What Are The Effects Of COVID-19 On People With Diabetes?

COVID-19 has impacted people’s lives for quite some time now. It severely affects people with different comorbidities. What are the main causes of concern for people with diabetes with respect to COVID?

The major problem areas or risk factors of COVID in people with diabetes and of COVID related to diabetes are:

1. If a person with diabetes gets the COVID infection.
2. If a person who gets COVID develops diabetes after the infection.
3. People who have developed diabetes during the pandemic.

For people with diabetes – if they get a COVID infection

COVID infection, due to the toxicity of the virus, is dangerous and can be fatal. Uncontrolled diabetes amplifies the problem if a person gets COVID.

Uncontrolled blood sugar levels increase COVID risk for people with diabetes. This means that if a person has diabetes and gets infected with COVID, the COVID complications can become severe and the pace of COVID disease progression is faster. This is further worsened if the diabetes is uncontrolled. COVID complications with uncontrolled diabetes can become a cause of mucormycosis.

Does this mean all people with diabetes will get COVID complications? 

The severity of COVID in people with diabetes is due to uncontrolled blood sugar levels. As a known complication of diabetes, people with diabetes are at a greater risk of having a blood circulation problem and inflammation in the body.

Diabetes is known to cause long-term damage to nerves, blood vessels, kidneys, and other organs. Generally, people with diabetes are also prone to inflammation of cells and tissues. One such condition is called Cellulitis. Such conditions are listed as criteria for a person being classified as a high-risk patient. These conditions can increase the risk of COVID in people with diabetes.

However, it does not imply that if a person has diabetes, the chances of contracting COVID can increase. It just increases the chances of severe infection after contracting COVID. The impact of COVID in people with diabetes can vary as per the type of diabetes.    

It also depends on other comorbidities or conditions, such as

– Dyslipidemia (high cholesterol or triglyceride levels)

– High Blood Pressure

– Blood circulation problems, clots in the arteries

– History of angioplasty or bypass surgery

These comorbidities or associated conditions, besides type-2 diabetes, can increase the COVID complications and severity of the infection in people with diabetes.

Does COVID affect a person even if the blood sugars are under control?

No, even if diabetes is under control, COVID risk for people with diabetes continues to be present since it causes a fluctuation in blood sugar levels. 

For a person with controlled diabetes maintaining normal blood glucose levels, COVID infection may offset the control. The body’s inflammatory response to the virus causes fluctuations in blood sugar levels.

Normally, for a person who gets COVID infection, the following parameters are closely observed and monitored:

• Body temperature (fever)
• Respiratory rate
• Oxygen Saturation (SpO2)

For COVID infection in people with diabetes, monitoring blood sugar levels is vital. There will be fluctuations throughout the day starting from the time of the infection. Blood Glucose monitoring via the machine at home is sufficient to keep a check. One must communicate the readings to the doctor for records.

Even if the diabetes is in check with routine oral medication, there is a possibility that the blood sugar fluctuations due to COVID may require your diabetologist to start insulin therapy. This insulin is warranted to keep the blood glucose levels in control during the COVID infection with minimal side effects during sick days. After recovery and complete healing, the insulin dose may be stopped by your doctor.

Rise in the Number of Diabetes Cases Due to COVID

So as long as someone with diabetes does not contract COVID, there is no problem?
No, not necessarily. Even without contracting the actual virus, COVID has created trouble for people with diabetes. While it sounds odd, there is an indirect impact of the Global pandemic for those with diabetes. COVID can also induce hyperglycemia in people without previously diagnosed diabetes and increase the risk of critical diseases. There are two distinct problem groups owing to the COVID pandemic.

• People with diabetes, controlled or uncontrolled, finding their situation get worse due to the COVID pandemic related lifestyle changes.
• Otherwise healthy, non-diabetic people, who have developed high blood sugar levels due to the COVID pandemic related lifestyle changes

 The COVID pandemic related lifestyle changes can be summarised as follows:

Stress – caused by or for the following reasons:

• Financial instability
• Risk of contracting the infection
• Lockdown and the restrictions with it
• Family health and security
• Death of near and dear ones

Sedentary lifestyle

• Lockdowns meant no movement and home isolation.
• Work From Home (WFH) meant no travelling to the office.
• No exercise as gyms and parks were closed.

Steroids

• Steroid medications were used as an important part of treatment for severe COVID-19 in many patients. Some patients even self-medicated themselves with these medicines during COVID infection. Steroids increase the risk of diabetes especially when given in high doses or for a long duration of time.  

All these three factors directly affect the body’s metabolism which impacts the way your body processes sugars and reflects on blood glucose readings.  

Conclusion

The best possible solution for decreasing the COVID risk in people with diabetes is to maintain sugar levels in the healthy range, follow COVID-appropriate behaviour and get the COVID vaccine. The COVID vaccine for people with diabetes will directly reduce the severity of the infection and the impact on people’s health.

The COVID vaccine is safe, and as more people take the COVID vaccine, the severity of the disease’s impact will decrease. Subsequently, it will lead to reduced restrictions and lockdowns, which will provide the opportunity for people with diabetes to take better care of their health. But, people with diabetes and other comorbidities must consult their doctor before taking the vaccination.

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