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| COVID 19 (Novel Coronavirus Disease) and Diabetes -Frequently Asked Questions | | |
Dr. Junaid Rashid
1) What is COVID 19?
COVID19 stands for "Corona Virus Disease" caused due to a newly mutated (novel) strain of corona virus which struck the world in late"2019" and came to attention from Wuhan situated in Hubei province of China. This novel virus has higher infectivity and results in higher degree of complications than the usual corona virus infection.
2) How does one acquire this infection?
Though its believed to have started from the wet animal market in Wuhan China,however,Infection spreads from person to person. It spreads between people who are in close contact with one another (within about 6 feet) & through respiratory droplets when an infected person coughs or sneezes. These droplets can go in the mouth or noses of people who are nearby and possibly get inhaled into lungs. A person can get infected by touching a surface or object that has the virus on it and then touching their own mouth, nose or possibly their eyes.
3) What are the symptoms of the disease?
Fever is seen in 98% of the cases. Other prominent symptoms include cough, shortness of breath,loss of energy, pain and aches all over the body, discomfort in the chest , headache, vomiting and diarrhoea and lack of taste
4) Who are the patients most likely to acquire the severe form of infection?
Although the virus can infect anyone, however, those who are at higher risk of acquiring the severe form of disease and more frequently landing into complication include elderly persons, those who already have other co morbid illnesses like diabetes mellitus, hypertension, heart, kidney and liver ailments, cancer patients, organ transplant recipients, those receiving immunosuppressive medications and those already with underlying respiratory tract diseases like COPD, Bronchial Asthma.
5 Are Diabetic patients more prone to get COVID 19?
Uncontrolled diabetes mellitus impairs immunity. Consequently patients of diabetes with uncontrolled blood sugars are at increased risk of acquiring microbial infections. There is delayed clearance of virus in the diabetics. People who already have diabetes-related health problems are likely to have worse outcomes if they contract COVID-19 than people with diabetes who are otherwise healthy, whichever type of diabetes they have.
When infected with COVID19 diabetes patient can experience severe symptoms, complications & even death compared to healthy people. In one study from China by Xiabogo Yang et al, 22% of those who succumbed to covid19 had diabetes mellitus. People with diabetes are not more likely to get COVID19 than the general population but they transform into worse outcome due to uncontrolled sugars. Well managed diabetes, reduces the risk of getting severely sick from COVID19 to same as the general population.
6) When should a diabetes mellitus patient consult his doctor on priority?
• When blood sugar stays high for more than 24 hours or classic signs of high blood sugar are present like increased frequency of urination, increased thirst, dry mouth, fatigue, weight loss etc.
• Symptoms which could be indicative of their developing diabetic ketoacidosis like fast breathing, abdominal pain, drowsiness etc.
7) What special advice is to be given to a patients of diabetes on Insulin therapy during COVID-19 illness?
• Insulin treatment should never be stopped.
• Blood glucose levels to be checked every four hours.
• Always contact treating physician for Insulin dose adjustments. Never do it yourself. The insulin dose may need to be increased or fast-acting Insulin needs to be added.
• Ideal blood sugar levels should be between 110-180 mg/dl.
• Specific instructions are given about abnormally low blood sugar (hypoglycaemia) management.
8) What are the sick day rules for people with diabetes?
• Take diabetes medication as usual.
• Test blood glucose every four hours.
• Drink extra (calorie-free) fluid*, and try to eat as normal.
• Weigh yourself every day.
• Check temperature every morning and evening.
Drink plenty of fluids – 120 to 180 ml every half an hour to prevent dehydration.
9) what other precautions should be taken?
If you are on insulin your urine and / or blood ketone bodies may need to be monitored. Patients , particularly with type 1 diabetes should be advised to check urine ketones when there is sustained rise in blood sugars with two consecutive sugar readings above 250mg/dl.If urine ketones are moderate or large or there are symptoms of Diabetic ketoacidosis like abdominal pain, nausea, vomiting, they should immediately report to the emergency department of nearby hospital..
Follow your local health care teams recommendations.
People who suspect they may be exposed to the virus should contact their health care provider immediately
Social distancing which means avoiding mass gatherings and congregate settings (approximately 6 feet) from others when possible.
10) What is the takeaway message for diabetes patients?
Key is to maintain better blood sugar control and to implement basic protective measures. These include washing hands with clean water and soap so as to lather your palms, back of hands, between your fingers and under your nails. Scrub your hands for at least 20 seconds and then rinse your hands well. If soap and water is not available use alcohol based sanitizer that contains at least 60% alcohol. Avoid close contact with people suffering from fever & cough. Avoid touching eyes, nose or mouth. Avoid touching your face before you have washed and dried your hands. |
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