Diabetes is a long-standing lifestyle disease in Singapore. Despite the government's best efforts to combat it via a series of measures to lower sugar intake, the prevalence of diabetes in Singaporeans above 40 is expected to increase from 400,000 today to 600,000 by 2030. With the current COVID-19 pandemic at large, let us understand how this affects diabetics and what can be done to reduce the risk of COVID-19 infection among people living with diabetes.
What is Coronavirus?
Coronavirus has been around and causing illness ranging from common cold to more serious diseases such as the Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). COVID-19 is transmitted via air droplets from an infected person by sneezing, coughing or talking. Depending on environmental conditions, the virus can survive for a few hours to a few days. Severe cases of infection can lead to lung infection (pneumonia), kidney failure and even death.
COVID-19 has been declared a pandemic by the World Health Organization and at present, there is no vaccine against the virus. Those who are infected will present signs and symptoms such as fever, dry cough, difficulty in breathing, lethargy and muscle aches. These signs and symptoms will normally start between three and seven days after exposure. However, in some cases it could take up to 14 days before the first symptom appears.
Why Should Diabetics Take Extra Precautions?
The elderly and people with pre-existing medical conditions such as diabetes are more vulnerable to COVID-19 infection due to fluctuations in blood sugar levels and the presence of existing diabetes complications. There are two main reasons for this:
- With a compromised immune system, it is harder for the body to fight off the virus and this will lead to more complications and a longer period of recovery.
- Diabetics treated with thiazolidinediones may have increased risk of COVID-19 infection (Fang et al, 2020)
What Can A Diabetic Do To Minimize Risk of Infection?
Standard precautions issued by the Ministry of Health are doubly important if you are a diabetic. These include:
- Regular hand washing with soap and water for at least 20 seconds, especially before and after food consumption, after visiting the washroom, or when hands are dirtied by respiratory secretions
- Avoid touching your face as much as possible
- Do not share food, towels and glasses
- Cover your mouth and nose with a tissue paper when you sneeze and dispose the tissue appropriately
- Avoid contact with people who are unwell or show signs of respiratory illness
- Avoid social gatherings of more than 10 people and defer all travel abroad
What Additional Precautions Can You Take If You Are A Diabetic?
Aside from the above-mentioned precautions, people living with diabetes should also:
- Pay extra attention to your blood sugar control
- If you have flu-like symptoms (fever, cough, difficulty in breathing), immediately consult your healthcare professional.
- Infections will raise your blood sugar and the need for fluids also increases. Ensure you stay hydrated by drinking a sufficient amount of water.
- Keep a good supply of diabetes medicine that you take regularly. This is vital in case you need to quarantine yourself for a few weeks.
- If you are a diabetic living alone, you will need to ensure someone knows of your medical condition and can assist you if you get sick.
In conclusion, diabetics need to take extra precaution to reduce the the risk of infection from COVID-19 by being vigilant in applying the steps mentioned above. It is also important to be get updates from reliable sources such as the Ministry of Health and the World Health Organization on methods to avoid infection if a person is living with diabetes.
Chan JF-W, Yuan S, Kok , K-H , et al: A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020
Fang, L., Karakiulakis, G., Roth, M. (2002) Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?, The Lancet, 2020 March 11. (accessed on 17 March 2020) https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext.
Infection prevention and control during health care when novel coronavirus (COVID-19) infection is suspected, Interim Guidance. WHO Jan 2020
Interim infection prevention and control recommendation for patients with confirmed 2019- Novel coronavirus or patient under investigation for COVID-19 in healthcare setting. Updated Feb 3 2020. CDC
Li Q, Guan X, Wu P, et al: Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020
Song Z., Xu Y., Bao L., Zhang L., Yu P., Qu Y., Zhu H., Zhao W., Han Y., and Qin C.: From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses 2019 Jan 14; undefined: pp. 11
Wu Z., and McGoogan J.M.: Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. J Am Med Assoc 2020 Feb 24
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