The risk is not that those with diabetes are more susceptible to infection. The risk lies in the fact that the severity of the COVID infection can be greater in those with diabetes

In trying to understand the nature of the Coronavirus and how it attacks individuals, studies have shown several findings because the virus seems to attack every individual differently. This has a lot to do with the personal medical history of the infected individual. From the start of the pandemic one section of society has always been more at risk than others – people with diabetes. What is the connection? What puts people with diabetes in the high-risk category?

What needs to be made clear is that the risk is not that those with diabetes are more susceptible to infection. The risk lies in the fact that the severity of the COVID infection can be greater in those with diabetes. Even though we have now been battling with the coronavirus and its evolving/ changing strains, studies are still in its nascent stage. Whether the person has Type 1 Diabetes, Type 2 Diabetes or Gestational diabetes – they are at increased risk of complications if they are infected with COVID.

THE RELATIONSHIP BETWEEN COVID & DIABETES

Anyone can get infected with the coronavirus. However, the reason we see elderly people having it worse than the younger generation, is the fact that the former section of people tends to have more underlying medical conditions. These medical conditions worsen with a COVID infection. However, what makes it even worse for those with Diabetes, is the fact that in general, people with diabetes are prone to complications from any viral infection, and COVID is a viral infection.

When people with diabetes contract a COVID infection, treatment is difficult because of the fluctuation of their blood sugar levels. Recent studies suggest that COVID-19 could precipitate acute metabolic complications of diabetes such as diabetic ketoacidosis and non ketotic hyperglycaemia by interrupting insulin secretion. Diabetic Ketoacidosis occurs when high levels of acids called ketones build up in the blood. This is a potentially serious condition. Hyperglycaemia in diabetes causes dysfunction of immune response. An impaired immune system makes the person more vulnerable to disease and infection. Hence the possibility of severe complications in the face of a COVID infection.

The first reaction of the body to the coronavirus (in some people) is sepsis – which is when the immune system releases a lot of chemicals into the blood, triggering off widespread inflammation that can further lead to organ damage. To treat sepsis, body fluid and electrolyte levels need to be managed. However, Diabetic Ketoacidosis causes loss of electrolytes making it hard to control and sepsis. It’s like a chain reaction of one adverse event leading to another. And with immunity down, treatment becomes that much more complicated.

In addition to diabetes if the individual has a heart condition or a lung condition, COVID related symptoms will be even more severe – often life-threatening even.

PRECAUTION IS THE BEST MEDICINE

Those with diabetes need to be extra careful and hence must follow all necessary pandemic precautions. The basic precautions being:

• Staying indoors.
• Wearing a mask when stepping out of the house.
• Maintaining social distance while outdoors.
• Washing hands regularly
• Sanitizing one’s home and surroundings on a regular basis.

Additional Precautions for those with Diabetes:

• Check your blood sugar more often. Those who keep their blood sugar under control, may not have severe COVID symptoms should they contract the disease.
• Drink lots of fluids and eat a healthy diet. Your body needs all the nutrients it can get to fight off infections.
• Be wary of over-the-counter medications. Some over the counter medicines for fever and cough can increase blood sugar levels, Check with your doctor before taking them.
• Check Oxygen Saturation periodically. Ask your doctor what levels of oxygen are healthy. If it dips lower than that, get to a hospital. Do not wait till you are gasping for breath.
• Get the COVID vaccine. Discuss with your doctor if you have any misgivings about the vaccine and get the shot ASAP.

Reviewed By:

DR.GEETHALAKSHMI

CONSULTANT – ENDOCRINOLOGY

MBBS, MD, DM (ENDOCRINOLOGY)