COVID-19 and Diabetes

COVID-19 is the new and potentially serious coronavirus infection that is spreading worldwide. The World Health Organization (WHO) has already declared the COVID-19 outbreak as a public health emergency of international concern.

COVID-19 is spread through air droplets that are scattered when a person who is infected talks, sneezes or coughs. The COVID-19 virus can survive from a few hours up to a few days, depending on the environmental conditions.

The majority of people who contracted COVID-19 do not have symptoms or only have mild symptoms such as fever, cough, tiredness and muscle aches. However, COVID-19 can cause more severe disease in about 10 to 15% of infected individuals. These people can suffer more serious chest infection (pneumonia), heart and/or kidney failure, or even death.

Treatment of COVID-19 infection is supportive based on the patient’s clinical condition. There is currently no proven specific treatment or anti-viral drug for COVID-19 available. There is also no vaccine available for COVID-19 at the moment.

People who are older in age and those with pre-existing medical conditions, such as high blood pressure (hypertension), diabetes mellitus, heart disease, or asthma, appear to be more prone to severe COVID-19 complications, including adult respiratory distress syndrome (ARDS) and multiple organ failure. These individuals can become severely ill if they contract COVID-19.

Currently available data show that 20 to 50% of patients with COVID-19 infection have diabetes as an underlying medical condition, depending on the country.

There is currently no evidence that those with diabetes are more susceptible to catching the COVID-19 infection compared to people without diabetes. So people with diabetes do not have a higher chance of catching COVID-19 compared to normal individuals.

Why are people with poorly controlled diabetes more prone to severe COVID-19 infection?

People with diabetes already have a compromised immune system due to high blood glucose levels. The immune system is further weakened if diabetes control is poor with higher blood glucose levels.

When a person with diabetes contracts COVID-19, it is harder for the immune system to fight the virus and serious complications like pneumonia can result. The recovery from the infection may also take a longer time.

Another possible reason may be that the COVID-19 virus thrives in an environment of higher blood glucose levels.

Most important step – Prevent catching COVID-19

The most important thing for individuals with diabetes to do is to prevent themselves from catching the COVID-19 virus. Therefore general hygiene measures for everyone apply for people with diabetes as well.

  • Wearing a face mask when outside of the house
  • Washing your hands thoroughly and regularly
  • Avoid touching your face before you have washed and dried your hands
  • When coughing or sneezing, cover your mouth and nose with tissue paper or hands – be sure to wash your hands thoroughly if you do not have tissue paper
  • Avoid contact with anyone who has symptoms of respiratory illness such as cough and running nose

Second important step – Maintain good diabetes control

It is crucial to maintain good diabetes (blood glucose) control so that your risk of developing severe complications is reduced if you do catch the COVID-19 virus. This means keeping your HbA1c (three months average blood glucose control) less than 8.0% – preferably less than 7.5%.

Keeping a well-balanced, reduced carbohydrate diet and regular physical activity (even if you are at home) is fundamental to blood glucose control. Continuing to take your medications (tablets and/or insulin injections) regularly as prescribed by your doctor is also paramount. Ensure that you do not run out of supply of your medications.

If your diabetes is not satisfactorily controlled, you may need to see your doctor to optimize treatment for blood glucose levels.

Check your blood glucose levels at home regularly so that you can know whether your diabetes is under control. Fasting blood glucose levels should be between 4.0 and 7.0 mmol/L (between 70 and 130 mg/dL) and 2-hour post-meal blood glucose levels should be less than 10 mmol/L (180 mg/dL).

Do keep to a regular schedule and avoid overworking. It is also important to have a good night’s sleep and make sure that you stay well-hydrated daily by drinking plenty of water.

Third important step – Watch out for symptoms of illness

Pay attention to symptoms that may be suggestive of COVID-19 infection:

  • Fever
  • Dry cough
  • Tiredness
  • Muscle aches and pains
  • Shortness of breath (having trouble breathing)

Monitor your blood glucose levels more often when you develop any abnormal symptoms.

See a doctor as soon as possible if symptoms persist for more than 3 days.