People with existing predispositions, who do not have diabetes, would do well to keep a watch over their blood glucose level in this pandemic season.

We are getting a lot of new patients now. One big reason for that is stress that has increased manifold amid this uncertainty. Young people are unable to go out, children cannot play outside, adults who are bread-earners for their families are under economic duress… Stress is precipitating diabetes. Perhaps they would have got diabetes but after a year or two or five. But this period of stress is acting as an immediate trigger.

There is a definite reason for this. Stress triggers the release of hormones, one of which is steroid. Steroid causes a spike in blood sugar.

Lack of exercise is also not helping. People usually cite a packed schedule for being unable to exercise, though they are aware it would help keep diabetes under control. They do have a lot of free time now. But if they are mentally down, the motivation would be missing.

Many are in a constant state of panic wondering what would happen if anyone in the family got infected with coronavirus.

Existing diabetic patients are also reporting poor control because of stress and lack of exercise. Another hindrance to their well-being is lack of medical supervision. Many patients are unable to visit their doctor because of transport problems during lockdown. Many pathology laboratories were shut. Some others are avoiding doctor consultation as they are scared to visit a hospital.

Watch over meals

In some houses, the lockdown has led to feasting. That is not a good idea for diabetics. Avoid fried items and fast food, in general. Take fruits that are rich in fibre and green leafy vegetables. Timely meals help in blood sugar control. We advise patients to take three major meals and three minor meals a day. The minor meals are to be taken between breakfast and lunch, between lunch and dinner, and at bedtime. This cuts down the risk of sugar fall as well as sugar spike, as one would not feel hungry enough to crave a big meal at either lunch or dinner. The timings of the meals should be maintained.

If one is house-bound, one can do freehand exercises indoors for 15-20 minutes. One can even do spot walking, simulating feet and hand movement during a walk but standing at one place. Look up yoga routines on YouTube and follow them. One can do meditation also.

Mental peace is very much needed in controlling diabetes.

Check for warning signs

Are you feeling thirsty all the while? Is your throat getting parched? Are you feeling the urge to urinate every now and then? Are you having to even wake up at night to relieve yourself? Are you eating a lot but still losing weight? These are some of the common symptoms of the onset of diabetes. Some suffer blurring of vision. Some report genital infection. Some experience a tingling sensation under their feet or in their palm. Some in contrast lack sensation in the glove and stocking areas. Diabetes affects the nerves of the hands and feet, effecting the extremities first. Sexual problems like erectile dysfunction or apathy towards intercourse are also possible. Patients admit such problems only on being probed. Delayed healing of wounds is another give away.

Some patients who leave diabetes undetected for three or four years may end up with heart attack or brain stroke or kidney ailment. Their high blood sugar is detected on hospitalisation.

Diabetes and Covid

Are diabetics more prone to Covid-19 infection? No, the risk is the same as that of non-diabetics. But seriousness of the infection, like requirement of oxygen, will be more in diabetics especially if the sugar level is poorly controlled (i.e. HbA1c test result is more than 7.5 to

8). In my experience, in 30 to 40 per cent Covid-19 deaths, diabetes was a significant contributor. If you add their heart, kidney or blood pressure ailments, the percentage of mortality goes up to 70.

We endocrinologists are having a tough time managing blood sugar in Covid patients. Someone requiring 20 units of insulin might need 200 or more units daily once Covid-19 sets in. We are then forced to administer insulin intravenously round the clock.

As told to Sudeshna Banerjee.

Hammadur Rahaman is an endocrinologist with Medica Superspeciality Hospital and consults at Path India Polyclinic, next to New Town Business Club.