Dubai: This year, as the world ushers in World Diabetes Day on November 14, most diabetics will stay indoors while expressing their solidarity to avoid risk of exposure to COVID-19. Endocrinologists worldwide agree that while diabetics are not at a higher risk of catching COVID-19 than anyone else, they do they are at much higher risk of organ complication and even death from it.
A recent published in the medical journal Lancet, based on a study conducted on COVID-19 patients admitted to hospitals in UK from March to May 2020, showed that out of the 7,434 deaths that occurred during that period, nearly a third were patients suffering from Type II diabetes while those with Type I diabetes also were at risk of mortality although less at risk compared to Type II diabetics.
Diabetics more vulnerable to complications
Speaking to Gulf News, Dr Bithika Thompson, Endocrinologist, Mayo Clinic, Arizona, US said diabetics in general risk complications when they were sick and COVID-19 was no exception. “Diabetic patients are not at higher risk of contracting COVID-19 infection, rather they experience more severe symptoms, particularly those people whose glucose control is not optimal. Among patients who are hospitalised due to COVID-19, a higher proportion of them has diabetes.”
While the UAE’s National Health Survey approved by the World Health Organisation (WHO) and released in 2019 show that the overall incidence of diabetes has fallen to 11.8 per cent as compared to 18.9 per cent in 2010, endocrinologists say the bigger issue is with a large number of young people being pre-diabetic and many going undiagnosed with high blood sugar.
Risk of exposure for many undiagnosed diabetics too
Dr Job Simon, consultant endocrinologist and diabetologist at the Burjeel Hospital, Abu Dhabi, told Gulf News that a very large percentage of the population that was already suffering from metabolic syndrome symptoms of obesity, high triglycerides, polycystic ovaries in women, already had blood sugars in the pre-diabetic ranges. “I get at least one individual below the age of 30 in my clinic with diabetes every single day. What is dangerous is that a large number of people who may already have high blood sugar may not even be aware of it and be undiagnosed.”
When such people face exposure to the COVID-19 virus, one of the risk factors of having complications is diabetes.
Diabetes is a condition that affects all vital organs that include pancreas, kidneys, heart, liver, peripheral nervous system and even the eyes. Poor blood sugar control reduces one’s immunity. Their organs are already compromised and according to Dr Sarla Kumari, specialist Physician and Diabetologist at the Canadian Hospital, Dubai, these patients are at higher risk of developing serious organ complications and even death. “The more uncontrolled your diabetes is, the higher the risk of developing more severe disease or complications from COVID-19 infection,” explained Dr Kumari.
This means that not only should you follow all of the universal precautions needed to prevent the spread of COVID-19 if you are diabetic, but you’ll also need to be sure to focused on carefully monitoring your blood sugar levels and maintaining optimum blood sugar control, she advised.
Dr Thompson added said no matter what type of diabetes a person has, monitoring and managing blood sugar are the most important things to minimise risk for complications. It can be harder to control blood glucose levels during an illness or infection.
What is diabetes?
Diabetes is a chronic health condition that occurs when the level of sugar in the blood is too high. That happens because of a problem with the hormone insulin, which is made in the pancreas. When you eat, the pancreas releases insulin into the bloodstream. This allows sugar to enter your cells, lowering the amount of sugar in your blood.
There are several forms of diabetes, including Type 1, which is an autoimmune disorder, and Type 2, which results from both loss of insulin production and development of insulin resistance in body tissues. Gestational diabetes is another form that may occur during pregnancy.
Type I and Type II
Patients with type 1 diabetes are completely insulin-deficient and require daily insulin injections. Despite ongoing research, Type 1 diabetes currently has no cure. Treatment focuses on managing blood sugar levels with insulin as well as diet and lifestyle to prevent complications.
Type 2 diabetes develops when the pancreas does not make enough insulin, and the body can’t use insulin as well as it should. That means sugar cannot move into the cells, and it builds up in the blood. Exactly what causes type 2 diabetes is unknown, although genetics and environmental factors, such as being overweight and inactivity, seem to be contributing factors.
Although there’s no cure for Type 2 diabetes, studies have shown that it is possible for some people to reverse the condition. For many patients, losing weight, eating well and exercising can help manage the disease. If lifestyle changes are not enough, some people may be prescribed any number of oral medications or even insulin to help them manage their disease.
Are your prediabetic?
Prediabetes is a condition in which blood sugar is higher than normal, but it’s not high enough to be considered Type 2 diabetes. If left uncontrolled, pre-diabetic patients are at high risk to develop Type 2 diabetes.
The good news is that often lifestyle changes alone, such as diet and exercise, can lower your blood sugar level and decrease your risk of developing diabetes.
Tips to strengthen immunity and reduce risk of complications from COVID-19
• Check and monitor your blood sugar regularly and record the fasting and post prandial blood glucose levels and be in touch with your doctor if you have a consistently high reading despite medication. Poor glucose control can make one more susceptible to catching infection
• Take your medications consistently and on time as well as maintaining the healthy habits that help keep it under control. Discuss issues with your doctor. If your medication for diabetes causes your blood sugar level to drop too low or raise them consistently too high, the dose or medication schedule may need to be adjusted.
• Stay active. Have a regular physical fitness routine of at least 45 minutes to an hour daily. Exercising makes one more sensitive to insulin and gives better blood glucose control.
• Make healthy food choices, choose complex carbohydrates, control portion size, balance your protein, carb and fat intake and cut out trans fats, processed foods that are refined and could have hidden sugars and preservatives and are likely to spike your blood glucose levels Avoid sugar-sweetened beverages
• Stay hydrated. Drink plenty of water or other fluids while exercising because dehydration can affect blood sugar levels.
• Be prepared. Always have a small snack or glucose tablets with you during exercise in case your blood sugar level drops too low.
• Keep in touch with your primary diabetic doctor and don’t skip check-ups with your diabetic care team.
• Get the flu vaccine as catching the flu can expose your to respiratory distress and make one more weak
• Restrict your outings and social visits to a bare minimum. If you do go out, follow all the protocols of hygiene, social distancing, hand sanitisation and wearing a mask.
• Keep stress levels low: When you are stressed, the hormones your body produces in response to prolonged stress may cause a rise in your blood sugar level. Additionally, it may be harder to closely follow your usual diabetes management routine if you’re under a lot of extra pressure. Identify the triggers, learn coping mechanism like relaxation techniques and don’t be afraid to ask for extra help when needed.
• Keep your hormones in equilibrium: Changes in hormone levels before and during menstruation can result in significant oscillations in blood sugar levels. Try to identify patterns and speak to your physicians if you experience fluctuations in blood sugar levels.
• If you do test COVID-19 positive, contact with primary health care providers or DHA, to get assisted. Further action on quarantine or hospitalisation will depend on upon the severity of infection.
Source: Dr Sarla Kumari diabetologist Canadian Hospital and Dr. Vikram Hundia — Consultant Endocrinologist at Al Zahra Hospital Dubai