Covid triggering diabetes in recovering patients

 

Is Covid triggering diabetes in recovering patients?

While doctors have been saying that diabetes complications including death among patients with Covid-19, they are now finding that an increasing number of patients discharged from Covid-19 wards have elevated levels of blood sugar: On most occasions, they may require medication with tablets or even insulin for at least a short period of time.

Why diabetes?

While research is under way on what triggers diabetes post recovery from the viral infection, senior diabetologist Dr R M Anjana from the Madras Diabetes Research Foundation points to three different reasons.

It is possible that many of these patients had diabetes before they had Covid infection, but they weren't aware. To rule out this possibility, doctors ask for HbAlc (Hemoglobin A1C) test, besides checking sugar levels at random in patients admitted for Covid treatment. The HbAlc test gives the aver- age level of blood sugar over a period of three months.

"If the HbA1C levels are above 6.5%, it indicates that the person already has diabetes. It is just that it has been diagnosed incidentally during ad- mission for Covid," she said.

Some patients with moderate or severe Covid are ad- ministered steroids such as dexamethasone, which can also increase blood sugar. This can trigger diabetes in patients, who are in the pre- diabetic stage.

"Besides, many Indians also have a genetic predisposition that puts them at risk for diabetes. Inflammatory markers that increase during Covid

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expedite the process. There is also the possibility that the virus can directly affect the pancreas and reduce insulin secretion," she said.

Care after Covid recovery 

If you've lost a lot of weight ,while being treated for Covid-19, your goal should be to regain muscle strength. If you haven't lost weight and are above the recommended BMI (above 25) work towards bringing it down. Exercises such as walking can help maintain insulin sensitivity and slow the progression to diabetes. However, it is better to avoid strenuous exercise for a couple of months after you have recovered from Covid. Slow and steady should be the motto.

Watch what you eat

Senior dietician Thangam- ani Suresh of Dr Mohan's Diabetes Specialities Centre in Chennai suggests a balanced home cooked meal with nuts, vegetable and legume salads, freshly set curd and lots of water: "It is better to consult a dietician to get a personalised diet chart. A diet chart for a person with hypertension or

kidney disease is different from a person with just diabetes," she said. In general, it is important for people with diabetes to cut down on sugary drinks, sweets, chocolates and high starch food.

Other complications

Some patients can have Covid-19 symptoms such as cough, breathlessness, head ache, body ache for up to 28 days. These symptoms may vary from patient to patient based on their immune system. Such patients may re quire frequent monitoring of sugar levels during their isolation period.

After recovery, there is an increased risk of a serious fun gal infection called mucormycosis (black fungus), particularly in patients with uncontrolled diabetes. Good control of blood glucose can help pre vent this complication.

Don't ignore these signs

Most hospitals recommend a sugar test after one month of discharge and a repeat test between 3-6 months. They also ask patients to report to hospitals if they have frequent urination, thirst and blurry vision, acute weight loss, slow healing of wounds and fatigue. Most doctors ask patients to meet their doctor one month after recovery to check for post-covid complications.

Why you should seek help Uncontrolled high blood sugar can affect eyes, kidneys and heart, cause loss of sensation in the feet leading to foot ulcers and increase risks of mortality.

"But with tight control of blood sugar, many people with diabetes have been able to remain healthy over several decades," Dr Anjana said.