Corona and Diabetes: How to Maintain Sugar Balance During the COVID-19 Pandemic and Protect Your Health

Statistical data indicates that individuals aged 60 and above, and those suffering from chronic underlying conditions such as heart disease, diabetes, high blood pressure, lung diseases, cancer, as well as those with immune suppression, are at higher risk. Therefore, individuals in these risk groups are required to strictly follow the safety guidelines issued by the Ministry of Health and reduce outings from home as much as possible.

It appears that infection with the coronavirus has different risk factors like age, high blood pressure, and cardiovascular diseases. However, among diabetics, the risk of infection itself is not increased, but the risk of a more severe disease with complications and death is higher, as the body’s ability to fight off infection is impaired. Therefore, the likelihood of contracting COVID-19 is the same for diabetics as for the general population. Despite this, based on known data so far, both the rate of complications and the mortality rate are higher in all types of diabetes. The mortality rate is 7% among diabetics compared to 2% in the general population. The assumption is that the more balanced the diabetes and the fewer the diabetes complications, the lower the rates of complications and mortality. The reason is probably related to impaired immune system function in diabetics, which may lead to an acute inflammatory response in the lung area where the virus strikes.

For diabetics, it is crucial to exercise extra caution towards their surroundings and themselves. So, what is recommended during these times?

* Separate sleeping - It is advisable for diabetics to sleep in a separate room with the door closed to avoid exposure to household members who have been outside.

* Hygiene - It is important to wash hands before eating and regularly clean dishes and surfaces to prevent the virus from staying on surfaces.

* Diabetic ketoacidosis - When diabetics contract the coronavirus, they are at high risk of developing diabetic ketoacidosis - a life-threatening condition. Therefore, it is crucial to continuously monitor blood sugar levels, and if sugar levels exceed 240 mg/dl more than twice consecutively, ketones should be checked.

* Fluid intake - Diabetics should drink plenty of fluids, at least two liters per day. If having difficulty, take small sips approximately every 15 minutes throughout the day to avoid dehydration.

* Low blood sugar levels - Since fever-related illness can cause "hypoglycemia" (low blood sugar levels), if experiencing low sugar levels - below 70 mg/dl, it is recommended to consume 15 grams of simple carbohydrates that are easy to digest, such as jam, candies, popsicles, juice, or soda, and recheck the sugar level after 15 minutes. It is essential to maintain normal levels consistently.

* Medical monitoring - Even during these times, it is recommended to avoid outings but important to continue medical monitoring. Diabetes doctors, along with the entire team, continue to care for diabetics online. Nowadays, using new sugar monitoring technologies, it is possible to view data and discuss treatment continuation and changes accordingly.

* Physical activity - Physical activity improves the body’s response to insulin and is also essential for mood. Thus, it should be continued. Currently, there are multiple workouts of varying difficulty levels available online that can be easily done at home.

* Proper nutrition - Maintain healthy nutrition during these times despite the difficulty. Try to prepare healthy snacks with a low glycemic index (which do not cause an increase in blood sugar levels) to have on hand, to avoid succumbing to unhealthy snacks in moments of difficulty.

What are the warning signs?

Signs indicating possible coronavirus infection include fever, cough, or shortness of breath and require consulting a medical professional. More severe signs, such as breathing difficulties, chest pain or pressure, confusion, drowsiness, or a bluish tint on the lips or face, may indicate severe illness and necessitate immediate medical attention.

In conclusion, this period can be endured in health, and it may even be an opportunity to strengthen and improve connections within the nuclear family and also with more distant family members through phone or video calls. Nevertheless, in any case of symptoms such as fever, cough, shortness of breath, muscle aches, or headache, it is recommended to consult MDA or a family doctor by phone.

Prof. Julio Weinstein is the head of the Diabetes Unit at Wolfson Hospital and a senior diabetes doctor at the DMC Center for Diabetes Treatment.