Navigating diabetes through a Covid-19 lens

Diabetes is one of the leading lifestyle disorders of the modern age, affecting millions of people across the globe. Just before the pandemic hit, in 2019, it was estimated that there were about 77 million diabetic patients in India, the second-highest in the world. Health experts also projected even graver numbers for the future, with the IDF Diabetes Atlas estimating that over 134 million Indians would be diabetics in the next 25 years.

With diabetes becoming increasingly prevalent in the modern age; the disease, along with the pandemic, is one of the gravest health concerns of today. And hence it is crucial to navigate diabetes, while keeping in mind the many changes ushered in by the pandemic, which is here to stay.

There are several factors that have contributed to making diabetes even more prevalent amidst the pandemic. The rigid social distancing norms and reduced access to timely healthcare have been restricting patients from doing some of the things that help prevent and manage diabetes. This includes promoting a sedentary lifestyle, as the pandemic has radically increased the average amount a person spends sitting, each day. As a result, inactivity has hit dangerous new levels, creating a well-noted spike in diabetes occurrence across the world.

The latest figures by IDF now show that diabetes prevalence has increased by 16 per cent in the past two years, in the post-pandemic era. As many as 53.7 crore adults aged between 20 and 79 years are now estimated to be living with the chronic condition.

The widespread diabetes problem has been supplemented by the fact that two out of three adults suffering from the disease live in middle- and low-income countries. With many of the patients already suffering from average or poor medical health infrastructure in their country, the pandemic has substantially reduced timely treatment for these individuals across the world. The disease was responsible for 6.7 million deaths in 2021, with one death from the condition every five seconds.

India in particular is at a huge risk owing to the latest developments across the world due to Covid-19. According to the latest findings of the National Family Health Survey 2019-21 in India, Indians have become more obese, hypertensive, and prone to diabetes than ever. The survey, which was conducted in two phases – phase one from June 2019 to January 2020 and phase two from January 2020 to April 2021 effectively captures the widespread impact of the pandemic on the health of the nation’s population. Additionally, undiagnosed diabetes is very prevalent in a country like India. Many people are on the borderline, with the disease, and Covid-19 can push people to the other side. Covid-19 acts as a huge stressor for such patients and often precipitates diabetes.

The treatment of diabetes complications has often been a challenge for medical professionals everywhere. Covid-19 infections across the world have further increased global complications for people already suffering from a previous health condition, especially diabetics. While there are several studies that are understanding the link between Covid-19 and common health problems across the world, navigating the link between diabetes and the pandemic is crucial to public health.

A particularly important study was conducted by the World Health Organization (WHO )in Africa, which indicates the role diabetes plays in worsening Covid-19 among those affected. According to the organization, Covid-19 has been found to be four times deadlier in people with diabetes in Africa, as compared to Africans without diabetes. WHO calculated the case fatality rates from Covid-19 by comorbidity for 13 nations in Sub-Saharan Africa, with a cumulative population of 270 million. The overall case-fatality rate was 2·5 per cent. But for patients with diabetes, it was 10.2 per cent, a leap of about 10 per cent.

Furthermore, in the United States, two studies supported by the National Institute of Health (NIH) found that Covid-19 was causing heavy damage to the beta cells in the pancreas, limiting insulin creation, a phenomenon that could cause a serious spike in diabetes.

With the new variant Omicron swiftly spreading across the world, it is crucial for diabetes patients to help safeguard themselves in every possible way against the Covid-19 virus.

The first and most important step towards the same is getting vaccinated as soon as possible, to boost the body’s immunity and radically decrease the chances of contracting the virus. Another way of increasing one’s immunity naturally is by exercising regularly, which can not only keep diabetes in check but also make the body stronger. Eating timely and nutritious meals and incorporating an antioxidant-rich diet also goes a long way in helping one keep the disease at bay.

While medical professionals are still actively deciphering the extent of the co-relation between Covid-19 and diabetes, it is important to focus on the larger picture, which is universal health. Actively taking steps to keep diabetes in control and protecting the body from Covid-19 will go a long way in safeguarding oneself, as well as near and dear ones, from the two deadly conditions.

(Dr. Ashish Kumar Jangir is an endocrinologist at Shalby Multispecialty Hospitals in Jaipur)