COVID-19 Update / If you are a sugar patient, then be alert before the third wave of Covid-19, know the reason from the expert

After the second wave of Kovid-19, now the danger of the third wave is looming. The doctor says that uncontrolled sugar can be fatal in Kovid infection. Controlling sugar has made it more challenging for diabetic patients during the covid period, if diabetes is not controlled then it also affects the treatment of covid. In such a situation, if you are suffering from diabetes and the level of blood sugar is continuously increasing, then what should you do? Dr., from the Department of Endocrinology and Metabolism, AIIMS. Know special opinion from Nikhil Tandon on the topic of Kovid and Diabetes.

Dr Nikhil says that viral infection increases the level of blood sugar. This is because any infection or viral fever can raise blood sugar levels. It is basically a result of the mechanism, which the body employs to fight the infection. In some cases, the medicines given to treat that infection can cause this increase in blood sugar levels. If the sugar rises beyond a limit, it reaches a critical stage.

A better example of this is the cytokine storm in the case of COVID-19. It affects both insulin secretion by the pancreas as well as the sensitivity of the tissue to insulin. Insulin facilitates the movement of glucose into tissues and any malfunction (either in production or tissue sensitivity) increases the level of glucose in the blood. In the case of COVID-19, a patient with moderate to severe illness may need to be administered steroids, which can also lead to an increase in the patients' blood sugar levels.

Is it difficult to treat diabetic covid-19 patients? To this, Dr. Tandon says that in most cases, a person with well-controlled diabetes responds to COVID 19 treatment in the same way as a non-diabetic patient. However, in people with chronic and poorly controlled diabetes or with diabetic complications such as kidney or heart disease, the management of COVID-19 can be more complicated. In such patients the course of the disease may be more severe, requiring aggressive management, including the need for oxygen, ventilators, ICU care, etc.

Management of COVID 19 in such patients may make the treatment of diabetes more difficult. For example the use of steroids which are an important part of COVID 19 treatment. Steroids can cause a significant drop in blood sugar control. Therefore, diabetic patients always require treatment with an intensive insulin regimen. In addition to steroid therapy, there are several other factors during the course of the disease that contribute to this increase in blood glucose levels such as a change in the patient's dietary habits. The stress of illness and the patient's inability to follow regular eating and exercise regimens can also increase blood sugar levels.

Let us tell you that diabetes is an A-symptomatic disease in most of the people and there may be a good number of people who may not be aware of their diabetes before getting the Kovid 19 infection. There are many studies that tell us that in countries with poor resources, 50 percent of people with chronic diseases like diabetes are not treated properly. Many patients are either unable to afford medical care or not managing the disease properly, even knowing they have diabetes. As a result, only one in eight diabetic patients have optimally controlled blood sugar levels. Then there are people who are at risk of getting diabetes.

In some patients it can also lead to diabetes due to stress or hyperglycemia and a combination of drugs like steroids which can increase the blood sugar level. Discussions are still going on about any possibility that a new type of diabetes can occur in the infected patient due to Kovid 19. Theoretically, covid 19 can also cause diabetes because pancreatin has ACE2 receptors that can enable SARS Cov-2 to enter pancreatic beta cells. This can result in structural and functional damage although we still need more data to support this fact.

At the time of covid 19, if we get the HBA1C test, which gives the average glucose for the last three months, and the result shows an increase in its level, then it means that the person was already diabetic before getting infected with covid 19. If HBA1C comes back to normal then we should have the blood sugar level checked again after the COVID recovery. If steroid therapy (if used) is discontinued during this time, glucose levels will return to normal thereafter. If post-covid blood sugar remains high even a few weeks after recovery from illness or discontinuation of steroids or both, it will increase the likelihood of covid due to diabetes.

Let us tell you that the HBA1C test helps doctors to know whether the high blood sugar level in a Kovid 19 patient is temporary, which we have just discussed. There is a need to understand these causes and manage the disease in the long term. In the first case, blood glucose levels return to normal as soon as the person recovers from COVID, or when the steroid is stopped. Control your blood sugar level after these diseases are cured.