COVID – 19 AND DIABETES – THE DO’S AND DONT’S FOR DIABETICS – Dr. Arathi Darshan

COVID-19 pandemic has brought the world to a standstill. COVID-19 term was coined by WHO, on 11th February 2020, for the disease caused by a novel coronavirus, SARS- COV2 (Severe acute respiratory syndrome – coronavirus 2).

In 80-85% of patients, COVID 19 presents like mild flu-like illness. The common presenting symptoms of COVID 19 incidence wise, are as follows; Fever(87%), Dry cough(67%), Fatigue(38%), Cough with Sputum(33%), Shortness of breath(18%), Myalgia(14%), Sore throat (13%), Headache(13%), Chills (11%), Loss of Taste and Smell (10%), Vomiting and Diarrhea(5%). Patients with the mild disease show a good recovery.

Around 15% of patients develop complications like pneumonia and 5% develop a critical illness. The warning symptoms of worsening of the disease are, difficulty in breathing, drowsiness, confusion, persistent chest pain or pressure in the chest and bluish lips or face. Patients with such symptoms deteriorate rapidly and they need to seek urgent medical care and hospitalization. The time of onset of the first symptom to hospital admission has been an average of 5-7 days.

The worse outcome and need for intensive care can be predicted in COVID 19 patients. Elderly patients are at a greater risk of developing complications. Data from US and China have revealed that 15-20% of patients of COVID 19 had Diabetes. Likewise, other comorbidities include Hypertension, Cardiovascular disease, Pre-existing lung disease, Obesity, Cancer, etc.

Studies have revealed a threefold increase in mortality, among diabetics with COVID 19 compared to non-diabetic patients. The length of hospital stay was longer among diabetics. The poor prognosis for diabetic patients can be explained by an impaired immune response to infection, the presence of other Diabetic complications like Diabetic kidney disease, and Ischemic heart disease. Thus, leading to increased severity of complications. Type 2 diabetics who are obese are also more prone to complications.

The Do’s and Don’ts for diabetics during lockdown-

1. Try to maintain the same schedule and routine as it was prior to lockdown. Medications should be taken on time. Keep a good stock of required medications, glucometer strips, lancets etc. Checking blood sugars on glucometers is advised. Maintain a fasting blood sugar between 90-130mg% and post-meal sugar between 160-180 mg%.

2. The eating pattern should be the same as prior to lockdown. Don’t indulge in overeating. Carefully watch what you are eating and how much you are eating? Try to cut down the portion of food as the activity level is low during the lockdown.

3. Avoid refined carbohydrates like bread, pasta, noodles, pizza, cakes, canned juices etc. Food rich in fiber like green leafy vegetables, salads, fruits, soups are preferred. One or two slices of mango can be occasionally consumed. The day one is eating mangoes, do not binge on other high sugar foods as the calorie content in mangoes is very high. Avoid mango juice and mango shrikhand as the sugar content is high.

4. Avoid snacking in between meals especially while watching TV or while using mobile. Low-calorie food like salad, buttermilk, green tea should be preferred.

5. Maintaining physical activity is imperative for good diabetic control. Activities that can be done easily at home are skipping, gardening, climbing stairs, dancing, aerobics, spot walking, spot jogging, floor exercises, walking on terrace, yoga and indoor games. Routine household chores like mopping and dusting are also good exercises. Breathing exercises are extremely useful to de-stress. Avoid sitting in a place for a long time.

6. Stay hydrated. Drink plenty of water, Avoid and limit the use of Alcohol.

7. Ensure adequate sleep.

8. Avoid stress and be positive. Spend more time with children and family members. Try to utilize this time in learning new activities like yoga, meditation techniques, new exercises, cooking etc.

9. Avoid going out unless it’s a dire necessity. Avoid unnecessary visits to hospitals /clinics, unless it’s an emergency. This viral infection has no specific treatment. Hence, it’s extremely important to take all precautions while stepping out of the house.

STAY HOME- STAY SAFE!

Dr. Arathi Darshan MD, FICP Consultant Physician & Diabetologist, K LE’s Dr. Prabhakar Kore Hospital & MRC
Professor & Head, Department of Medicine, J N Medical College, Belagavi. (M) 9448845883