Every individual needs to be careful to avoid the virus that causes COVID-19. Taking precautions is necessary for all, and if you are suffering from any other illness, then you are supposed to take extra care. Even if you have someone at home who is already sick from any other disease, such lungs or heart disease, you are required to take proper care and be cautious, because the virus is contagious.
You have to be extra careful if you have diabetes or live with anyone who has diabetes. If you have type 1 diabetes or type 2 diabetes, you should be even more cautious than a normal individual.
The risk of catching the novel coronavirus by a diabetic patient isn’t higher than anyone and they may have worse complications if they catch the infection. And this true especially if the individual’s diabetes isn’t well-controlled.
To reduce your chance of catching the coronavirus:
- Use good hygiene.
- Keep your distance from other people.
- Keep your blood sugar under control.
Have a dietary plan in place in case you get sick.
Diabetes during Coronavirus
Early studies have shown that about 25 percent of the people who went to the hospital with severe COVID-19 infections had diabetes. Those with diabetes are more likely to have serious complications and issues, and are likely to die from the virus. The main reason is that high blood sugar weakens the immune system and makes it less able to fight off infections. The risk of severe coronavirus infection is even higher if the diabetic patient is suffering from another condition, like heart or lung disease.
If you get tested COVID-19 positive, the infection might put you at greater risk for diabetes complications such as diabetic ketoacidosis (DKA). DKA happens when high levels of acids known as ketones build up in your blood and this can be very serious.
Certain people who catch the novel coronavirus have a dangerous body-wide response to it, known as sepsis. To treat sepsis, doctors need to manage your body’s electrolyte levels and fluid. DKA causes you to lose electrolytes, which can even make sepsis harder to control.
Tips for diabetic patients to avoid the infection
The best method to avoid getting sick is to stay at home as much as you can. According to the Americans With Disabilities Act, people with diabetes have the right to “reasonable accommodations at work.” Which means you have the right to work from home or take sick leave when you need it.
If it is an emergency and you have to go out, keep a distance of at least 6 feet from other people, and wear a face mask. Wash your hands often when you get home and carry a hand sanitizer while you’re out. Remember to wash your hands before you give yourself a finger stick or insulin shot. Clean each side first with soap and water or rub the sanitizer properly.
To protect you, everyone in your house must wash their hands often, especially before they cook something for you. Don’t share any of your utensils or other personal items and if anyone in the house is sick, they must stay in their own room and as far as possible from you. They must wear a cloth face mask when you have to be in the same room and maintain a distance of at least six feet.
Type 1 diabetes cannot be prevented because it’s caused by a problem with the immune system. Certain causes of type 2 diabetes, like your genes or age, aren’t under your control either. Yet several other diabetes risk factors can be controlled. Most diabetes prevention strategies include making simple adjustments to your fitness routine and diet.
If you have been diagnosed with prediabetes, here are a few activities you can do to delay or prevent type 2 diabetes:
- Cut trans and saturated and fats, along with refined carbohydrates, out of your diet.
- Do aerobic exercises for at least 150 minutes in one week, such as walking or cycling.
- Eat smaller portions.
- Eat more vegetables, fruits, and whole grains.
- Try to lose at least 7 percent of your body weight if you’re overweight or obese.
Doctors treat diabetes with different kinds of medications. Some of these medicines are taken by mouth, while others can be injected.
Type 1 diabetes
Insulin is the main cure for type 1 diabetes. It replaces that particular hormone which your body isn’t able to produce.
There are mainly four kinds of insulin that are most commonly used. They are differentiated by how quickly they start to work, and how long lasting their effects are:
- Short-acting insulin starts to work within 30 minutes and lasts up to 6 to 8 hours.
- Rapid-acting insulin starts to work within 15 minutes and its effects last for 3 to 4 hours.
- Long-acting insulin starts to work a few hours after injection and lasts 24 hours or more than that.
- Intermediate-acting insulin starts to work within 1 to 2 hours and lasts up to 12 to 18 hours.Also Read: Coronavirus And Diabetes: How To Deal With It?
Type 2 diabetes
Exercise and diet can help some people manage type 2 diabetes. If lifestyle changes don’t seem enough to lower your blood sugar, you’ll need to take certain medications.
These drugs lower your blood sugar in a variety of ways:
• Alpha-glucosidase inhibitors – This would help in slowing down your body’s breakdown of sugars and starchy foods.
• Sulfonylureas- This drug would stimulate your pancreas to release more insulin.
• Biguanides- This would reduce the amount of glucose your liver produces
• DPP-4 inhibitors- This would improve your blood sugar without making it drop too low.
• Glucagon-like peptides – It changes the way your body produces insulin.
• Meglitinides – This drug would stimulate your pancreas to release more insulin.
• SGLT2 Inhibitors- This drug would help your body to release more glucose into the urine.
• Thiazolidinediones- This would help the insulin work better.
You may need to take more than one of these drugs or even take a combination, as your doctor prescribes. Some people with type 2 diabetes also take insulin.
Coronavirus updates regarding diabetic patients
The first study of coronavirus to specifically analyse the effect of the infection in hospitalised patients with diabetes has found that at least one in ten patients dies within 7 days after admitting, and at least one in five is intubated and mechanically ventilated by this point. The research is published in Diabetologia, which is the journal of the European Association for the Study of Diabetes (EASD), by Professor Samy Hadjadj and Professor Bertrand Cariou, diabetologists at l’institut du thorax, University Hospital Nantes, CNRS, INSERM, and University of France, Nantes, and colleagues.
The study explains that two thirds or 65 percent of coronavirus patients with diabetes admitted to hospital are men, and the average age of all the patients is 70 years. Worse blood sugar control did not seem to impact a patient’s results, however the presence of diabetic complications and increasing age increases the risk of death, and increased Body Mass Index is associated with both increased risk of needing mechanical ventilation and with increased risk of death.
The study was called the ‘CORONADO’ study and it analysed 1,317 patients admitted to 53 French hospitals, public and private, between 10 March and 31 March, 2020. The majority of hospitalised patients had type 2 diabetes (89%) while only 3% had type 1 diabetes, with other types of diabetes in the remaining cases. In 3% of cases, diabetes was actually diagnosed during hospitalisation for coronavirus.
Microvascular complications (eye, nerves and kidney) were found in 47% of the patients in the study, while macrovascular complications (arteries of the brain, heart, legs) were present in 41% of the patients. Across all patients in this study, by day 7 one in five patients (20.3%) had been intubated and placed on a ventilator in intensive care unit, and one in 10 (10.3%) had died. A further 18% had been discharged home or cured at this point.
The presence of macrovascular or microvascular complications each more than doubled the risk of death at day 7. More age substantially increased the risk of death, with the group of patients aged 75 years and more than 14 times more likely to die as compared to the younger patients aged under 55 years, while patients 65-74 years old were three times more likely to die as compared to those under 55 years. The presence of the respiratory condition obstructive sleep apnoea almost tripled the risk of death after 7 days, as did the presence of dyspnoea symptoms or in simple words, shortness of breath.
The study even confirmed that insulin, and indeed all other treatments for modifying blood sugar, are not a risk factor for severe forms of coronavirus and should be continued in patients diagnosed with diabetes. Fortunately, there were no deaths in patients under 65 years of age having type 1 diabetes, but the authors highlighted that there were only 39 patients with type 1 diabetes in this study and other work is ongoing to establish the effect of coronavirus in this specific population.