Diabetes care during COVID-19
Eat well, but in moderation. It’s easy to order fast food, but avoid excessive consumption of fried foods and limit foods high in sugar, carbohydrates and fat
I always advise my patients with diabetes to eat healthy, balanced diets and to exercise regularly. While being confined to our homes is not an excuse to ignore this advice, the reality is that many have resorted to food delivery (ube-cheese pandesal, anyone?), stress eating and bingeing on snacks and TV shows (how many Korean telenovelas so far)?
Three months later as we now have a little more freedom to leave our homes, many are afraid their clothes won’t fit! But we must venture out, to go back to work, get laboratory tests done and follow-up with doctors. The fear of the omnipresent COVID-19 still hampers our movements however, and many patients are not getting the care they need.
It is true that patients with diabetes have a worse outcome if they get COVID-19. If you have diabetes and then develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels. This is due to a compromised immune system, making it harder to fight the virus and likely leading to a longer recovery period. The virus may also thrive in an environment of elevated blood glucose.
So it is even more important to keep your diabetes under control. Eat well, but in moderation. It’s easy to order fast food, but avoid excessive consumption of fried foods and limit foods high in sugar, carbohydrates and fat. Eat more green, leafy vegetables and less starchy ones (potatoes and corn). These can be delivered too! As for fruits, these contain fructose or fruit sugar, so you should have only 2-3 servings a day.
Staying home doesn’t mean you can’t get in any physical activity. You don’t need fancy equipment to exercise at home. Doing chores and housework also count. And there are many free exercise videos online. Some fitness instructors have also started teaching live classes online, and you can still get that group class vibe from the safety of your home. Precautions to take before exercising if you have diabetes ---- if you take medications that can quickly lower your blood glucose like insulin, check your blood glucose level before you exercise. If it is less than 100 mg/dL you should eat a small snack first. Do not exercise right after injecting insulin either. Patients with diabetes should also continue to take their medications as prescribed and get regular laboratory tests as advised by their doctors. But my patients all say they are afraid to go to diagnostic centers or the hospital, for fear of getting COVID-19. The truth is your risk of contracting the infection is the same as a patient without diabetes.
What better place than somewhere that has standards and practices to ensure everyone’s health and safety? People are also very vigilant inside the hospital because they know there are sick patients there and everyone wears their masks correctly, practicing hand hygiene and social distancing. These are good practices to have anywhere, and not just in the hospital.
If your check-up is long overdue, reach out to your doctors. Most are already practicing telehealth and you can speak with your doctor without having to leave home. If your doctor is able to see you online, be ready for your consult. Coordinate with your doctor’s secretary or nurse to set an appointment. Get your laboratory tests done and send the results ahead, including a list of all your medications and doses. List any questions or problems down to save on time.
The fear of the omnipresent COVID-19 still hampers our movements however, and many patients are not getting the care they need.
In the unfortunate event that you do get sick, be prepared. Have someone you can rely on who knows about your health history and medications. Pay extra attention to your diet and blood sugar control. Regular monitoring can help avoid complications caused by high or low blood glucose. Keep a regular schedule, avoiding overwork and get enough sleep.
Any infection is going to raise your glucose levels and increase your need for fluids, so you should have access to a sufficient supply of water. Make sure you have the diabetes medications you need. You should have at least a month’s worth on hand in case you need to quarantine yourself for a few weeks.
Make sure you will be able to correct the situation if your blood glucose drops suddenly. The fastest way to get you blood glucose up is to drink some juice followed by some solid food, like crackers or fruit.
If you do show flu-like symptoms (fever, cough, difficulty breathing), it is important to consult a healthcare professional immediately. If your symptoms are worsening, do not wait too long to seek medical support. Early treatment can make a difference in your outcome. We are all learning to adapt to this new way of life, but be assured that you can still get the care you need. Together with your doctor you can continue to manage your diabetes and get it under control.