Diabetes and Covid 19 – How can the risk for patients with diabetes be reduced?

COVID‐19 (Coronavirus Disease 2019), is caused by the SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus‐2) viral infection. It was first reported in Wuhan, China, in December 2019. Just like its predecessors, SARS‐CoV, (severe acute respiratory syndrome coronavirus) and Middle East respiratory syndrome coronavirus, SARS‐CoV‐2 is highly pathogenic and can cause severe lung infection, acute respiratory distress syndrome (ARDS) and multi-organ failure. Covid 19 death toll in India has crossed 35 lakhs as of 18^th June 2021.

Diabetes and obesity are labeled as co-morbidities of the fatal infection, and there are also unique and complex interactions between diabetes medicines and other commonly used agents for diabetes mellitus‐related co-morbidities with COVID‐19 infection.  Some of the promising Covid19 therapies are also associated with metabolic effects. Before we understand how to reduce the risk for patients with diabetes, we need to understand the risk factors.

Risk factor No 1: Poor Glycemic Control

Diabetes mellitus has been listed as the 3rd most prevalent co-morbidity, after cardio‐cerebrovascular disease and hypertension. Diabetes mellitus is a well‐recognized risk factor for all infections. The risk increases multifold with poor glycemic control. HbA1c >9% (glycated hemoglobin) has been shown to be connected with a 60% amplified risk of severe pneumonia. It is also related to a 2 ‐ 3 fold increase in complications.

Risk Factor No 2: Obesity

Obese people with BMI >35 kg/m² are at nearly 7 fold higher risk of needing intubation and ventilators. A recent study showed a lower BMI threshold of 25 kg/m² for disease severity hierarchy in the Asian population^. In addition, patients with microvascular and macrovascular complications of diabetes mellitus, as well as obstructive sleep apnea, were found to be at considerably more risk of severe infection and mortality.

BOTH THESE MEASURABLE RISK FACTORS CAN BE MITIGATED BY GLYCEMIC CONTROL AND OBESITY REDUCTION

So what can we do globally to decrease these high-risk factors?

1. Test yourself and your loved ones to see if you are in a high-risk zone
2. If your HbA1c is below 7 – maintain to low carbohydrate diet, increase your lean protein intake, keep up your physical activities and practice stress relief techniques like pranayama.
3. If your HbA1c is above 7 – consult your doctor and adjust your medication and lifestyle as per the physician’s advice.
4. If you are unable to test your HbA1c, check your blood sugar either through a diagnostic lab or using a glucometer. If your fasting sugars are more than 100mg/dl or your 2 hour postprandial is above 140mg/dl then you need a diabetes specialist’s advice to bring it to normal levels.
5. If you are obese, check your thyroid, cholesterol and blood pressure too and as per physician advice, embark on a healthy weight loss regimen. Do not resort to any fad diets without consulting your doctor. Keto diets are not healthy and may cause more harm than good. Zero carbohydrate diets can lead to production of ketones that are harmful to patients with diabetes.
6. Keep a watch over your vitamin D levels – low vitamin D can lower your immunity – simple supplements as prescribed by the doctors after checking your nutrition levels can help.
7. Take your vaccines. Covid 19 vaccine is of prime importance to help create herd immunity to arrest the spread of the virus. You may also protect yourself against bacterial pneumonia with the pneumococcal vaccine and flu (influenza vaccine) if you have not been vaccinated against them yet. However, please consult with your physician regarding the timing and the gap between such vaccinations.

As a means of prevention of severe Covid infection in patients with diabetes, we would like to declare June as the #diabetescontrolmonth

Free blood sugar testing:

In order to facilitate easy blood sugar testing among the public, we are offering free random blood sugar tests using a glucometer to all those who walk into our clinics, along with FREE diet counseling during this #diabetescontrolmonth. Those with diabetes may check if they are in control. Those who have been affected by Covid or have been administered steroids and recovered may also check if their blood sugars have reached back to their normal levels. Because #bloodglucose one parameter that can affect one’s health and well-being greatly. Uncontrolled diabetes is one of the main reasons for serious complications pertaining to #Covid like #mucormycosis (#blackfungus). For appointments call 8939110000 or email appointments-gop@drmohans.com