COVID-19 and Diabetes

COVID-19 is a novel coronavirus that can cause several symptoms, including fever, coughing, shortness of breath and difficulty breathing. As COVID-19 continues to persist in several countries globally with death toll still rising in some countries it is important for everyone to take the necessary precautions to help prevent infection and spread of the virus. Individuals over 60 years of age and those with pre-existing medical conditions, including diabetes, are at the highest risk for complications.

How does COVID-19 impact a person with diabetes?

At this time, scientists all over the world are still learning about Covid-19. We don’t have enough data to prove that people with diabetes are at increased risk for Covid-19 infection; however, with the limited experience that we have so far, it has been observed that people with diabetes who got infected with Covid-19 have had much higher rate of complications and increased mortality compared to those who did not have diabetes.

What predisposes people with diabetes to Covid-19 infection?

The exact mechanism by which the virus influences glucose metabolism is still unclear. Several factors could predispose diabetic patients to infections. These include:

  • Genetic susceptibility to infection
  • Altered cellular immune defenses
  • Local factors including poor blood supply and nerve damage
  • Alterations in metabolism
  • Depressed antioxidant systems and humoral immunity in diabetes

Risk of lung infection in diabetes

Diabetics are also at an increased risk for lung infection. High blood glucose is thought to damage the blood vessels in the lungs  the same way as  it damages the  blood vessels in other organs. This causes damage to lung tissue, which results in diminished diffusion of oxygen. The extent of the changes in lung tissue seems to depend on the level of glycemic control.

Diabetics also are susceptible to pulmonary infections because of an increased risk of aspiration secondary to gastroparesis, diminished cough reflex, and disordered sleep patterns. It has also been reported that diabetics may be more likely to have recurrent pneumonia.

When people with uncontrolled glucose develop a Covid-19 infection, it can be harder to treat due to fluctuations in blood glucose levels and presence of complications. This is due to two reasons:

1-Immune system in diabetics is compromised, making it harder to fight the infection and recovery may take longer.

2-The virus may thrive in an environment of elevated blood glucose.

Does COVID-19 cause diabetes?

Some scientist suggests a dual relationship between Covid-19 and diabetes. They postulate that Covid-19 may trigger changes in glucose metabolism by causing damage to the pancreas resulting in worsening of preexisting diabetes and development of new diabetes. However, there’s no evidence to prove this hypothesis and more research is needed to unfold this.

 Risk of Diabetic Ketoacidosis with COVID-19

It has been observed that diabetics have an increased risk of developing diabetic ketoacidosis when infected with Covid-19, especially those with uncontrolled diabetes. Those who did develop DKA suffered from more complications with prolonged recovery times.

How is the virus transmitted?

Covid-19 is transmitted through the air droplets that are dispersed when an infected person coughs, sneezes, or talks. The virus is thought to gain entry into the body through mucous membranes of the nose, mouth, and eyes. It can be spread through close contact with the infected person or by contact with droplets in the environment such as touching an object that has droplets and then touching your mouth, eyes, or nose.

Signs and symptoms of Covid-19 infection

Symptoms may start in 3-7 days after exposure to the virus, but, in some cases, it may take up to 14 days. Therefore, a quarantine of 14 days is advised for anyone who has had potential exposure to the virus.

  • Fever with or without chills
  • Shortness of breath
  • Chest pain
  • Loss of taste and smell
  • Headache
  • Fatigue
  • Nausea
  • Vomiting
  • Diarrhea
  • Sore throat
  • Muscle ache

What precautions should a diabetic take?

Because people with diabetes may also have other comorbidities such as organ failure and cardiovascular disease, it is imperative that they follow specific Covid-19 precautions and prevention guidelines from the CDC and WHO along with the instructions provided by their Endocrinologist or Health care provider.

- Diabetics are advised to monitor glucose frequently so fluctuations can be detected early and treated.

- Diabetics should also take prescribed medications regularly, have ample supply of diabetes medications, and call their provider for adjustment in medication if glucose is running high.

-They must also watch their diet carefully, stay hydrated, and try to be physically active.

-It is advisable to avoid using any alternate medication for treatment of covid-19 as there is none available.

-They must cover their nose and mouth with mask at all times when in public as recommended by local authorities.

-They must maintain social distancing at least 6 feet distance from another person.

-They must make every possible effort to avoid contact with a potentially exposed or infected person.

-They must wash hands frequently with soap and warm water.

-They must avoid unnecessary travel, public transportation, or large gatherings.

What to do if someone is sick with Covid-19 in your home

-Person must stay in a separate room if possible.

-Person must avoid close contact with other family members.

-Household contacts who are already exposed must quarantine for 14 days   to avoid further spread of the virus.

-Person must not share utensils and all surfaces must be cleaned regularly.

-Only one family member should take care of the sick person to avoid minimal exposure of the rest of the family members.

-Elderly populations and those with long-term diabetes or advanced diabetic complications are particularly at risk of early death.

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