Managing diabetes during quarantine by Dr. Manjunath Malige

The risk of diabetes patients getting infected with COVID-19 is essentially the same as the nondiabetic population. However, it is important to note that diabetes patients with COVID-19 infection are at a higher risk of developing complications of COVID-19 infection compared to the non-diabetic population. From the recent data about COVID-19 infection under death from countries like China, Italy and Spain it has been noted that the risk of death due to COVID-19 infection in diabetes patients has increased by up to 30 to 40%. Hence it is very important that diabetes patients take extra care to try and avoid COVID-19 infection.

There are two reasons why patients with diabetes and COVID 19 virus infection can become severely ill. Firstly, the immune system (defense against infection) is compromised and relatively weaker in diabetes patients. Secondly, any infection, be it viral or bacterial will thrive if the blood sugars are high.

Home care tips for diabetes patients:

1. Have all the contact details of Hospital, Pharmacy, Emergency room, Tele Consultation numbers to hand in case you need them.
2. Keep an eye on your blood glucose levels by checking at home with a glucose meter which can help avoid complications due to high or low blood glucose levels.
3. If you develop flu-like symptoms ( cough, difficulty in breathing, fever) then please attend one of the fever clinics set up by the State Government or seek professional help from your doctor.
4. Any infection will raise your blood glucose level and also increases your fluid requirements, hence it is important to drink water well to avoid dehydration whilst monitoring blood sugar levels.
5. Ensure you have a good supply of medications  (tablets, insulin), glucose meter strips, insulin needles, and insulin pens. Have at least 2-3 weeks extra supply at home, for the quarantine
6. Make sure you have access to enough food.
7. Ensure you know how to treat hypoglycemia ( low blood sugars ) at home. If the blood sugar is below 70, one tablet of Hypotab will bring your sugar level to normal within minutes
8. If you live alone, ensure that people you know and rely on know that you have diabetes and may need assistance if you get ill.
9. If you develop COVID 19 or any other infection, it’s advisable to consult your diabetes doctor as you may need a change in medications and or insulin.
10. During the lockdown period, one could make use of the teleconsultation facility and can consult the doctor from home.
11. If you become unwell, develop nausea, vomiting, dehydration you will need to seek immediate medical help. Emergency departments in all hospitals will be open 24 hours a day.

A healthy diet is an essential part of Diabetes management. Following are the diet recommendations:

1. Try to eat foods with a low glycemic index like whole wheat chapati, wheat noodles, vegetables, etc.
2. Avoid fried foods
3. Limit eating foods with high sugars, carbohydrates, and fat
4. Eat more protein food like fish, meat, eggs, milk, beans, etc
5. Eat green leafy vegetables (well cleaned)
6. Eat one fruit a day (apples, pears, papaya, pomegranate)

Try and do home-based exercises like Yoga, exercise bike, treadmill, etc.

Authored by Dr. Manjunath Malige, Chief and Lead Consultant – Endocrinology & Diabetes, Aster RV Hospital