The relationship between diabetes and COVID-19 is one that can best be described as a complex pathophysiology that is still not well understood. It has been described as “a classic example of a lethal intersection between a communicable and a non-communicable disease. Everyone needs to be careful to avoid the coronavirus that causes COVID-19. If you have type 1 or type 2 diabetes, you should be even more cautious.
Since the initial COVID-19 outbreak in China, much attention has focused on people with diabetes because of poor prognosis in those with the infection. Initial reports were mainly on people with type 2 diabetes, although recent surveys have shown that individuals with type 1 diabetes are also at risk of severe COVID-19. The reason for worse prognosis in people with diabetes is likely to be multifactorial, thus reflecting the syndromic nature of diabetes. Age, sex, ethnicity, comorbidities such as hypertension and cardiovascular disease, obesity, and a pro-inflammatory and pro-coagulative state all probably contribute to the risk of worse outcomes. Glucose-lowering agents and anti-viral treatments can modulate the risk, but limitations to their use and potential interactions with COVID-19 treatments should be carefully assessed. Finally, severe acute respiratory syndrome coronavirus 2 infections itself might represent a worsening factor for people with diabetes, as it can precipitate acute metabolic complications through direct negative effects on β-cell function. These effects on β-cell function might also cause diabetic ketoacidosis in individuals with diabetes, hyperglycaemia at hospital admission in individuals with unknown history of diabetes, and potentially new-onset diabetes.
COVID-19 Diabetes Plan
- Continue taking their medication, including insulin, as usual
- Test and keep track of their blood sugar levels
- Make sure that they have at least a 30-day supply of diabetes medications, including insulin
- Speak with a healthcare provider, such as by contacting the nearest community health center, to discuss any concerns about diabetes and COVID-19
Prevention
- Frequently washing the hands with soap and water
- Using an alcohol-based hand sanitizer when soap and water are not available
- Avoiding frequently touched surfaces when possible
- Frequently disinfecting any potentially contaminated surfaces, such as countertops, tabletops, and door handles
- Not touching the eyes, nose, or mouth with unwashed hands
- Practicing physical distancing by staying 6 feet, or 2 meters, away from others in public
- Avoiding all contact with people who are sick, especially if they have a fever, a cough, or both
- Keeping the immune system strong by getting at least 7 hours of sleep a night and reducing stress levels as much as possible
- Maintaining an adequate intake of food and fluids
- Trying to keep blood sugar levels in a healthy range
Tips
- Dietary modifications
– Avoid Carb-heavy foods
Carbohydrates are an important part of all meals. However, people with diabetes will benefit from limiting their carbohydrate intake in a balanced diet or pairing carbs with a healthful protein or fat source.
– Avoid High-GI fruits
Most fruits are low on the GI scale, though melons and pineapple are high-GI. This means that they can increase blood glucose more.
– Avoid Saturated and trans fats
Unhealthful fats, such as saturated and trans fats, can make a person with diabetes feel worse. Many fried and processed foods, including fries, chips, and baked goods, contain these types of fats.
– Avoid refined sugar
People with diabetes should aim to limit or avoid refined sugar, likely present in both store-bought and homemade sweets, cakes, and biscuits.
– Avoid Sugary drinks
Drinks that contain a lot of sugar, such as energy drinks, some coffees, and shakes, can imbalance a person’s insulin levels.
– Avoid Salty foods
Foods that are high in salt can raise blood pressure. Salt may also appear as sodium on a food label.
– Avoid Alcohol
Drinking alcohol in moderation should not have serious risks for people with diabetes and should not affect long-term glucose control.People using insulin or insulin secretagogue therapies may have a higher risk of hypoglycemia linked to alcohol consumption.
- Stay active
Diabetics should stay physically active as it will not only keep them fit but also help them overcome anxiety and stress related to the pandemic.
