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2. COVID-19: Precautions to be taken by people with diabetes

      World over, more COVID-19 deaths were reported in the presence of diabetes and similar co-morbidities. Many myths related to the outbreak of the disease are spreading globally. In such a situation getting the right information and strictly following it is very much essential. Keeping this in mind, we are presenting some of the useful information to our readers and patients to stay safe and to stay healthy.

      The World Health Organization (WHO) has declared the COVID-19 outbreak to be a public health emergency of international concern and characterized COVID-19 as a pandemic on 11th March 2020 owing to its spread at an alarming level. There is no exemption of age for the viral attack. The common symptoms of the disease are like that of flu which a fever, cough, breathing difficulties, tiredness and muscle aches.

      The important fact to be considered here is that older people and people with pre-existing medical conditions such as diabetes, heart disease and asthma appear to be more vulnerable to becoming severely ill with the corona virus. Therefore people belong to this category should take all the necessary precautions to protect themselves against COVID-19. In the case of patients with diabetes, when they develop a viral infection, it becomes harder to treat them due to fluctuations in blood glucose levels and the presence of other diabetes complications. As their immune system is compromised it will take a longer time for recovery from the illness and also the virus may multiply vigorously in an environment of elevated blood glucose.

      The recommendations that are being widely issued to the general public are doubly important for people living with diabetes and anyone in close contact with people living with diabetes.

      If you have diabetes follow these guidelines recommended by the WHO and the CDC:

  • Prepare in case you get ill.
  • Make sure you have all relevant contact details of your doctors and healthcare team, your pharmacy, and your insurance provider to hand in case you need them.
  • Pay extra attention to your glucose control. Maintain list of medications and doses and simple carbs to help keep your blood sugar up if you are at risk for lows and too ill to eat. If a state of emergency is declared, get extra refills on your prescriptions so you do not have to leave the house. Always have enough insulin for the week ahead, in case you get sick or cannot refill. Extra supplies like rubbing alcohol and soap to wash your hands. Keep Glucagon and ketone strips, in case of lows and highs.
  •       If you get sick, some common tips are as follows and may vary for each person:

  • Drink lots of fluids. If you’re having trouble keeping water down, have small sips every 15 minutes or so throughout the day to avoid dehydration.
  • If you are experiencing a low BG (below 70 mg/dl or your target range), eat 15 grams of simple carbs that are easy to digest like, honey, jam, Jell-O, hard candy, popsicles, juice or regular soda, and re-check your blood sugar in 15 minutes to make sure you are coming up. Check your blood sugar extra times throughout the day and night (generally, every 2-3 hours, with a CGM, monitor frequently).
  • If your blood sugar has registered high BG (greater than 240mg/dl) more than 2 times in a row, check for ketones to avoid DKA.
  • Be aware that some CGM sensors (Dexcom G5, Medtronic Enlite, and Guardian) are impacted by Acetaminophen (Tylenol). Check with finger sticks to ensure accuracy.
  • Change your lancet every time you check your blood sugar.
  • Wash your hands and clean your injection/infusion and finger-stick sites with soap and water or rubbing alcohol.
  • Have your glucose reading, ketone reading, track of your fluid consumption and report, clarity on your symptoms while calling your doctor.
  • Make sure you will be able to correct the situation if your blood glucose drops suddenly.
  • If you live alone, make sure someone you can rely on knows you have diabetes as you may require assistance if you get ill.
  • This newsletter is published for free distribution through the Internet for doctors, patients and public for promoting healthy lifestyles.
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