Dr Subhankar Chowdhury, DTM&H, MD, DM, MRCP, Prof and Head, Department of Endocrinology, IPGME&R and SSKM Hospital, Kolkata, shares his views on why people having diabetes are more likely to experience severe symptoms and complications once diagnosed with COVID-19, and should take greater care
With 1.3 billion people across India showing diverse cultural values, health inequality, social and economic disparities, it poses a greater challenge to handle the situation even after implementation of one of the largest COVID-19 national lockdown in the world.
With the currently available evidence, people with diabetes do not seem to be at a higher risk of developing COVID-19 compared to the general population. However, those with diabetes are more likely to develop severe diseases compared to the general population. The risk of a fatal outcome from COVID-19 is up to 50 per cent higher in people with diabetes than in those who do not have diabetes. The same is also true for people with hypertension, cardiovascular disease and cancer.
If good glycemic control is not achieved, they are more likely to experience severe symptoms and complications once diagnosed with COVID-19 and should take greater care.
Here are some do’s and don’ts that people with diabetes should follow during this pandemic to stay safe and healthy:
* Monitor glycaemic status to watch out for both low and high blood sugars
* Stay hydrated and keep simple carbohydrates ready to manage hypoglycemia
* Organisations like Centre for Disease Control (CDC), American Association for Cancer Education (AACE) and the World Health Organization (WHO) advise people with diabetes to continue to take prescribed medications, maintain a sufficient stock of medications for at least 30 days, along with personal hygiene and home quarantine
* Continue regular home-based exercises such as cycling, treadmill, stationary jogging and resistance exercise with small weights as it promotes healthy lifestyle balancing — both physical and mental health
* Apart from maintaining general hygiene, social distancing and hand sanitising is a must for people with diabetes. In addition, ensure that you avoid crowded areas and non-essential travel
* Elderly people with type-2 diabetes should be vigilant about their glycaemic state
If people with diabetes are suspected or diagnosed with COVID-19, it is important to seek immediate medical attention and follow the recommended advice by the physician. A few precautions are as below:
*Avoid dehydration
* Eat smaller portions, but more often
* Be aware of hypoglycaemic episodes. If experiencing low blood glucose (<70 mg, glucometer), it is recommended to consume 15g of simple carbs like glucose, honey, jam, hard candy, juice or regular soda, and re-check blood sugar in 15 minutes.
Many published articles have hypothesized that insulin is one of the better alternatives to treat people with diabetes, owing to its multiple benefits and is a sure shot in getting high blood sugar levels under good control. Insulin analogues have more favourable pharmacokinetic properties than human insulins and hence may be preferred. However, price of insulins, especially with analogues, is a barrier to insulin accessibility. Premix insulins are well suited to provide good control with safety and convenience in the Indian context of limited consultation time with the doctors, consumption of high carbohydrate diet by people with diabetes and need for simple and convenient insulin regimens to ensure treatment adherence. In this hour of need, pharmaceutical industries have the responsibility to evolve strategies to improve availability and affordability of life-saving medicines and it is a welcome gesture by one of the large global insulin innovator and manufacturer to reduce the price of its new generation insulin analogue suited to the Indian reality of managing T2DM by 30 per cent.
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