Diabetes Patients Are at Great Risk
While COVID-19 infection is entirely asymptomatic in some people, in others the course of the disease can be more complex and sometimes fatal.
Both during the first wave of the pandemic caused by the COVID-19 infection and during the second wave, it quickly became clear that certain people were at a particularly high risk of contracting the COVID-19 infection.
Diabetes mellitus is generally seen in the type-2 form (90%) and is most commonly seen in people over the age of 50. Uncontrolled diabetes in particular negatively affects the functioning of the immune system and, at least partially, hinders the body’s ability to fight pathogens. For this reason, diabetic patients are at risk in this pandemic due to both their disease and their age.
There is serious evidence that coronavirus infection follows a worse course in chronic diseases such as diabetes, heart disease, and lung disease, as well as in patients with a suppressed immune system.
Data obtained from the regions most seriously affected by COVID-19 show that the risk of death for diabetic patients has increased by almost 50%. Studies published in the French Journal of Diabetology in June 2020 and September 2020 showed that 1 in every 10 diabetic patients died within the first 7 days after being hospitalized.
THE RISK IS INCREASING
Now, in these days when we are experiencing the second wave, we have much more information on this subject. According to recent studies, observations, and identified findings, old age, male sex, obesity, high blood pressure, cardiovascular diseases, and especially diabetes pose a great risk in terms of coronavirus infection.
Risk factors in terms of COVID-19:
- People over the age of 50-60
- Diabetes
- High blood pressure
- Lung diseases (such as COPD)
- Obesity
- Cancer
- Use of biologic agents
- Weakened immune system
In diabetic individuals, the risk increases considerably when other diseases are also present.
In coronavirus infection, good blood sugar control is the most important measure for reducing the risk and severity of infection. Good blood sugar control means a fasting blood sugar level of around 80-130 mg/dl, and a postprandial (2 hours after meals) blood sugar level below 160 mg/dl.
IT WEAKENS THE IMMUNE SYSTEM
The coronavirus damages the inner walls of blood vessels by increasing oxidative stress. This damage to the vascular system harms many organ systems. People with uncontrolled diabetes experience this oxidative stress to the greatest extent. Depending on how long a person has had diabetes, or on the irregularity of their blood sugar levels, blood vessels — especially the inner layer of the blood vessels — and nerves can be damaged. Diabetes, especially in people whose blood sugar control is poor, disrupts the body’s vascular structure and weakens the defense system, that is, the immune system.
In diabetic patients, COVID-19 infection and other infections tend to follow a more severe course than in non-diabetics. Many studies have shown that the need for hospitalization, the need for intensive care, and mortality rates are higher in these individuals than in non-diabetic people.
In diabetic patients whose blood sugar regulation is poor, if there are organ systems previously damaged due to this irregularity (especially hypertension), it becomes easier to contract an infectious disease, the clinical course becomes more severe, and the risk of death increases.
Damage occurring in the blood vessels and irregularities in nerve conduction lead to organ damage that can cause secondary diseases. It has long been a well-known fact that secondary diseases develop much faster and more easily, especially in those with irregularities in the circulatory system, irregularities in nerve conduction, and digestive difficulties, and that these people experience a constant state of inflammation.
Common complications associated with diabetes:
- Vascular and coronary heart disease
- Formation of emboli (blood clots)
- Stroke (paralysis)
- Kidney damage and decline in kidney function
- Frequently recurring cystitis-like urinary tract infections
- Delayed wound healing
- Hormonal irregularities, erectile dysfunction
- Worsening of menopause course
- Neuropathy due to nerve damage
- Clinical findings presenting with chronic fatigue
- Chronic wound infections
Patients with poorly regulated blood sugar are at greater risk!
Among diabetic individuals who maintain good blood sugar levels, eat a balanced diet, pay attention to physical activity, prioritize sleep, and make an effort to manage stress, secondary diseases are rare despite having diabetes. Even though they keep their blood sugar levels well under control, they should be aware that they are in the risk group and protect themselves as well as possible from coronavirus and other viral infections.
Diabetic patients presenting with metabolic syndrome, in particular, are at great risk!
We observe that people with type 2 diabetes who are also overweight and have hypertension carry a greater risk.
The fact that many diabetic patients are of advanced age and have secondary diseases is why the disease follows a more severe course. Due to blood sugar irregularity, the immune system weakens, and patients become more vulnerable to infectious diseases. The functional strain on the pancreas, the suppression of pancreatic function by the coronavirus itself, and the increased risk of blood clotting triggered by microcirculatory disturbances in the blood vessels also cause the clinical course to be more severe.
THEY MUST BE MORE CAREFUL THAN ANYONE ELSE
A new study reveals that the COVID-19 virus selectively damages the insulin islets located in the pancreas, worsening the clinical course in diabetes.
Especially in these days, as we experience the second wave of COVID-19, the general safety measures recommended — hygiene and masks above all — apply to diabetic patients just as they do to everyone else. Diabetic individuals need to pay more attention to these coronavirus measures than anyone else. Diabetic individuals need to be more careful about self-care, physical activity, and proper nutrition.
We recommend that diabetic individuals experiencing circulatory problems avoid taking risks. These recommendations can also include avoiding unnecessary travel, avoiding enclosed spaces if possible, wearing a mask and glasses in public to protect the mouth, nose, and eyes, and definitely staying away from people with cold symptoms.
Anyone who has had contact with a person confirmed to be infected with the coronavirus should remain in home quarantine for 14 days, regardless of any prior illness. Diabetic individuals in particular must strictly adhere to this quarantine period. If symptoms of a respiratory tract infection appear, they should contact their doctor by phone immediately.
In conclusion;
We observe that the coronavirus follows a much more severe course in people who have diabetes, whose blood sugar is irregular, and who are overweight. These observations suggest, on one hand, that in people with weakened insulin resistance and blood sugar irregularity, the body may develop an immune response to this infection, and on the other hand, that the virus most likely finds a rapid-growth environment in diabetics by exploiting the disrupted ACE1/ACE2 balance, thereby damaging the islet cells in the pancreas and worsening the overall picture.
Spend your days not by eating large amounts, but by eating an adequate and balanced diet. First and foremost, stay away from foods high in carbohydrates, sweets, and flour-based foods, engage in daily physical activity, try to lose excess weight as soon as possible, pay attention to your sleep, drink enough water, remove cigarettes and alcohol from your life, definitely avoid processed and ready-made foods, try to be happy with small things, give yourself small daily rewards that make you smile and feel happy, and faithfully follow the recommended protective and hygiene rules for coronavirus infection.
Remember that regular sports and physical activity both break your insulin resistance and strengthen your immune system, while also helping you lose excess weight, strengthen your muscles, and help repair your body’s circulatory system.
In these days when we are fighting against coronavirus infection, it is extremely important for diabetic individuals to isolate themselves at home and manage their disease well during this process. Taking precautions is easier than repairing damage after it has occurred. If you are unable to find a solution through your own efforts, I strongly recommend that you consult your doctor...
Hüseyin Nazlıkul