Steps for diabetics to keep Covid-19 away

Misery loves company. So too diseases as is evidenced by the high prevalence of Covid-19 among diabetics.

Hi, I am Dr Ashwini Joshi of Aloha Clinics, Pune, one of Pune’s finest healing and therapies centre that has helped people turn their lives around to live and see better days. We have had our share of Covid-19 patients who have in an equally substantial numbers also been affected by diabetes as co-morbidities.

Today I tell you the connection and how to take care.

Covid-19 or for that matter most viral diseases being the result of weak immunity, one of the first and most obvious question that comes to mind is how does diabetes affect immunity.

The body’s response to any external attacks by pathogens is three-layered. Of these, the first two are more or less an auto-response to any aggression (by pathogens that include bacteria and viruses). The third, an adaptive immune response is launched by the body’s fighter-cells the WBC. Of all the three layers, it’s the third which is most affected by elevated blood sugar. It impairs and limits the WBC’s response due to a process called acidosis. Add to that the presence of open wounds on the skin of chronic diabetics, and the chances of contracting the virus goes up substantially. That, and the overall presence of a conducive atmosphere rich in sugar is most likely to make the person very sick for a very long time. In such a state, like it or not, the one with co-morbidities including diabetes is most likely to go down to the likes of the Covid-19 virus.

Another aspect that adds to the mess is the thickening of the blood due to excessive sugar that obstructs its easy flow within the body. This affects the transfer of essential nutrients to fight off the infection.

Has the instance of diabetes affecting Covid-19 increased during the lockdown? If so, why?

Majority of the deaths caused during both the first and second phase of the pandemic has been attributed to comorbidities like heart disease and diabetes. Of these, the latter has shown a marked jump. As described before, diabetes as a condition reduces the efficacy of one’s immune system drastically which lets the virus have a free run and in a very short while patients are known to succumb to the disease. As for the sudden rise in diabetes, two things are attributed:

• Lack of normal exercise and movements during the lockdown
  The lockdown severely restricted people’s movements. There are those who did lose weight but at the same time, there are also those who gained weight, became obese and most of all, ate their way to high blood-sugar levels. Simple things like walking and stair-climbing that are known to control high-blood sugar levels could not be accomplished.
• Boredom leading to excessive eating
  Humanity today isn’t used to being cooped up in small places for the longest of time. For a change, the entire world has gone through the experience. And while they were there, human did what they do when they get bored. Eat, and eat like there’s no tomorrow. In a regime of zero exercise, such unending eating did one thing in particular. It sent humanity’s blood-sugar shooting thru the roof taking diabetics right down the slippery path into the open arms of the pandemic.
• To an extent, lack of medical care during the lockdown
  There is yet another though not too thought-about angle. Medication of any kind was almost non-existent or not easily available which in the case of diabetics made their condition deteriorate further.

Where does diabetes lend itself to the present pandemic?

Diabetes has affected people’s health in the following ways: Higher chances of contracting Covid-19.

A compromised immune system is the right setting for the Corona virus to attack and take hold. With most diabetics being obese & also suffering from heart diseases, overwhelming the lungs doesn’t take too long to succumb.

• Diabetic Ketoacidosis:
  Diabetics with severely low insulin tend to develop ketoacidosis when the body increasingly turns to fat for its energy needs. High level of ketones that are thus are produced in the body are a warning sign that poison-like substances is forming in the body that may even lead to coma. Such a situation easily translates into a Covid-19 attack.
• Mucormycosis or ‘black fungus:
  It's rare but just as deadly when contracted. The overwhelming number of Covid-19 patients getting it led to a study that has found that India particularly has all the right ingredients for its manifestation. First, prevalence of diabetes in large numbers. Second, high doses of steroid meant to keep away the Covid-19 virus. Both these led to the third, contracting mucormycosis or black fungus that has proven fatal in substantial number of cases.

What to do to stay healthy?

• Take diabetes medication to keep blood- sugar in check:
  Lockout or no lockout, a diabetic has to take all the prescribed medication to keep things in check which include blood-sugar and insulin. It makes sense to keep medication stocked for the long, long haul. If you suffer from Type 1 diabetes, you have practically zero option but to depend upon diabetes medication and medical supervision.
• Take the shots and take precautions:
  With everyone in a position of authority having shouted themselves hoarse that the Covid-shot is safe, it makes sense to take it (with medical supervision lest it leads to further complications) at the earliest.
• Eat right.
  Type 2 diabetes is characterised as a “Lifestyle Disease” which sees the consumption of foods that invariably lead to heavy and uncontrolled spikes in blood-sugar brought about by foods rich in sugar, carbohydrates, sweetened, carbonated drinks, processed foods rich in oil, fats and sugar. These if consumed regularly without any semblance of exertion to burn them off, is sure to lead to insulin resistance and then diabetes. These to the extent possible should be stopped and substituted with leaner foods that may have more nutrition than taste.
• Exercise.
  One of the best and most assured ways of keeping blood-sugar in check in the case of Type 2 diabetes is to exert the body in ways that increase heart- rate, precipitation and most of all, uses calories in large quantities- while keeping the body’s metabolism rate high and steady throughout the day. All this is possible only with regular exercise. In the absence of scope to go out an exercise, diabetics should to the extent, exercise at home. Be it spot jogging, lunges, squats, push-ups or anything else, it should be done under medical supervision and advice. But it should be done with unerring regularity.
• Sleep.
  Lockdown or otherwise, a diabetic should get his/ her ideal duration of sleep to keep sugar spikes in check. Numerous studies on the subject have confirmed that sleep has a positive effect on the mix of oxidative stress, insulin and cortisol. That said, those who sleep more than 7 to 8 hours too need to be medically investigated as the same can have the opposite effect of more harm than good.
• Don’t stress.
  The lockdown in all its forms was a stressful period. And stress one of the main reasons for blood-sugar shooting up. The body priming for action, sugar is dumped into the blood in larger quantities. But in the absence of adequate insulin, all it does is cause multiple problems down the line. The most natural response could be to isolate stress by weigh options and letting things be instead of fretting unnecessarily. With things turning normal, blood sugar too comes under control.

In the end, given the war footing at which things are moving, the Covid-19 pandemic would be tamed eventually. As for Diabetes, and more so Type 2 diabetes, much has to be done by those suffering from it to bring in any sense of semblance.