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Q: My father has been a diabetic for the past 10 years. Now, with the Covid-19 pandemic, could you please tell me what he should keep in mind?
The coronavirus spreads like any other respiratory disease, through contaminated air droplets that come out of the mouth of infected persons when talking, coughing or sneezing. The virus can survive in the environment from a few hours to a few days (depending on surfaces and environmental conditions) and touching affected surfaces and then the mouth or nose is thought to be the way of transmission. The virus is killed in the environment with alcohol-based solutions.
People affected with Covid-19 can have fever, cough, shortness of breath (trouble breathing), feel tired and have muscle aches. Breathing problems occur when the infection affects the lungs and causes pneumonia. Symptoms usually start a few days after a person is infected with the virus, with most cases occurring approximately 3-7 days after exposure. In some people, it can take up to 14 days for symptoms to appear.
Covid-19 can lead to serious problems, like pneumonia or even death. This is more common in people who have other health problems, particularly the elderly, those with diabetes, cardiovascular disease, chronic lung disease and hypertension.
In general, people with diabetes are more likely to experience severe symptoms and complications when infected with a virus. It’s thought that hyperglycemia (which occurs when you have high levels of sugar, or glucose, in the blood) in diabetics may be a cause of dysfunction of the immune response, which results in failure to control the spread of invading virus. However, if diabetes is well-managed, the risk of getting severely sick from Covid-19 is about the same as that of the general population.
When people with diabetes do not manage their diabetes well and experience fluctuating blood sugars, they are generally at risk for a number of diabetes-related complications. Having heart disease or other complications above-target blood sugars, and both could contribute to more severe complications.
When sick with a viral infection, people with diabetes do face an increased risk of DKA (diabetic ketoacidosis) commonly experienced by people with type 1 diabetes. DKA can make it challenging to manage your fluid intake and electrolyte levels – which is important in managing sepsis. Sepsis and septic shock are some of the more serious complications that some people with Covid-19 have experienced.
Fluid samples taken from the nose or throat will show if the virus is present or not. There is currently no specific treatment for Covid-19, but since the majority of cases are mild, only a limited amount of people will require hospitalisation for supportive care. However, it is essential that people affected and those that they have been in contact with are identified and isolated for a couple of weeks, to avoid the further spread of the virus.
Protecting people with diabetes from Covid-19
• Healthy family members in the household should conduct themselves as if they were a significant risk to them. For example, they should be sure to wash their hands before feeding or caring for them. If possible, a protected space should be made available for vulnerable household members, and all utensils and surfaces should be cleaned regularly. If a member of your household is sick, be sure to give them their own room, if possible, and keep the door closed. Have only one family member care for them, and consider providing additional protections or more intensive care for household members over 65 years old or with underlying health conditions.
• Have enough medication for two to three weeks in case you cannot get to the pharmacy to refill your prescription.
• Always have enough insulin for the weeks ahead.
• Ensure all your medications have refills available so you don’t have to leave the house if you become ill.
• Ensure you have enough device supplies as well (glucometer, glucostrips, pen supplies and pump supplies, etc.)
• Have extra supplies of rubbing alcohol, hand sanitisers and soap to wash your hands.
• Keep simple sugars (glucose tablets) jam, honey etc., 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 enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.
How to prevent Covid-19 infection
• Clean your hands often
• Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in public place.
• If soap and water are not available, use a hand sanitiser that contains at least 60 per cent alcohol.
• To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails – handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
• Wash your hands after touching surfaces in public places.
• Avoid touching your face, nose, eyes, etc.
• Clean and disinfect your home to remove germs. Practice routine cleaning of frequently touched surfaces, for example, tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks and cell phones.
• Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like Covid-19 may increase.
Practice social distancing measures
• Social distancing measures are steps you can take to reduce the social interaction between people. This will help reduce the transmission of coronavirus.
• Avoid contact with someone who is displaying symptoms of coronavirus. These symptoms include high temperature and/or new and continuous cough.
• Avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible. Work from home, where possible. Your employer should support you to do this.
• Avoid large gatherings.
• Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet and social media.
• Use telephone or online services to contact your doctor or other essential services.
If you develop emergency warning signs for Covid-19 get medical attention immediately. In adults, emergency warning signs include:
• Difficulty breathing or shortness of breath.
• Persistent pain or pressure in the chest.
• Bluish lips or face.
Dr. Asok Cheriyan is specialist diabetologist at Al Waha Clinic Diabetes Centre, Dubai. Got a problem? Our fantastic panel of renowned experts is available to answer all your questions related to fashion, well-being, nutrition, finance and hypnotherapy. Email your queries to firstname.lastname@example.org.