Now, with Covid 19 for over a year and a half, our understanding of the effects and complications it can cause on the human body continues to evolve.
Covid19 and diabetes are bidirectional:
The relationship between Covid-19 and diabetes is bidirectional. We know that diabetes is a risk factor for poor Covid-19 outcomes, severity (ICU), and mortality (death). After diabetes was once a risk factor for the clinical course and outcome of Covid-19, we are now seeing a new set of metabolic problems, a new diabetes!
This is indicated by various studies from the USA, CHINA and Great Britain.
New diabetes can occur directly or indirectly through reduced exercise, nutritional problems, isolation stress, etc. Let’s look at some mechanisms.
Diabetes due to Covid-19: New occurrence / Post-Covid / Covid-induced diabetes.
There can be various reasons for this. There’s a good chance a person who gets Covid-19 could have it directly attacking the beta cells in the pancreas (the organ on the left side of the abdomen that is responsible for making insulin). This can lead to an increase in glucose (sugar), which can lead to diabetes. Other mechanisms are indirect, such as an increase in cytokine and the tremendous inflammatory response that the Covid-19 virus causes that infects it. Problems with the lining of the intestinal lumen can be a contributing factor in causing diabetes. It is also known that steroids, oxygen and anticoagulation form the mainstay of treatment for moderate to severe Covid-19; in some patients with pre-existing (pre-existing) diabetes, the use of steroids may only result in unmasking. (Commonly used steroids for Covid-19 are: dexamethasone, methylprednisolone).
In addition, Asian Indians are genetically predisposed to diabetes, and a person with Covid-19 may have diabetes before the infection. This can be easily checked by doing a test called HbA1c or the glycated hemoglobin test. If the HbA1c value at or before Covid-19 is> 6.5, these are not corona-triggered. These are considered incidentally diagnosed diabetes at the time of infection.
Just a note, while maximum cases of type 2 diabetes are observed after Covid, although the likelihood of type 1 diabetes case is minimal, these are extremely rare.
How to treat diabetes caused by Covid:
The good thing about it is whether it is a mild, moderate or severe infection with Covid-19, it is treatable and controllable. Just like we would treat any other type 2 diabetic patient. When to check It is important to note that all patients with Covid-19 can be tested for diabetes at admission or diagnosis, if in isolation or quarantine, during hospitalization, tests increase when starting steroids, and at follow-up to check for new diseases diabetes. Can be checked monthly after recovery to reveal this as a post-covid complication. Watch out for any recent weight loss, thirst, hunger, frequent urination, fatigue as these could be symptoms of new or sudden diabetes after Covid. What to do? Eat your meals on time, with regular exercise only as tolerated, avoid heavy meals, avoid weight gain, sleep at least 7-9 hours, meditate and take medication on time if you need them at all, as from Recommended by your endocrinologist. In most cases, post-covid diabetes is controlled and regulated with lifestyle management, some may require tablet treatment while some may require timely insulin to control and overcome acute and emergencies.
To sum up, diabetes caused by Covid-19 is a rapidly evolving science, apart from other complications, diabetes is one of the most important and can be saved! Talk to your endocrinologist about reversing diabetes. Preventing or reducing the severity and mortality of Covid-19 through vaccination is also a critical step in preventing Covid-19-induced diabetes. Therefore, while treatable, it is best to prevent Covid-19 through mask, distance, hygiene, and vaccine to prevent Covid-19 triggered diabetes.
(Dr. Altamash Shaikh, Consultant Endocrinologist, Diabetologist and Metabolic Super Specialist, Masina Hospital)
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