What impact does diabetes have on infection with COVID-19? This question was answered by Prof. Krzysztof Strojek, MD, PhD, Associate Professor in an article published in the Polish daily broadsheet newspaper, “Rzeczpospolita”.
As Prof. Strojek writes, initial statistics showed that patients with diabetes are more susceptible to complications when they are infected with COVID-19. We now know that it is not diabetes itself, but uncontrolled diabetes, obesity or complications of diabetes that are the determining factors driving an increased risk of death or complications. This is why maintaining the correct control of blood sugar levels is so crucially important.
The Professor reminded us that the appropriate and up-to-date treatment of diabetes is based on the diabetes patients themselves independently selecting their dose of insulin depending on the current glucose level, the size of the planned meal or physical exertion. To be able to treat themselves independently, patients need to have received the right education. The team, i.e. the treating physician, nurse educator, dietician need to teach patients with diabetes about how they should eat, what and when to monitor with respect to their state of health, how to take medications and inject insulin. It’s also crucially important to motivate the patient to manage their illness properly. This does not just mean issuing recommendations regarding dosages of medications or education, but also – and perhaps above all – to regularly remind patients of the important and critical impact that complying with the recommendations they receive on a day-to-day basis has on the course of their diabetes.
If contact with your physician becomes more difficult, as is the case during the pandemic – you need to opt for a teleconsultation – advises Prof. Strojek. To this end, the BIOTON company has prepared a special educational platform called “Ask a Specialist”, where patients can make use of advice from a physician, diabetes nurse or dietician. This is all done quickly and safely – via an online form or phone conversation.
If diabetes patients get infected with COVID-19 this may cause their blood sugar level to rise, because the inflammation increases their need for insulin on account of their accelerated metabolic rate. On the other hand, a loss of the sense of taste, and the associated reduced appetite, may cause the glucose level to fall (referred to as hypoglycaemia). This means that the insulin dose needs to be adjusted, which the diabetes patient can do by themselves independently, bearing in mind the principle that in type 1 diabetes 1 insulin unit reduces the glucose level by 40 mg%, whilst in type 2 the figure is 30 mg%. Depending on the current glucose level, based on these conversion factors, the patient can adjust their insulin dose. Patients with diabetes should remember that if they have a raised blood sugar level they need to boost their fluid intake, with these of course being sugar-free beverages.
According to prof. Strojek, the key to diabetes treatment is the saying of Dr. Elliot Joslin, the founder of the first specialist diabetes clinic in the world, which is still operational today in Boston: “The diabetic who knows the most, lives the longest”. Knowledge is ensured by education which is provided by the medical team as well as by using distributed educational materials.