Published on Aug 28, 2020 and last reviewed on Apr 10, 2023 - 4 min read
Abstract
Diabetic patients are prone to getting severe complications of COVID-19 if they get infected. Read this article and know more.
Introduction
The question that strikes the mind is why people with diabetes are at an increased risk of having severe COVID-19 illness. It is well known that in diabetes, the total available sugar in the blood is not very well utilized by the cells. This higher-than-normal circulating blood sugar makes the immune system weaker and the person vulnerable. This is a vicious cycle that is mainly contributed by the following impaired immune response. Higher than normal blood sugar provides a good thriving bed for infectious agents. A dysfunctional immune system cannot fight off the existing infection efficiently, thus making it longer and tougher to heal. Both types of diabetes, type 1 and 2, puts a person at increased risk of contracting the infection followed by related secondary complications and hospitalization.
This article attempts to address the issues and find ways to cope and take charge of life with diabetes and effectively manage it to stay healthy and avoid unnecessary hospital trips. Thus decreasing the chances of getting exposed to patients or asymptomatic carriers of COVID-19.
This situation of household responsibilities, as well as working from home with increased restrictions, has added to significant stress and pressure in our daily lives. In the current scenario, visiting a doctor is risky as well as challenging. A person with diabetes of any age group is at higher risk of getting an infection leading to critical COVID-19 illness. Therefore, it is imperative that people belonging to this vulnerable group take special measures to keep themselves safe. Here are a few important points for consideration:
1) Stay Active -
Make a routine of at least 30 minutes of exercise, which includes some aerobic activity and deep breathing exercises, and be consistent with the same. It will not only help the person to maintain a healthy weight but optimize sugar levels too. It has been proven time and again in several studies that regular physical activity goes a long way in effective diabetes management. It is never too late to start exercising.
2) Optimal Hydration -
Diabetes dehydrates our bodies. Excessive sugar in the blood is excreted through urine and takes away lots of water and other essential electrolytes from the bodies. Therefore, it is important to drink enough water, which is at least 8 to 9 glasses (2.5 liters) in 24 hours, excluding tea and coffee.
3) Balanced Diet -
Staying homebound can make anyone give in to temptations. The best way is to never stock junk food items. Instead, stock up on healthy snacks such as whole wheat or multigrain crackers, fresh fruit, and nuts. Not only social distancing but distancing from sugary and high-fat foods is important too. Also, control the portions because too much of anything is bad even if it is healthy food.
4) Get Enough Sleep -
At the time of the pandemic, everyone was supposed to be at home, being at home people can aim to get at least 6 to 7 hours of sleep every night. They can also try for a power nap in the afternoon if that works for them. Adequate sleep helps in boosting immunity and thus increases the ability to fight off infection.
5) Manage Stress and Anxiety -
It is very much easy to fall prey to depression because of limited or no interaction with friends and colleagues. One can start feeling lonely. Keeping distance from near and dear ones can be stressful too. Staying calm and positive is as important as other things. This can be achieved by meditation, keeping a journal, and expressing thoughts and feelings by writing them down is a great way to stay balanced. Remember, stress can make sugars go haywire.
Preventive Measures from COVID-19 for Diabetic Patients:
The following are the preventive way for COVID-19 for diabetic patients:
Check the blood sugar and blood pressure periodically, and monitor the urine output.
Watch out for symptoms of hypoglycemia. Most diabetics know about it.
Always keep candy, chocolate, or some form of glucose handy in case a person needs it. If a person does not have any of these, then having some fruit such as a few grapes, an orange, or a small piece of pineapple can help instantly too.
Make sure to keep enough stock of essentials such as glucometer strips, Lancets, Insulin syringes, and anti-diabetic tablets.
People should always take all necessary precautions to protect themselves from COVID-19 Infection.
Refrain from meeting anyone who a person thinks could be infected or has a cold and cough.
Avoid handshaking.
Wash the hands from time to time.
Do not go out in public unless absolutely necessary.
If a person go out, then maintain a distance of 6 feet from others.
Use a proper face mask when in public. It should cover the nose and mouth completely.
Do not share food, towels, and masks within the family, even if all are staying indoors.
Avoid social gatherings on the same premises or buildings.
Stay home even if a person has mild flu-like symptoms.
It is important to keep the phone number or any other contact information of the primary care physician.
Conclusion
It is all the more important to keep sugars in the normal range. If a person has any doubts, then speak with a doctor. Be watchful of any changes that are occurring in the body so as to get time management. If going to a clinic is not possible, then one can use the facility of telemedicine. Do not change the dose or stop taking your regular diabetes or blood pressure medications or Insulin in case you get infected with COVID-19.
Along with taking preventive measures for COVID-19, it is important not to overlook other things. People should take care of themselves and keep their hands, feet, footwear, and clothes clean and sanitized. Use a lubricant to moisturize the skin and prevent cracking. Watch for any sores in the mouth or on the lips. All in all, prioritize natural immune boosters such as regular exercise, adequate sleep, and citrus-based fruits (lemon, orange, etc.). Be vigilant of any unusual changes or symptoms in the body and know when to call the doctor. Above all, stay positive.
Yes, diabetic people are more prone to developing serious complications such as lung infections in COVID-19 illness. Diabetes is a risk factor for developing infections and also delays recovery. However, well-controlled diabetes with good glycemic control does not lead to severe complications and ensures complete recovery.
People having diabetes are more likely to get infected by COVID-19 because their resistance to being infected by the virus is slightly compromised when compared to healthy individuals, but, that should be a cause for worry. Following adequate precautionary measures like avoiding crowded places, wearing masks, avoiding outside foods or drinks, and maintaining optimal blood sugar levels through proper medications reduces the risk of being infected by Covid.
Not only Covid but any viral infection that affects diabetic patients increase their blood sugar levels. They are required to monitor their blood glucose levels regularly and should not skip their medications. Viral infections in diabetes increase the risk of developing diabetic ketoacidosis (DKA).
The progression of Covid is similar in diabetic individuals as in healthy people. However, diabetica are more likely to develop serious complications if their blood sugar levels are poorly controlled. Good glycemic control in diabetic patients lowers Covid complications and is generally well-managed.
Since the risk of developing serious problems like infections are more common in diabetic patients, frequent or periodic glucose monitoring is essential. An appropriate healthy diet along with adequate hydration should be followed to prevent electrolyte imbalance in these individuals. Insulin dosages and anti-diabetic medication doses should be adjusted according to their covid illness severity.
Self-testing blood sugar or blood glucose level is an important tool for the effective management of diabetes and for preventing complications. Portable devices such as glucose monitoring (CGM) meters are used to test blood sugar levels at home itself. When sick or infected with Covid it is advisable to monitor blood sugar levels every 6 hours periodically
Diabetic individuals should not skip their regular anti-diabetic medications. They should strictly follow covid isolation precautionary measures such as wearing masks, remaining isolated (quarantined) till infection subsides, and most importantly avoiding going out or visiting crowded places. These precautions would protect them from getting secondary (bacterial) infections.
If the blood sugar level is increased above 300, it is advisable to consult the doctor and be hospitalized if the doctor recommends it. Pregnant women with gestational diabetes also require close monitoring and frequent hospital visits. Increased severity of covid symptoms such as difficulty in breathing, and prolonged fever also require hospital visits.
Insulin doses or their requirements depend on the blood sugar levels of the diabetic patients during the time of covid illness. Hormones that are released to fight the covid virus tend to increase the levels of blood sugar levels, hence insulin doses are adjusted according to it.
Diabetics should eat proper meals at the appropriate time without skipping their regular medications. They should drink adequate water to prevent fluid imbalance or dehydration. They should include fresh fruits and vegetables in their diet. Instant energy foods and alcohol consumption should be avoided.
Last reviewed at:
10 Apr 2023 - 4 min read
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