Even before COVID-19 emerged at the start of this year, the global health threat posed by diabetes was increasing at an alarming rate. Approximately 463 million adults, or one in 11 people, are living with diabetes according to the International Diabetes Federation (IDF). That number will rise to 700 million by 2045.[1] The World Health Organization (WHO) estimates that diabetes is the seventh leading cause of death, and almost half of all deaths attributable to high blood glucose occur before the age of 70.[2]

There is evidence that diabetics are particularly vulnerable to COVID-19. The reason is likely to be multifactorial. Age, sex, ethnicity, co-morbidities such as hypertension and cardiovascular disease, obesity, and a pro-inflammatory and pro-coagulative state all probably contribute to the heightened risk. This makes it important to understand how to diagnose, treat and prevent diabetes in the pandemic environment.

Regular health checks to diagnose at an early stage

One of the challenges of treating diabetes is that many diabetics do not know they have the disease as they don’t recognize the symptoms. One in two adults with diabetes go undiagnosed.[3] This means you may be even more vulnerable to COVID-19 because you do not know you are diabetic.

Symptoms of diabetes include weight loss, lethargy, excessive thirst and hunger and frequent or excessive urination. However, people may easily overlook these symptoms, and many diabetics are totally asymptomatic. The best way to diagnose diabetes is to have regular health checks including fasting sugar and HbA1c tests,[1] especially if you are in a high-risk group such as being overweight, over 45 years old or having a family history of diabetes.

Everyone wants to minimize their exposure to COVID-19 but diabetics should be particularly conscientious about protecting themselves. Maintaining good social distancing, wearing a mask, and ensuring good hand hygiene are effective measures. They should also be vigilant and look out for potential COVID-19 symptoms such as fever, dry cough, shortness of breath, and abnormal glucose and ketone readings. To avoid visits to hospitals during the pandemic, diabetics need to ensure they have a good supply of medication and seek help from clinics or other smaller medical facilities where possible.

Remember “ABC” to keep you well

Your risk of getting serious complications from COVID-19 is likely to be lower if your diabetes is well-managed, and the most important thing you can do is to control your “ABC” which stands for A1c, blood pressure and cholesterol.

HbA1c is a blood test that shows what your average blood glucose has been over the last 2 to 3 months. It is an important indicator of the risk of long-term diabetes complications. Maintaining your A1c level below 7% can help reduce the risk of complications. In addition, diabetics are more likely to have diseases caused by high blood pressure such as kidney disease, heart attack and stroke. Controlling your blood pressure is as important as controlling your blood glucose. Also, remember avoiding bad cholesterol can prevent cholesterol build up clogging your blood vessels which can lead to a heart attack or a stroke.

Under the pandemic, people have been spending more time staying in and cook at home. This is a good opportunity for diabetics to maintain a healthy diet. Try to avoid refined carbohydrates and sugars and consume more high fibre foods such as oatmeal. A balanced diet with lean meat with good quality protein and polyunsaturated fat is recommended, and never forget to control your portion size to help control your weight. It is also important to have regular cardiovascular exercise four to five times a week for at least 30 minutes each time. The goal is to sustain an optimal body fat percentage and avoid obesity around your midriff.  

Increasing the awareness of the disease, preventing infection, monitoring ABC and having a healthy diet and lifestyle can help reduce the risk and impact of diabetes complications. At the same time, don’t forget to talk and share with families and friends. Mental health is just as important as the physical health. Managing the disease can be demanding so make sure everyone around you is there to support you.