The COVID-19 virus can be particularly concerning for people with certain health conditions, and one of the most common is diabetes. According to the Centers for Disease Control and Prevention, more than 34 million people in the United States have diabetes, making them particularly vulnerable to complications should they become infected with COVID.
People who have diabetes can’t produce enough insulin or their bodies can’t use insulin correctly. Insulin helps to control blood sugar (glucose) level. Without treatment to keep blood sugar levels under control, diabetes can cause damage to the eyes, kidneys, nerves and feet. Over the long term, diabetes can increase the risk of heart disease, heart attack and stroke.
Diabetes is manageable with proper medical care and treatments ranging from diet and lifestyle changes to insulin and other medications. Unfortunately, for some people, the COVID-19 pandemic has derailed their efforts to keep blood sugar controlled.
“In many cases, patients have taken to comfort eating to cope with the pandemic and social isolation, and those increased calories are driving up people's weight,” says Dr. Levine. “Also, their outlets for exercise are not as accessible; gyms that they might use, for example, are not available.”
In addition, people whose income has been impacted by COVID may be struggling to afford their medications. For any of these reasons, diabetes may worsen, making a COVID infection even more dangerous.
“Anytime there's an infection, when somebody has diabetes, the immune system is weakened,” explains Dr. Levine. “With COVID, unfortunately, many such patients can have worsened symptoms, worsened respiratory complications, and increased risk for hospitalization, intubations and death.”
Type 1 diabetes occurs when the pancreas is unable to produce adequate insulin. It usually develops in childhood and is not preventable. Type 2 diabetes, which represents 90% of all diabetes, is often related to lifestyle factors, including being overweight, not getting enough exercise, and having an unhealthy diet. The risk is higher for people over age 45. For some people, there is a genetic component; if you have a family history of Type 2 diabetes, your risk of developing it may be increased by 50% or more.
More than 84 million Americans have prediabetes, a condition where the blood sugar is higher than normal but not high enough for a diabetes diagnosis. Studies have shown that most people with prediabetes develop diabetes within 10 years. Prediabetes, also called impaired glucose tolerance (IGT), often has no symptoms.
Dr. Levine notes that even people who have diabetes may have mild or no symptoms early on. Often, symptoms such as frequent urination and unusual thirst occur only when blood sugar levels are significantly high.
“The main way to prevent diabetes is to make sure you're getting regular checkups and proper bloodwork to screen for it,” he says. “If you know you're at risk because of your genetics, you need to make sure that you're eating right, staying healthy, keeping your weight managed and getting exercise.”
Your primary care physician is your first step in screening for diabetes, especially if you have risk factors; a simple blood test can check blood sugar levels.
Primary care doctors can manage many cases of diabetes. People who need more complex diabetes management or have other health conditions may need to see an endocrinologist who specializes in diabetes care.
Dr. Levine stresses that it is important to get the care you need, and that Scripps providers are taking extra precautions to ensure patient safety. Scripps also offers virtual care options for patients who prefer not to be seen in person.
“I want to emphasize how important it is, especially now during the pandemic, for patients who have diabetes to continue to come in to see their physicians to get their blood sugars under control as safely as can be achieved to lessen their risk of complications should they become infected,” he says. “And it is very safe to come to Scripps for care.”