With more than 1.5 lakh cases infected with COVID-19, the country’s health system is undergoing a tumultuous time where hospitals and medical facilities are overwhelmed with COVID-19 patients.

This may affect people living with diabetes, especially a sub-group whose blood glucose level is uncontrolled due to which immediate medical attention is required.

Studies from countries heavily affected with SARS-CoV-2, CDC and other national health databases indicate that the risk of death from COVID-19 is up to 50% higher in those with diabetes compared to compared to those without diabetes, which is an important risk factor associated with severe pneumonia and sepsis due to the viral infection.

Unfortunately, if diabetes is combined with other metabolic diseases like high blood pressure, long-term heart and kidney diseases, the risk of severity of COVID-19 further worsens. While people with diabetes are not more likely to get COVID-19 as compared to non-diabetic population, a good glycemic control is the key in staying away from severe symptoms and complications of COVID-19, if it develops.

Maintaining a good glycaemic control boosts the immune system. Most of the physicians may consider reviewing the prescription over continuing current therapy or intensifying them, in order to achieve a good glycaemic control.

Furthermore, the American Diabetes Association suggests that it important to monitor glycaemic status to watch out for both very low and very high blood sugars and monitor blood glucose frequently throughout the day and night.

In preparation, staying hydrated and keeping simple carbohydrates handy like hard candies, honey, jam, etc., to manage very low blood sugars is crucial. If people with diabetes are suspected or diagnosed with COVID-19, immediate medical attention should be sought.

Along with medications, people with diabetes should also do regular home-based exercises for good sugar control and boost immunity. A workout routine not only promotes healthy lifestyle but also balances both physical and mental health.

In particular, elderly people with type 2 diabetes should take additional measures maintain good glycemic control since studies have shown higher fasting plasma glucose levels during COVID-19
outbreak in this sub-group. Pregnant women with diabetes should use flash systems to access blood sugar values remotely and avoid commuting to outdoor medical facilities for blood sugar testing.

Since the onset of the pandemic, several studies have recommended insulin as one of the most effective treatments for people with diabetes, owing to its multiple benefits such as better glycemic control, making the pH unfavorable viral infection.

Insulin is the single most effective therapy for people with type 1 diabetes, and a superior alternative in people with type 2 diabetes. If blood glucose level is high at any time, the use of insulin can hasten and intensify control.

A study published by Dr Ewen and colleagues in BMJ Global Health on Insulin prices suggests that improving insulin availability and affordability is of utmost importance. In view of this study and the new realities of social distancing due to COVID-19 pandemic, Novo Nordisk India, one of the pioneers in providing innovative insulins has reduced the price of Ryzodeg™, an Insulin analogue that controls both mealtime and in between meal blood sugars, in India by 30%.

People with diabetes should adapt to the new reality in seeking medical assistance while navigating through the fast-changing situation on the ground. Remote consultations using telemedicine should be utilized to reduce exposure.

Moreover, blood glucose should be tested routinely along with the prescribed medications for diabetes. Keeping the glucose level under control through effective management is a critical medium through which, risks from COVID-19 and possibility of severe disease can be tackled with, by people living with diabetes.

Dr. Siddharth N Shah, Consulting Physician & Diabetologist, Mumbai