Diabetes and obesity found to increase COVID-19 severity – Bangkok Post


Posted: July 2, 2020 at 8:42 pm

Diabetes and obesity found to increase COVID-19 severity

published : 2 Jul 2020 at 13:37

The COVID-19 pandemic is the defining global health crisis of our time and it has become the greatest challenge we have recently encountered. Based on currently available information obtained from clinical studies, older adults and patients who have certain underlying medical conditions, especially diabetes and obesity are at higher risk for severe illness from COVID-19. Besides following all preventive measures recommended by health authorities, keeping blood sugar under control while remaining of a healthy weight can significantly reduce risks of developing serious complications in case of infection.

Although there is inadequate data to indicate whether people with diabetes and/or obesity are more likely to get infected with COVID-19 than the general population, clinical research has suggested that diabetes and obesity are firmly associated with increased risk of COVID-19 complications or severe symptoms. Diabetic patients with uncontrolled blood sugar levels are more susceptible to developing severe symptoms, resulting in prolonged hospitalisation and increased risk of death. In addition, risks of developing critical illness caused by COVID-19 in patients with diabetes or obesity rise proportionately in the presence of other pre-existing medical conditions such as hypertension, cardiovascular disease and chronic kidney disease.

When patients with diabetes cannot control their sugar levels, they are generally at risk for a number of diabetes-related complications. When patients with uncontrolled diabetes develop a viral infection, it can potentially result in severe symptoms. This appears to be for the following reasons:

- Higher-than-normal blood sugar levels weaken the immune system, causing an impaired immune response. As a result, it becomes more difficult to fight against the virus effectively. Viruses can grow exponentially and spread rapidly.

- Having diabetes-related complications or other co-morbidities in addition to diabetes increases the chance of getting seriously ill from COVID-19.

- Viral infections cause body inflammation, leading to an elevated blood sugar level in patients with diabetes. Poor blood sugar control affects the immune system and fluid balance and worsens the co-morbidity and diabetes complications.

Nevertheless, the severity of COVID-19 disease has not been evidentially related to type 1 and type 2 diabetes.

Obesity is also associated with other underlying conditions such as diabetes and heart disease, all of which likewise increase the risk of developing severe symptoms or complications due to COVID-19 disease. People with obesity presenting extremely high Body Mass Index (BMI) may have lower lung volume and limited lung expansion, resulting in increased risk of respiratory complications when they have a lung infection. Furthermore, clinical studies found that severe obesity is a major risk factor for prolonged hospitalisation and critical care. Moreover, if obese patients with COVID-19 infection have critical conditions that need intubation, it will be more difficult to manage compared to non-obese patients.

The preventive measures widely issued to the general public (for instance, frequent handwashing with soap and water or hand sanitiser, avoiding touching eyes, nose and face, wearing a face mask and social distancing) are doubly important for people living with diabetes or obesity. Besides these recommendations, additional advices include:1. Keeping blood sugar levels under control Since patients with uncontrolled diabetes appear to be at increased risk of having a more severe COVID-19 infection, healthy blood sugar levels within normal ranges should be maintained. Regular monitoring suggested by specialists can help to avoid complications caused by high or low blood sugar levels.

2. Maintaining physical and mental health There are plenty of ways to keep body and mind active during the pandemic. To remain healthy, it is highly suggested to exercise regularly, get sufficient sleep, eat a healthy diet with proper portions, and reduce stress or manage anxiety appropriately.

3. Drinking adequate waterEspecially during summer, dehydration can potentially occur, causing elevated blood sugar levels. Thus, sufficient supply of water is essential.

4.Prompt access to sources of carbohydrates and sugar Enough food, especially starch and sugar must be supplied at home in order to ensure that the situation can be readily corrected if blood sugar drops.5. Having sufficient medication supplyA good supply of medications for the diabetes or other underlying conditions must be assured, especially if self-quarantine for a few weeks is indicated.6. Having contact details in handAll relevant contact details such as hospital and doctor phone numbers must be readily available whenever medical assistance is needed. 7. Medical attention must be sought if developing flu-like symptomsIf any respiratory symptom presents such as fever, difficulty breathing, coughing, runny nose or sore throat, immediate medical assistance must be sought.

Source: Dr. Ongkarn Sarasombath, Endocrinologist (Endocrinology, Diabetes and Metabolism), Bangkok Hospital

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Diabetes and obesity found to increase COVID-19 severity - Bangkok Post

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