Dr. Keith Cryar is used to treating diabetes – he leads a team that cares for patients with metabolic disorders at Baylor Scott & White Medical Center – Temple. But during the COVID-19 pandemic, its case numbers skyrocketed.
Many of the new patients had no history of diabetes. Some who developed high blood sugar while in hospital with COVID returned to normal when they left Baylor Scott & White. Others went home diagnosed with full blown diabetes.
“We’ve definitely seen more cases,” said Cryar.
Baylor Scott & White endocrinologist said treating diabetics with severe coronavirus symptoms has been challenging because treatment usually involves steroids that can raise blood sugar levels.
Although COVID-19 frequently attacks the lungs, it is increasingly linked to problems such as blood clots, neurological disorders, kidney and heart damage, and newly diagnosed diabetes. However, scientists don’t know whether COVID-19 could accelerate or actually cause problems that are already emerging – or both.
Weight gain during COVID
According to studies, the average American gained two pounds a month – some much more – during the pandemic, and this is contributing to new and worsening cases of diabetes.
“Some are new to diabetes, some have switched from pre-diabetic to diabetic, and some who have had the disease have seen their condition worsen,” said Cryar.
Several factors play a role in weight gain.
“People were more sedentary because they stayed home more,” said Cryar. “There was a decrease in physical activity and a lot more stress, which led to more snacks.”
Stress can come in many forms – loss of work or business due to the pandemic, loss or illness of loved ones, or isolation from friends and family.
Cryar encourages diabetics to take steps to improve their condition, and in many cases it means losing weight. To achieve this, he recommends limiting calorie consumption and avoiding carbohydrates with simple sugars like refined and highly processed bread and pasta.
“You can’t just eliminate carbohydrates because you have to keep blood sugar levels in balance. You don’t want the levels to get high, but you don’t want them to drop too much either, ”said Cryar.
“Eat whole foods like vegetables, whole grains, and fruits.”
Cryar said fruits are often avoided unnecessarily.
“Not only do fruits contain important nutrients, but the fiber also slows the effects of the sugars in them by slowing the rate of absorption,” he said. “Juices are not recommended because they remove fiber and they are almost pure sugar. With no fiber, it’s almost like taking it intravenously. “
Exercise is another way to fight diabetes, he said. Unfortunately, fewer than 40 percent of people with type 2 diabetes participate in regular physical activity.
According to the National Library of Medicine, exercise can help the body fight off disease by increasing the activity of the immune system. During the pandemic, people with chronic diseases like diabetes are at greater risk of developing complications if they get sick. Boosting immunity through exercise – and controlling blood sugar – can help a person stay healthy.
There are many benefits to being active when you have diabetes. Can move more:
- Help your body make better use of insulin by increasing insulin sensitivity.
- Help control your blood pressure, as high blood pressure increases the risk of diabetes complications.
- Help improve cholesterol (blood lipids) to protect yourself from problems like heart disease.
- Help lose weight if you have to and keep the weight off after you lose it.
- Give yourself energy and help you sleep.
- Help your joints and flexibility.
- Help your mind and body – exercise releases endorphins, which you can think of as happiness hormones. Being active has been shown to reduce stress and improve bad mood.
- Help people with type 2 diabetes improve their HbA1c. In some cases, this can help people with the condition go into remission.
It’s important to remember that being active is even more beneficial if you also choose healthier foods, don’t smoke, and get enough sleep.
An exercise program can be as simple as 15 to 30 minutes a day of walking.
“Exercise is important,” said Cryar, “and in the context of reason, more is better. Walking can help you lose weight and lower blood sugar levels. “
Cryar also recommends activities like biking, swimming, and weight lifting.
“Ideally, an exercise program would include cardio activities and weight lifting,” he said. “Both are important and have benefits beyond the amount of time you spend exercising.”
Eating healthy and exercising go a long way in reducing the effects of diabetes, but they may not be enough. In many cases, medication is essential for improvement.
“There are two newer classes of diabetes drugs that don’t cause weight gain,” said Cryar. “In fact, they can help you lose weight. Some are even prescribed to non-diabetic patients who need to lose some weight. “
According to Cryar, GLP-1-class diabetes drugs like Ozempic, Trulicity, and Rybelsus can lower blood sugar levels and decrease appetite. Ozempic and Trulicity are injections once a week. Rybelsus is a daily pill.
“These drugs lower blood sugar levels, but they don’t cause levels to get too low,” he said.
The other newer class of diabetes medicine – SGLT-2 – includes Jardiance and Ivokana. These drugs use the body’s natural urination process to remove excess sugar from the body instead of allowing it to be reabsorbed by the kidneys.
“Both classes also help protect the heart and kidneys,” said Cryar. “You have additional advantages.”
Approximately 3 million people in Texas – 14 percent of the population – have some form of diabetes, and an estimated 664,000 are undiagnosed. Another 6.8 million have pre-diabetes with blood sugar levels above normal but not high enough to be diagnosed as diabetic.
The annual cost of treating diabetes and pre-diabetes in Texas is estimated at $ 25.6 billion.
