If you have type 1 or type 2 diabetes, you should be careful during the Covid-19 (Corona virus) pandemic, these people may have more serious complications than someone without diabetes. This is because high blood sugar weakens the immune system and makes the person unable to fight off infection. The risk of serious corona virus infection is even higher if people with diabetes have other health problems, such as heart disease or lung disease.
COVID-19 infection (Corona virus Disease -2019) is a double challenge for patients with diabetes. The first challenge is that diabetes has been reported to be a high risk factor for exacerbating the severity of viral infections. The second challenge is that optimal blood sugar control during this period is difficult.
According to a study conducted with more than 1,300 patients infected with respiratory COVID-19 infections, One in 10 corona virus patients with diabetes died within the first seven days of hospitalization. The results of this study were published on May 29 in the Diabetologia journal.
Two-thirds of the patients studied were male while the average age of patients (both male and female) and 70, were hospitalized at 53 hospitals in France from March 10th to 31st. The study concluded that diabetes made things more complicated and the older the risk of death. The BMI (body weight index, based on weight and height) is greater the risk of needing support for breathing and the risk of death from COVID-19.
1. Diabetes- risk factors for COVID-19
For COVID-19 patients, diabetes is a high risk factor that causes the patient to be hospitalized or possibly die. As data from several studies in China show that diabetes is a comorbid disease occurring in 22% of deaths. The number of comorbidities is also a predictor of mortality in COVID-19. In addition to diabetes, the common comorbidities are hypertension (about 20% of cases), coronary artery disease (16% of the cases) and lung disease (accounting for 6% of cases).
Notably, diabetes is also a high risk factor for death in infectious diseases such as SARS, MERS and the H1N1 pandemic (flu) in 2009.
2. Diabetics with Covid-19 are more likely to die
According to the US CDC, people with a history of chronic diseases such as diabetes, hypertension, and chronic respiratory infections often have weak immune systems, reduced resistance, so they are susceptible to COVID-19.
Newly research shows that people with diabetes are four times more likely to die, and hospitalizations are longer after nCoV infection. The scientists looked at health data for more than 1,000 Covid-19 patients in the United States from March 1 to April 6. Among them, 40% have diabetes or hypertension.
Results showed that diabetic patients had a hospital mortality rate of 29%, much higher than the 6% in patients without background disease. In addition, 42% of patients with diabetes but not previously diagnosed also died.
Lead researcher, Dr. Bruce Bode, an expert at the Atlanta Diabetes Association, said although diabetes and high blood pressure are fatal factors in people with Covid-19, the 42% rate is alarming. .
Utpal Pajvani, assistant professor of endocrinology at Columbia University, said the study showed that people with diabetes are at risk of health complications after nCoV infection. This is similar to the findings in recent hospital data in China.
3. What causes people with diabetes become vulnerable subjects “knocked out ” by COVID-19?
When infected with the virus, the body is not strong enough to resist will launch a series of disorders associated with chronic disease is diabetes, complicating treatment.
It is a fact that people with diabetes are at higher risk of infection, including influenza and complications associated with secondary pneumonia. Patients with diabetes have impaired immune responses including impaired macrophage function, impaired T-cell function and immune cytokines. Poor glycemic control weakens the immune response to the virus and increases secondary bacterial infections in the lungs.
Not only infected with Corona virus, diabetics with weakened immune system are more susceptible to other infectious and inflammatory diseases caused by bacteria, virus such as tuberculosis, skin infection, urinary tract infection, female fungal infection vagina.
Many people with type 2 diabetes are obese, and obesity is also a high risk factor for aggravating the condition. Late complications of diabetes such as diabetic nephropathy, ischemic heart disease can complicate the condition, make the patient weaker and increase the severity of COVID-19. Some findings indicate that COVID 19 can cause acute heart damage or heart failure. The most common comorbidities in COVID-19 are hypertension and diabetes.
4. Diabetes treatment with COVID-19 infection
Poor blood sugar control is a high risk factor for serious infections and other disadvantages. Pneumonia can be reduced with good blood sugar control. However, the problem of treating hyperglycemia during COVID-19 infection is not simple: Patients may have to use corticosteroids, fever patients, the diet of patients changes. To maintain optimal blood sugar, be sure to: closely monitor blood sugar and adjust early hypoglycemic drugs.
In patients with type 2 diabetes whose moderate to severe illness, metformin and SGLT2 agonists should be stopped. DPP4 and linagliptin inhibitors can be used in patients with impaired renal function without risk of hypoglycemia. Sulfunylure can cause severe hypoglycemia in patients with low calorie intake.
For type 2 diabetics, insulin treatment is always a priority and needs to be started early. For patients who have used basal insulin before, it is necessary to supplement the launch insulin (bolus) to ensure blood sugar.
For patients with type 1 diabetes who are receiving basal-bolus insulin therapy or on continuous insulin pump therapy, the dose of insulin should be adjusted regularly, in addition to regular ketones testing to avoid hypoglycemia of patients who are with reduced food intake, add insulin bolus to avoid severe hyperglycemia as well as ketoacidosis.
Diabetes is a disease that causes many complications, so patients need a diet and exercise medication properly. Depending on the condition of your illness: duration of illness, complications … the doctor will prescribe the most appropriate treatment for each stage of your disease.
Diabetes is a chronic disease, each stage of the disease needs to be adjusted so that blood sugar as well as other cardiovascular risk factors such as blood pressure, blood fat, weight are under optimal control but less affected. Most drug side effects. You need to meet your doctor regularly and have your blood sugar checked regularly so your doctor can adjust your medication in time, avoiding the improper folk advice that seriously affects your health.
If you must go out, diabetics stay at least 6 feet away from others and wash their hands often.
Conclusion: Diabetes patients are a group of patients at high risk and complicated when COVID-19 infection. This group of patients needs special attention in treatment to minimize the risk of death.