Managing diabetes: The masked killer behind COVID-19

From the observations conducted in the study of the virus, comorbidities stand to be one of the important aspects of making the infection fatal or causing complications in its treatment.
Managing diabetes: The masked killer behind COVID-19

Coronavirus has taken the world by the storm. Since its inception, the world has been trying to contain the spread of the disease. Researches alongside have been running a rat race to find a vaccine. The only fact that remains is taking precautionary measures can help prevent us from contracting the infection.

But despite the preventive measures suggested by the health organisations, governments and medical experts there is an exponential rise in the number of cases. As of today, the total number of cases globally stands at 33.8 million of which 1.01 million have been reported dead.

From the observations conducted in the study of the virus, comorbidities stand to be one of the important aspects of making the infection fatal or causing complications in its treatment.

But what is comorbidity? defines comorbidity as the presence of one or more additional conditions often co-occurring with a primary condition. Diabetes is one of the most prevalent comorbid conditions in our country.

Several studies have shown that patients with diabetes are at a higher risk of developing complications if contracted with COVID-19.

Diabetes and COVID-19

The Bridge Chronicle spoke to Dr Vaishali Deshmukh, to understand the importance of managing diabetic condition better in the times of COVID-19.

"Diabetes patients are a significant proportion of Covid patients because people with diabetes (PWD), particularly uncontrolled diabetes are more susceptible to viral, bacterial, and fungal infections as compared to those without diabetes. This is because they have a less robust immune function," says Dr Deshmukh.

The Senior Endocrinologist and Diabetologist at Kem Hospital, Mumbai, adds that "across the world, it has been noted that although by itself diabetes does not seem to increase the risk of getting COVID-19, it is a condition that is more prevalent among patients with severe COVID-19. Other factors such as age above 60 years, male sex, obesity, hypertension and heart disease have also been found to increase the complication rates in diabetes patients affected with COVID-19."

While the symptoms of both diabetic and non-diabetic patients are the same, their risk of developing complications is higher.

"Data from Wuhan, China showed that approximately 20 per cent of the intensive care unit (ICU) admissions for COVID-19 had diabetes as a comorbidity. Similarly, data from Italy showed that more than two-thirds of those who died from COVID-19 had diabetes. In India too, of the first 125 deaths from COVID-19, 56 per cent had diabetes, 47 per cent had hypertension, and over a third had both diabetes and hypertension," says the doctor.

The case fatality rate with pre-existing co-morbid conditions compared to around 2 per cent of the normal population is:

Percentage of fatality rate with co-morbid conditions
Percentage of fatality rate with co-morbid conditions The Bridge Chronicle

In general, diabetes is known to increase and worsen the morbidity and mortality in COVID-19, increasing the chances of cardiac complications and respiratory failure. Thus, it becomes important to control sugar to reduce the fatality rate and control blood pressure with Asprin therapy.

Apart from that, advising on the precautions to be taken by diabetic patients Dr Deshmukh said, "regular use of mask, hand hygiene, sanitation and social distancing is more important in diabetes and hypertension patients than the normal subjects, as they reduce the chances of acquiring COVID -19."

"All patients above 60 years should avoid moving out of their house unless required and should avoid going into crowded public places such as cinema halls, marriage or party halls or malls and restaurants. Patients with diabetes should report to their COVID physician or centre at the earliest if they develop fever, sore throat, breathlessness or a dry cough," she added.

Diabetes patients may also require to take extra efforts post-COVID-19. Fatigue, breathlessness, weakness, fear, sleep disturbances, appetite loss, anxiety may be heightened in diabetics and it is important to ensure their wellbeing.

"Eating healthy foods along with rest and supplements can go a long way. Light walks and breathing exercises also help to improve lung function. During recovery, intake of fluids and protein supplements is recommended along with inhaler and steam if the cough is persistent," says the doctor.

Additionally, the doctor recommends, "Yoga, pranayama and meditation are important and so is spiritual health. A doctor must be consulted if recovering patients experience breathing difficulty, and oxygen levels fall below 90 per cent."

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