Diabetes and COVID-19

With diabetics having a higher risk factor when it comes to being affected by COVID-19, consultant diabetologist, Tejas Kamat shares with NT BUZZ how this group of people can try to stay free of this pandemic
NT BUZZ

COVID-19 (Coronavirus Disease – 2019), a disease caused by the coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome – Coronavirus-2), has emerged as a rapidly spreading communicable disease affecting more than 100 countries across the globe at present. The disease is primarily spread through large respiratory droplets; though the possibility of other routes of transmission cannot be ruled out, as the virus has been found in stool and urine of affected individuals. The disease severity has varied from mild self-limiting flu-like illness to fulminant pneumonia, respiratory failure and death.
Individuals with diabetes are at risk of infections, especially influenza and pneumonia. Not only this, but patients with diabetes also have a severe disease when infected with respiratory viruses. Indeed, diabetes was seen as an important risk factor for mortality in patients infected with Pandemic Influenza A 2009 (H1N1), Severe Acute Respiratory Syndrome (SARS) coronavirus and Middle East Respiratory Syndrome-related coronavirus (MERS-CoV). Data about COVID-19 in patients with diabetes is limited and still not conclusive whether people with diabetes are more likely to get COVID-19 than the general population.
But the risk, says consultant diabetologist Tejas Kamat, can be reduced – though not completely eliminated – by good glycaemic control and all diabetics, above two years of age, are recommended pneumococcal and annual influenza vaccinations. “The problem with diabetic people is that of outcomes. Well-controlled diabetics with no other complications may have outcomes similar to non-diabetics. However, poorly controlled older diabetics especially with heart or kidney disease have worse outcomes if infected,” says
Kamat.
In addition to general preventive measures like social distancing, avoiding contact with infected and suspected persons, appropriate hand and respiratory hygiene, people with diabetes must maintain good glycaemic (sugar) control, as it may help in reducing both, the risk of infection as well as the severity. “More frequent self-monitoring of blood glucose levels is required. If your sugar level is high contact your treating physician for readjusting the doses of your medicines,” says Kamat, adding that good glycaemic control may even reduce the chances of superadded bacterial pneumonia.
Attention to nutrition and adequate protein intake is also important, he says. “Any deficiencies of minerals and vitamins need to be taken care of. Exercise too has been shown to improve immunity and should be continued at home in times of social distancing,” he adds. It is important as well to take influenza and pneumonia vaccinations. The latter may decrease chances of secondary bacterial pneumonia after respiratory viral infection.
However, in case a person with diabetes develops fever, cough, running nose or dyspnoea, the appropriate health authority needs to be notified as testing for this disease is available at selected places only, he says. “The affected person needs to be isolated for 14 days or till the symptoms resolve (whichever is longer). Country-specific guidelines need to be followed,” says
Kamat.
While a majority of patients have a mild disease that can be managed at home. Hydration, he says, should be maintained and home remedies like steam inhalation, etc
can be given.
“Frequent changes in dosage of oral medications and insulin may be required to maintain good glycaemic control. Patients should follow sick day guidelines and may need more frequent monitoring of blood glucose and drug adjustment,” adds Kamat.