High blood glucose levels can subdue immunity. Hence, good glucose control is important for reducing both, the risk for and severity of COVID-19, writes Dr. M Shafi Kuchay.

By: Dr. M Shafi Kuchay

These are testing times, but we need to put the facts in perspective: Most people with COVID-19 infection (about 98 percent) do not die from the disease. Senior citizens (those above 65 years) are at increased risk, particularly those with heart disease.

However, as COVID-19 is a new medical issue, we know little about the connection between this viral infection and diabetes. We don’t yet know whether the risk is the same or different for type 1 and type 2 diabetes, or for controlled and uncontrolled diabetes.

Scientific evidence

In a recent study published in JAMA, researchers analysed the findings of 44,672 confirmed cases of the novel coronavirus disease. The overall case-fatality rate (CFR) at that stage was 2.3 percent (1,023 deaths). Data indicated that the CFR was elevated among patients with pre-existing medical conditions.

For patients with heart disease, the CFR was 10.5 per cent; in patients with diabetes, it was 7.3 per cent; 6.3 per cent for those with chronic respiratory disease; six per cent for hypertension patients; 5.6 percent among cancer patients. In general, patients with diabetes – especially those with the uncontrolled disease – can be more susceptible to common infections, such as influenza and pneumonia. Possibly because high blood glucose levels can subdue immunity.

Plan of action

An important factor for infection control in patients with diabetes is whether or not their blood glucose levels are well controlled. Good glucose control, therefore, is important in reducing both, the risk and severity of COVID-19.

In order to maintain good glucose control, patients should monitor their blood glucose levels more frequently so that fluctuations can be detected early and immediately addressed. Patients should continue to take their prescribed medications and get them adjusted if blood glucose levels are off the mark. It is advisable to get medications adjusted through telephonic or online consultation, avoiding clinic or hospital visits.

People with diabetes should refrain from using any alternative medicine, or treatment advertised on the internet, both for treating diabetes or preventing the coronavirus infection. There are several recommended adult vaccinations, especially for patients with diabetes. The most relevant in this pandemic are the influenza and the pneumonia vaccines. People with diabetes are advised to be up to date with their influenza and pneumonia vaccination shots.

Preventive measures

Like the general population, people with diabetes too need to practise standard precautions to prevent the spread of the virus. For instance, frequent hand washing with soap and water for at least 20 seconds, avoiding handshaking, practising good respiratory hygiene by sneezing or coughing into a facial tissue or bent elbow, help reduce the risk of infection. Similarly, touching of the face should be avoided, as should unnecessary travel. Keeping doors open will prevent you from touching door handles or knobs frequently. Wearing glasses instead of contact lenses is recommended.

Patients with diabetes should continue to follow a healthy diet as recommended for diabetes care. They should continue to exercise regularly. It’s important to find the time and space to do some simple exercises, like yoga, stretching and walking for at least 45 minutes each day. This will not only help maintain healthy blood glucose levels but also reduce stress and anxiety.

In order to mitigate the risks and complications of COVID-19, the most important factor is to observe standard preventive measures. People with diabetes also need to maintain good control of their blood glucose levels at all times.

(The author is Senior Consultant Endocrinologist, Medanta The Medicity, Gurugram, India)