NE HEALTH BUREAU
AHMEDABAD, NOV 13
It’s a double whammy for diabetics to get infected with the coronavirus pandemic. Chronic diabetics contracting COVID-19 have the worst prognosis – more serious illness and a higher risk of death, says leading diabetologist Dr Vivek Arya.
He outlined three major reasons for the rise in COVID-19 cases among the diabetics aged 60 years and above— COVID fatigue and lack of COVID appropriate behaviour as people are not following social distancing or wearing masks; respiratory viruses peak during winter months.
Dr Arya said, “During this time of year there is an increase in allergic disorders like sneezing, running nose and a large number of cases of flu, therefore it becomes challenging in differentiating between upper respiratory manifestations. So, I think all individuals who have an influenza-like illness like fever, sore throat, headache, body ache, the cough should at least get themselves tested for COVID-19.”
He was speaking to navjeevanexpress.com to create awareness among the masses on World Diabetes Day which is celebrated on 14th November every year. It is the world’s largest diabetes awareness campaign reaching a global prevalence of over 1 billion people in more than 160 countries.
“Chronic diabetics contracting COVID-19 have the worst prognosis – more serious illness and a higher risk of death. Males with advancing age, longer duration of diabetes, and other illnesses like high blood pressure, and overweight increase risk amongst diabetics. Precautionary measures are the same for diabetics as compared to the general population. But all diabetics are recommended to keep blood sugar as normal as possible to minimize the the risk of infection’, said Dr Vivek Arya, Endocrinologist, and Diabetologist, Centre for Endocrine Disease and Diabetes.
Case study of diabetes patients
Diabetes may be more prone to all kinds of infection — viral infection or bacterial. If somebody is having poorly controlled diabetes, they get infected and the complication rate is quite high than others.
If any person who has abnormal sugar then the chances of getting COVID 19 related morbidity, getting more sick, or require admitting a person to ICU, gets increases in those kinds of cases.
“If we compare two different HbA1c levels, which is an average level of sugar in the last three months, we find that somebody who has poor control of diabetes has more risk of complications and death. Between two diabetics getting Covid-19 infection the person who has HbA1c more than 10 percent, the chances of that person getting complication, requiring ICU admission or the risk of death is at least two and a half to two times more as compared to somebody whose HbA1c is less than 7 or the person is under good control,” Dr Arya revealed.
Timely diagnosis, treatment saves precious life
Dr Vivek Arya came up with a person who got infected by Covid -19 and HbA1c 8.8 percent. According to him, the chances of him getting sick was high. First, he was having a simple kind of fever and cough for the last 4-5 days; he got admitted to the hospital. On the 3rd day of admission, the situation got worsened. He required ICU care and was about to be put on a ventilator. Fortunately, he was given appropriate treatment and thus saved him from putting on a ventilator. Steroids were part of his therapy in Covid-19. Steroids increase the blood sugar level. If the patient had been admitted and treated with steroids, chances of blood sugars getting worse are very high. To manage this complication, such patient was given insulin through Intra-Venously (IV).
Another phenomenon is the New Detection of diabetes. Multiple organs get affected by Covid-19. A person who has a family history of diabetes or risk of getting diabetes, once they get infected by Covid-19 they get a new onset of diabetes which is a new phenomenon that has been seen in this Covid-19 pandemic. Earlier, Sugar was normal on whatever test they have done but, during this Covid-19, they were suddenly high blood sugars and they have to be treated like any other diabetic patient. Even the patient who has detected diabetes for the first time during Covid-19 infection, they had something called Diabetes Ketoacidosis. It means that level of sugar goes very high and they have Ketone formation because of lack of absolute insulin. This is one of the complications of Diabetes, when sugar is very high or the body is not making any insulin then the person gets Diabetes Ketoacidosis.
Dr. Vivek Arya said, “The good thing is that more than 50 percent of the patients who have found to be diabetic for the first time, after they were cured of Covid-19, two to three weeks after that, their sugar level has come down to absolutely normal and there was no requirement for insulin or tablet. However, other 50 percent patients continue to have persistent diabetes.”
The high-risk factor for Covid-19 is the age factor. Comparing somebody who is 50-59 years and another person who is more than 80 years of age, the chances of serious illness and death is 2.3% in person aged 50-59 yrs and 15% in people aged 80 years. The second important factor is Obesity. Obesity is the other independent risk factor if your weight is more. If somebody is overweight, diabetic, and elderly, everything is adding up to the risk factor. It increases the risk up to 12 times compared to other normal people.
Dr Vivek Arya can be contacted over 9638668877, 9316545343 or send mail to vivekarya007@yahoo.com
