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| PRUDENCE TOWARDS COVID-19 PANDEMIC | | |
MANOJ KOTRU
Treating COVID-19 in patients with diabetes and hypertension
Twenty-one days lock-down imposed by most of the states across India has created a scare amongst patients of diabetes and hypertension for the risk of corona virus disease (COVID-19) infection. There are some emerging evidence to suggest that people with diabetes are more prone to COVID-19. COVID-19 leads to viral pneumonia, following which the chances of a secondary bacterial infection is much graver in patients of diabetes. Hence, people with diabetes should take particular precautions with respect to COVID-19, as they already have a slightly immune-compromised state.
How does COVID-19 act in those living with diabetes?
COVID-19 can cause more severe symptoms and complications in some people living with diabetes, the elderly, and those with other chronic conditions such as heart disease & lung disease. It is important to minimize this risk by being proactive with your prevention strategies.
How can I prevent infection?
Public health agencies world-wide have described actions that can help prevent the spread of viruses that cause respiratory illnesses. The following steps are suggested to reduce exposure to the virus and protect your health:
• Wash your hands thoroughly and regularly with soap and water
• Sneeze and cough into your sleeve; when using tissues, immediately dispose of them into the garbage as soon as possible and wash your hands afterwards
• Avoid touching your eyes, nose or mouth
• Regularly clean commonly used surfaces and devices you touch or handle.
• Try to avoid contact with people who are showing symptoms of respiratory illness, such as coughing
• Check national travel advice before planning or taking trips
• If you have a fever, cough and difficulty breathing, seek medical care early and share previous travel history with your health-care provider
• If you have a scheduled visit with your health-care provider, contact them via phone first to see what other options you may have (many clinics have increased their use of telemedicine) as visiting a clinic can increase your risk of being exposed to the virus.
• Follow the advice of your health-care provider
• The public health authorities are emphasizing that if you think you might be sick, stay home from work or school.
What steps to follow if a diabetic patient is infected?
It is recommended to stay cognizant of the signs and symptoms of COVID-19. Take note of symptoms like dry cough, high temperature and feeling short of breath. Continue with anti-diabetic medication and contact your primary care physician or local authority immediately, taking all self-isolation precautions.
Do not take any over-the-counter medications for COVID-19 infection.
Remember the risk of death from corona virus is quite low, and most people with COVID-19 will have a comparatively mild illness. Hence, if you become unwell for any reason, it is important that you practice sick day management.
How do I manage my diabetes during sick days?
A sick-day management would involve:
• Maintaining open communication with your primary care provider and diabetes care team and follow their advice regarding medication usage.
• Continue to routinely check your blood sugar at home.
• Be aware of the signs and symptoms of hypoglycaemia; low blood glucose(< 70 mg), eat 15 grams of simple crabs like glucose, honey, jam, hard candy, juice or regular soda, and re-check your blood sugar in 15 minutes to make sure your levels are rising. Repeat the cycle if low blood glucose is persisting and contact your doctor.
• Be aware of the symptoms of hyperglycaemia; passing more urine than normal (especially at night), being very thirsty, headaches, tiredness and lethargy; and contact your doctor accordingly.
• Staying hydrated and having unsweetened drinks on hand; and practicing eating smaller portions
Should I stop taking certain blood pressure medications because I’ve heard that these drugs may affect my risk of COVID-19 infection?
Blood pressure control is an essential part of managing diabetes.
In addition, certain blood pressure lowering medications[(a class of medications known as angiotensin converting enzyme inhibitors (ACEi) or Angiotensin Receptor Blockers (ARBs)] are often recommended for people living with diabetes to protect them from kidney and heart-related complications, even in the absence of high blood pressure. At the present time, there is no confirmed scientific link between these blood pressure medications and the risk of COVID-19 infection or its complications.
Please do not stop or change any of your medications without discussing with your health-care team.
How can I prepare in the event I become infected and have diabetes?
Your plan may include:
• Gather the contact information for your doctors, clinic, pharmacy
• Write down the names and doses of your medications
• Have enough medication for one-two weeks in case you cannot get to the pharmacy to refill your prescriptions
• Ensure you have enough device supplies as well (i.e. pump supplies, pen supplies, monitor supplies, etc.)
• Ensure all your medications have refills available, so you do not have to leave the house if you become ill
• Have extra supplies like rubbing alcohol, hand sanitizers and soap to wash your hands
• Keep simple sugars (i.e. glucose tablets) on-hand in case you need to treat low blood sugar which may occur more frequently with illness due to changes to eating patterns
• Have glucagon available in case of a significant low blood sugar (if taking insulin or medications that can cause low blood sugar)
• Have ketone strips available in case of illness (if you have type 1 diabetes)
As diabetes is a chronic disease, questions and concerns about the impact of COVID-19 is understandable. We can keep most of our patients with diabetes safe through this pandemic with kindness, comfort, and sound medical advice – and prompt, intensive care for patients who are seriously ill. |
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