Diabetes Care During COVID-19
26 May 2020
Since first being recorded late last year in China, COVID-19 has spread around the world and been declared a pandemic by the World Health Organization, sending billions of people into lockdown. As the world goes into some form of lockdown due to this pandemic, individuals with pre-existing medical conditions will be the most vulnerable to complications during this period.
“Individuals with diabetes are not more likely to get COVID-19 than the general population but the problem diabetic people face is that they may have a worse outcome, not a greater chance of contracting the virus,” said Dr Teoh Wei Leng, Consultant Physician and Endocrinologist, Sunway Medical Centre.
“Generally, the more health conditions a person has, the higher their chance of getting serious complications from COVID-19. Data from China observed that individuals with diabetes had much higher rates of serious complications and death than people without diabetes.
“Observational studies have shown that if individuals with diabetes effectively manage their sugar levels, the risk of getting severely sick from COVID-19 is about the same as the general population,” she added.
Dr Teoh advises individuals with diabetes to ensure they have enough medications at home and continue their medication as usual as instructed by their diabetes doctor. If you are unsure of your medication, please phone your diabetes doctor, or diabetes educator or nurse for advice.
“It is advisable for a healthy family member should go to the nearest pharmacy to buy enough medication and any related supplies such as lancets, glucose strips, alcohol swabs and insulin pen needles to last them for at least two months,” she said.
And like the general population, diabetic patients are advised stay at home and ensure hand hygiene by constantly washing their hands and not touching their face.
Diabetic patients need to be aware of symptoms of low blood sugar. Early signs of low blood sugar include feeling hungry, sweating, tingling lips, feeling shaky or trembling, dizziness, feeling tired, a fast or pounding heartbeat (palpitation), becoming easily irritated, tearful, stroppy or moody, and turning pale.
“Low blood sugar causes different symptoms to each person. Diabetic patients will learn how it makes them feel if they keep getting it, but their symptoms may change over time,” Dr Teoh said.
If this is not treated, patients then get other symptoms such as weakness, blurred vision, difficulty concentrating, confusion, unusual behaviour, slurred speech or clumsiness, feeling sleepy, fits (seizures), collapsing or passing out. Hypoglycaemia can also occur while sleeping, which may wake diabetic patients up during the night or cause headaches, tiredness or damp sheets (from sweat) in the morning.
For those people who has a blood glucose machine, they can check their blood glucose periodically to ensure that it is within acceptable readings. If they do not have this, they should be guided by their symptoms.
“If they feel dizzy, tired (more than usual), exceptionally hungry, sweating, irritable, trembling, tingling lips, pale, confusion – these are symptoms that their blood sugar is too low (hypoglycaemia), they are advised to have a sugary drink or snack followed by a more substantial carbohydrate meal,” Dr Teoh advised.
For diabetic patients who have a device to check their blood sugar level, a reading of less than 4mmol/L is too low and should be treated. Follow these steps if your blood sugar is less than 4mmol/L or if you have hypoglycaemia symptoms:
- Have a sugary drink or snack – try something like a small glass of non-diet fizzy drink or fruit juice, a small handful of sweets, or 4 or 5 dextrose tablets.
- Test your blood sugar after 10 to 15 minutes – if it's 4mmol or above and you feel better, move on to step 3. If it's still below 4mmol, treat again with a sugary drink or snack and take another reading in 10 to 15 minutes.
- Eat your main meal (containing carbohydrate) if you're about to have it or have a carbohydrate-containing snack – this could be a slice of toast with spread, a couple of biscuits, or a glass of milk.
“Let your diabetes team know if you keep having them or if you stop having symptoms when your blood sugar goes low,” Dr Teoh said.
Diabetic patients are advised to consume balanced meals and have a small supply of sugary snacks just in case they have a hypoglycaemia attack. They should also remain active by following exercise videos online or walking around their home compound. Doing housework is also a form of activity.
Meanwhile, family members can help diabetic patients by ensuring they have enough supply of medication, providing balanced meals and being there as company for emotional support, even if it’s through a phone call or video call. Together, we will overcome this pandemic.
Facts approved by Dr Teoh Wei Leng, Consultant Physician and Endocrinologist