The COVID-19 pandemic has created havoc all over the world and has severely affected India too. India has around 77 million patients with diabetes and about 40% to 50% of diabetics are hypertensive. Certain medical conditions like hypertension, diabetes, obesity increase the risk of severe COVID-19. Though people with diabetes are not at higher risk for acquiring the infection, but are prone to more severe disease and poorer outcomes once infected. When people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and, possibly, the presence of diabetes complications. Therefore, those with hypertension and diabetes need to take extra precautions to save themselves from getting infected with this deadly virus.
What is the link?
A weakened immune system is one of the main reasons people with diabetes and hypertension and other health problems are at higher risk of contracting coronavirus disease. In general, people with diabetes are more susceptible to develop complications and experience severe symptoms when infected with any virus. Patients with diabetes have chronic, low-level systemic inflammation, which results in dysfunction in the immune system. Also, high blood sugars impair the immune response and leads to increased inflammation and abnormal immune response that instead of just attacking the virus, affects the rest of the body’s healthy cells and tissue, leading to rapid deterioration in health and increased need for mechanical ventilation and renal replacement. Also, the virus may thrive in an environment of elevated blood glucose. Patients with diabetes and hypertension are more predisposed to clot formation. If diabetes is well-managed, a person’s risk of getting severely affected with COVID-19 is likely to be lower.
What are the complications seen in COVID-19 patients with diabetes and hypertension?
People with diabetes and hypertension often have underlying complications like cardiovascular disease, renal dysfunction. But the trio of diabetes, hypertension, and COVID-19 can be worrisome. The difficulties faced by people with hypertension and diabetes are:
Increased risk of developing neurological complications, such as bleeding in the brain and stroke.
Higher risk of developing secondary infections like black fungus or Mucormycosis.
Increased risk of developing respiratory complications like pneumonia or other acute respiratory infections.
Increase risk of kidney problems and increased risk of cardiovascular outcomes like heart attack and heart failure.
Studies report that Diabetes should be well controlled to target HbA1c less than 7% to avoid complications related to COVID-19 infection and secondary fungal infections like Mucormycosis. Everyone should get vaccinated as soon as it is available to them, especially those with diabetes and hypertension.
What measures should people having diabetes and hypertension follow to avoid complications?
People with diabetes and hypertension must ensure to follow some tips, which include:
Taking medicines regularly
Following diet and salt restriction as advised by the doctor
Avoiding packaged, processed and carbohydrate-rich food
Avoiding consumption of alcohol and tobacco smoking
Maintaining an optimal and a healthy weight
Staying active and exercising regularly
Avoiding stress by practicing breathing techniques, meditation, yoga, etc.
Including protein-rich food, green vegetables and fibre in the diet.
Monitoring blood glucose levels and blood pressure regularly
Regularly following up with the doctor via teleconsultation if one is unable to visit the clinic
Do not stop antihypertensives like ACE inhibitors, they have not been linked to increased severity of infection.
Apart from these tips, following a COVID-appropriate behaviour is a must.
Over the past two years, many people have lost their lives battling the deadly coronavirus. Our government’s initiative of vaccination has emerged as a ray of hope! The key to defeating the Coronavirus disease is by staying strong and staying positive. It is everyone’s responsibility to avoid crowded places, ensure social distancing and maintain good hand hygiene to prevent the spread of the virus and lead a healthy life in these difficult times!
[Dr Emmy Grewal, MD DM (Endocrinology) Principal Consultant Endocrinology, works with Max Hospital in Mohali]
