Explain why the coronavirus is so deadly in patients with diabetes

Vanesa Lopez

09/22/2020 - 23:27

• Clarín.com

• Society

During the annual meeting of the European Association for the Study of Diabetes (EASD), evidence was presented of the “devastating” impact that the new coronavirus is having on people with diabetes.

The alert is also lit in Argentina, where this disease is

in deaths from Covid-19 under 60 years of age.

"The main risk factors for mortality (from Covid-19) include old age and chronic conditions, in particular obesity, diabetes, hypertension, heart and kidney disease," said Professor Juliana Chan, from the University China from Hong Kong, in charge of the presentation.

A recent report published in

, based on a survey conducted in the United Kingdom, concluded that among 23,698 deaths due to Covid-19,

.

Taking into account multiple risk factors, such as age, ethnicity and the presence of other chronic conditions, people with type 1 diabetes had

risk of death

and those with type 2 diabetes

risk

of dying by Covid-19 compared to those without the disease.

Patient with Covid-19 and diabetes prepares to be transferred to a hospital in Mexico City.

Photo Reuter.

Despite the short duration of the pandemic, less than a year, a search of the terms "Covid-19 and diabetes" returns some

on the PubMed platform.

"Many of these reports indicated close relationships between high blood glucose levels and

, including mechanical ventilation, intensive care unit admissions, and death of Covid-19 patients," says Chan.

Glucose is a fuel and its efficient use depends on the adequate supply of oxygen and the action of insulin to promote the entry of glucose into cells to maintain body functions and survival.

Diabetes is due to an

absolute or relative

.

People with poorly controlled diabetes have low inflammation, poor circulation, and body defenses.

During acute stress such as Covid-19, these interconnected systems

leading to uncontrolled blood glucose and multi-organ failure.

In a consensus statement published in

, international experts called for

, including the appropriate use of insulin to control blood glucose and the use of organ-protective medications to improve the outcomes of these high-risk patients.

The situation in Argentina

Consulted by

, Dr. Gabriel Lijteroff, Head of Diabetology at the Santamarina Hospital and director of the scientific committee of the Argentine Diabetes Federation (FAD), explains that when people with diabetes develop a viral infection it can be

due to fluctuations in blood glucose levels.

"For this reason,

is always an indispensable tool in the prevention of complications," says Lijteroff.

The expert shares data published in August in the Argentine Journal of Public Health, based on the first 116,974 cases of Covid-19 in our country.

The report shows that arterial hypertension was the most reported comorbidity in confirmed cases of Covid-19 (15.8%) and in deaths over 60 years (58.7%).

Proper glycemic control is essential for people with diabetes.

Photo DPA.

However,

Three out of ten (29.9%) of the "young" deaths from Covid-19 had this disease. 

In addition,

Covid-19 cases in Argentina

had diabetes

, surpassing other comorbidities such as asthma (5.6%), obesity (5.3%) and heart failure (2.7 %).

As for those over 60 years of age, the figure rises to 22.4% of those infected.

Another problem that Lijteroff raises - based on different publications - is that people who

in the context of the coronavirus disease.

"In other words, a direct condition of the coronavirus has been seen, producing inflammatory processes at the pancreatic level," he says.

"In turn, the coronavirus has determined greater fluctuations in blood glucose in people with diabetes.

That is, a worse metabolic control in the context of hospitalization.

For this reason, it has been seen that those who have been infected have a better prognosis if, prior to their coronavirus disease, they

”, Lijteroff closes.

Recommendations for people with diabetes

The “disaster committee” of the International Diabetes Federation for South and Central America (IDF-SACA) - led by Dr. Lijteroff - shares several recommendations for people with diabetes.

* Respect social isolation.

It is the most efficient strategy in the prevention of contagion by coronavirus.

* Strictly comply with medical recommendations

, respecting the established guidelines regarding physical activity, food plan and drugs.

* Good metabolic control

facilitates medical treatment in case of contracting coronavirus disease.

Respecting social isolation is the most efficient strategy to prevent contagion by coronavirus.

Photo Xinhua.

* Make sure you have enough medicines and supplies on time.

Being connected with associations dedicated to the care of diabetes and people with the same condition is a valuable strategy in case of delays or logistical problems in the usual provision.

* Have on hand sugary products

, such as honey, jams, packaged juices, regular sodas, sugary sweets to deal with hypoglycemia.

* Establish with the treating health team

what circumstances warrant attending hospital institutions or calling for home medical services, according to the recommendations of each country.

* Be attentive and abide by the recommendations

issued by the competent authorities.

It is to be expected that they will be very dynamic, according to how the infection develops in each place.

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