in blood glucose and possibly, the presence of diabetes complications. This is because the immune system is compromised, making it harder to fight the virus, and likely leading to a longer recovery period. Also, the virus itself may thrive in an environment of elevated blood glucose,” he explained.
Diabetes is classified intro three forms: Type 1, Type 2 and gestational diabetes. All three increase the risk of COVID-19 complications, but for slightly different reasons.
Type 2 diabetes
Type 2 diabetes — the most common form of the disease which is marked by the inability of cells to react to insulin properly — is also seen in older people with pre-existing medical conditions like heart disease. These pre-existing conditions complicate COVID-19 treatment in patients, and often extend the length of the recovery period.
Type 1 diabetes
In Type 1 diabetes, an autoimmune response has typically damaged the pancreas, which produces insulin. Dr Abdul Jabbar said these patients are more likely to not have blood sugar levels in optimal control, and when they contract an infection, it is difficult to adjust the dose to aid recovery. They also need insulin to control blood sugar. “The rate of hospital death due to COVID-19 among Type 1 diabetics is [much lower] however, because of the age difference in the two populations,” said Dr Jyoti Upadhyay, internal medicine specialist at Aster Hospital, Mankhool.
Gestational diabetes occurs as a result of the insulin resistance during pregnancy. Dr Al Hammadi warned on Tuesday that women with gestation diabetes are especially prone to complications. “Pregnancy, by itself, compromises the immune system, and having gestational diabetes adds another layer to this. [So] pregnant women may be more susceptible to the coronavirus, while gestational diabetes may increase the risk of severe illness,” Dr Upadhyay explained.
Pre-existing illnesses risk
Regardless of the form of diabetes, a COVID-19 patient with other existing conditions is more at risk than a diabetic whose blood sugar is under control, and who does not have other pre-existing illnesses. “Diabetics vary in their age, complications and how well they have been managing their diabetes. People who already have diabetes-related health problems are likely to have worse outcomes if they contact COVID-19 than people with diabetes who are otherwise healthy, whichever type of diabetes they have,” Dr Abdul Jabbar said.
Take prescribed medicines
During the press briefing, Dr Al Hammadi had also urged all diabetics to continue taking their medicines as prescribed. “There is no evidence that COVID-19 complications are associated with diabetes drugs. [On the other hand], stopping the drugs or insulin may cause high levels of blood sugar, and more serious [COVID-19] complications,” he had said.
*Take medicines as prescribed.
* Consult your doctor if you have any concerns, and use telemedicine if required.
* Wear a mask when going out. Practise regular handwashing. These are absolutely essential.
* Maintain social distancing.
* Avoid public transport, if possible.
* Avoid large gatherings.
* Clean and disinfect frequently-touched surfaces around the home frequently.
* Avoid contact with people showing respiratory symptoms. Seek medical help if you develop flu-like symptoms.
* Get vaccinated against the flu.
* Drink sufficient water and eat a healthy diet.
* Get enough, good-quality sleep.
Dr Abdul Jabbar said some patients may stop taking their medicines based on unreliable information spread over social media. “An expert panel report recommends that if [diabetic] patients are infected, some medicines may need to be stopped and diabetes controlled with insulin to optimise glucose control. But stopping medications without doctor’s advice jeopardise glucose control, and increases the risk of contracting various infection, as well as the risk of suffering from related adverse outcomes,” he explained. “It has been reported that people with high blood sugar levels at the time of hospital admission due to COVID-19 have a higher risk of developing severe forms of the infection,” cautioned Dr Simon.
How can diabetics protect themselves?
The standard precautionary measures therefore become even more important for diabetics. These include wearing masks in public and when meeting someone from outside one’s household, regular handwashing and social distancing. “Social distancing should be keenly followed, and is very important. Diabetic patients should limit going out in public and mingling among crowds as much as possible. This applied to everyone, but should be strictly followed by people in any high-risk group,” Dr Simon stressed.
In addition, diabetics should keep a close watch on their glucose levels, and ensure that they are under control. “It is important to optimise patients’ current therapies in order to achieve good glycemic control. And it is very important not to discontinue any therapies without consulting the doctor,” Dr Abdul Jabbar added.