Care for diabetics during pandemic

Covid-19 is a highly infectious respiratory illness caused by the Coronavirus subtype SARS-Cov-2 that is responsible for the current global pandemic. The incubation period ranges between 2-14 days. It mainly affects the respiratory system. The course of illness has been noted to be more debilitating and severe among vulnerable patient groups such as the elderly and people with pre-existing medical conditions.

The symptoms may range from mild to very severe needing medical attention. Because of the long incubation period, individuals can spread this infection while still relatively “asymptomatic” The most common symptoms include fever, dry cough fatigue and sore throat. Other symptoms like a running nose and abdominal symptoms may occur. Shortness of breath is experienced as the infection affects the lung.

Who are “vulnerable” individuals as far as diabetes is concerned?

• Those with poorly or sub-optimally controlled sugars: HBA1c > 7.6 percent or recent fluctuating sugars.

• Those aged 55 years and above.

• Those with diabetes and other illnesses like heart failure, hypertension, chronic obstructive pulmonary disease, chronic kidney disease, cancer and HIV.

• Diabetic women who are pregnant.

These individuals have a lower immunity due to the above states and it is therefore more difficult to fight other diseases.

What preventive measures should a diabetic person take?

The main preventative measures for persons with diabetes are the largely the same as the general measures for Covid-19 infection including social distancing, frequent hand washing for at least 20 seconds with running water and soap, or sanitize with a gel that has 70 per cent alcohol.

However, in addition to these, someone with diabetes should:

• Eat healthy and attempt to keep your sugars well controlled as possible.

• Do some exercises at home daily.

• Get enough rest and sleep.

• Test your sugars and inform your doctor if they are not well controlled.

• Ensure you have planned for your medications needs due to the government regulations on movement and curfews in place.

• STAY AT HOME especially for those who are older. The younger may still work but ensure you are able to keep your social distancing.

It is important to talk to your physician should you have any concern on your health at this time. At the Aga Khan University Hospital, Nairobi we are conducting tele-consult with our patients to ensure they continue receiving the care they need at this time.

What to do when you suspect you are infected?

In the event you suspect you may be infected with the coronavirus, call your health care provider. Talking to your doctor is important as they will guide you on the next steps. Do not attempt to go to the diabetes clinic or straight to hospital as you could spread the infection further to other people. Patients experiencing fever should take paracetamol and keep well hydrated. Avoid self-medication with non-steroidal agents like Ibuprofen and steroids.

Once you arrive at a health facility the medical staff will decide whether you are likely to have the infection and may take a swab from the back of the nose and the back of mouth and throat for testing. Remember there are still other causes of fever and cough and these should be tested for as well.

Treatment for patients

A majority of individuals will recover from Covid-19. Treatment is mainly supportive and with mild symptoms one may recover with minimal interventions. Those with moderate to severe symptoms which include low oxygen levels and shortness of breath will require hospitalization, oxygen and may need a machine to support their breathing, The specialists will decide on any other therapies to be given. Other existing medical conditions must be attended to as well.

Dr Kunyiha is a consultant Physician Diabetologist-endocrinologist at Aga Khan University Hospital, Nairobi.