Diabetes complicates COVID risks

Dear Dr. Roach: I’m a 67-year-old male who was recently diagnosed with diabetes. I have had both Moderna doses for COVID-19. I have read all along that people with diabetes are at a much higher risk for complications with COVID-19, and I’ve read that the breakthrough infections, for the most part, are not nearly as severe as those for nonvaccinated people. For those who have been vaccinated, have there been any studies showing that breakthrough infections are very dangerous for those with diabetes?

D.S.

Answer: There are two ways I could answer this question. The first is to say that for people who are fully vaccinated, having diabetes makes you both more susceptible to a breakthrough infection and makes you more likely to have a more severe case. This is why it’s important, even for vaccinated people, to continue to take precautions as long as there is ongoing transmission in your community. This is especially true for all people with risk factors, such as older age and immune system disease. Both obesity and diabetes are additional risk factors.

The second way to answer this is to say that even with additional risk factors, the vaccine is still highly protective. The risk of death or hospitalization is still very low, even for people over 65 with diabetes, as long as they are fully vaccinated. I’d advise you to get a third dose of vaccine when you are able to.

Dear Dr. Roach: Why do I feel colder after having breakfast?

J.S.B.

Answer: Eating sends your blood supply toward your stomach, intestines and bladder, and away from your extremities, which can lead to a cold sensation, especially in people who are a little predisposed to feel cold when others are comfortable. This is normal physiology.

People who feel cold more often might also have a medical condition. Low thyroid level is the first we usually think about, but people with diabetes and anemia may also feel colder, and have a larger than usual physiological effect after eating. Finally, people with blockages in the arteries often feel cold in the areas affected.